Depression may increase uterine fibroid risk in African American women
By Alicia Armeli

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Uterine fibroids are more common and more severe among African American women. In an effort to uncover the cause of this health disparity, researchers are now investigating how mental health conditions like depression may play a role in the growth and development of fibroids.

In a recent study published in the American Journal of Obstetrics and Gynecology1, L. A. Wise and a team of researchers from Boston University analyzed the medical data of 15,963 premenopausal women participating in the Black Women’s Health Study.

In 1999 and 2005, the researchers used questionnaires that included the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms among these women. Between the years of 1999 and 2011, women completed follow-up biennial surveys reporting if they’d been diagnosed with depression, had any history of antidepressant use, and whether they’d been diagnosed with uterine fibroids by either ultrasound or surgery.

In all, 4,722 cases of diagnosed uterine fibroids were reported. Among these women, the authors of the study discovered that as the risk of depressive symptoms increased so did the risk of fibroids—even after the use of antidepressants was taken into account.

Wise and colleagues believe this connection between depression and fibroids is due to something they refer to as the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is an internal communication system made up of the hypothalamus and pituitary gland inside the brain and the adrenal glands that sit on top of the kidneys. Among its many functions, the HPA axis is responsible for regulating emotions and stress responses.

If the HPA axis malfunctions, it heightens the body’s stress response and can lead to changes in mood. HPA axis abnormalities have been linked to mood disorders like depression. This change can then alter how the body processes hormones—including sex hormones that are thought to influence fibroid growth. For example, levels of progesterone—a fibroid-stimulating hormone—are higher in women who are depressed than in those who aren’t.

The HPA axis theory is one of the many that are being explored in hopes of finding a cause and cure for fibroids. Although the results of this study support this theory, how depression and fibroids are possibly linked is still unclear. The authors concluded that further studies are still needed.

ABOUT THE AUTHOR Alicia Armeli is a Health Freelance Writer and Photographer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering within her community.

REFERENCES

1. Wise, L. A., Li, S., Palmer, J. R., & Rosenberg, L. (2015). Depressive symptoms and risk of uterine leiomyomata. American Journal of Obstetrics and Gynecology, 212:617. e1-10.