Are Fibroids Hereditary?

Between 70-80% of women will experience uterine fibroids by the time they turn 50.¹ For some women, fibroids may remain small and have a minimal impact on one’s quality-of-life, while for others, fibroids may severely affect one’s social, mental, and emotional well-being. For women who struggle with large or painful fibroids, the cause of these growths is often the first question that comes to mind. And, with fibroids impacting women of color more than white women,² the question may arise if fibroids are hereditary. The answer is yes, in part, but there’s more that goes into it than your family history.

Genetics Play a Role

Many fibroids contain changes in genes that differ from those in normal uterine muscle cells.³ In a 2012 study published in The American Journal of Human Genetics, researchers from Brigham and Women’s Hospital analyzed genetic data from over 7,000 women and detected genetic variants that are significantly associated with uterine fibroids. One of these genes was FASN, which encodes a protein called FAS (fatty acid synthase). This FAS protein expression was found to be three times higher in uterine fibroid samples when compared to normal uterine tissue. Over-expression of FAS protein is also found in various types of other tumors and is thought to be important for tumor cell survival.⁴

So, what does this mean? Well for one thing, research findings lead physicians to believe there is a genetic component to your susceptibility when it comes to developing fibroids. In fact, having a family member with fibroids increases your risk – if your mother, sister, cousin, aunt, or grandmother had fibroids, your risk of also experiencing them is roughly three times higher than your friend that doesn’t have a history of fibroids in her family.¹

But Genes aren’t Everything

However, just because your mom or your sister had fibroids doesn’t necessarily mean you will too. Just as relevant to fibroid development are hormone levels. Both estrogen and progesterone levels directly affect fibroid development, which is why pregnant women often experience sudden fibroid growth.¹

Alternatively, during menopause, some women experience shrinking of their fibroids.⁵ What are other risk factors? As mentioned above, Black women are more likely to experience uterine fibroids at earlier ages and with more severity than others, though scientists are still searching for reasons as to why this may be the case.⁵ Though lower consumption of fruits and vegetables and being overweight has been linked to fibroids, scientists continue to review these links, while also focusing on other environmental factors that may contribute to the development of uterine fibroids.⁶ A recent study looked at Black women who were exposed to elevated levels of ozone from air pollution and identified a link between air pollution and fibroids – noting Black women who were exposed to elevated levels of air pollution had an increased risk for developing uterine fibroids.⁷ While this study was conducted on roughly 22,000 pre-menopausal Black women living in 56 metropolitan areas with 14 years of follow up, more research into the connection must be conducted in order to make any conclusions.⁷

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References:

1. “Uterine fibroids Fact Sheet.” Office on Women’s Health, U.S. Department of Health and Human Services. Accessed July 31, 2018. https://www.womenshealth.gov/a-z-topics/uterine-fibroids
2. Eltoukhi, H. M., Modi, M. N., Weston, M., Armstrong, A. Y., & Stewart, E. A. (2014). The health disparities of uterine fibroid tumors for African American women: a public health issue. American journal of obstetrics and gynecology, 210(3), 194–199. https://doi.org/10.1016/j.ajog.2013.08.008
3. “Uterine Fibroids.” Mayo Clinic. Accessed July 31, 2018. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
4. Stacey L. Eggert, Karen L. Huyck. Genome-wide Linkage and Association Analyses Implicate FASN in Predisposition to Uterine Leiomyomata. The American Journal of Human Genetics, 2012; 91 (4): 621 DOI: 1016/j.ajhg.2012.08.009
5. Ulin, M., Ali, M., Chaudhry, Z. T., Al-Hendy, A., & Yang, Q. (2020). Uterine fibroids in menopause and perimenopause. Menopause (New York, N.Y.), 27(2), 238–242. https://doi.org/10.1097/GME.0000000000001438
6. Tinelli, A., Vinciguerra, M., Malvasi, A., Andjić, M., Babović, I., & Sparić, R. (2021). Uterine Fibroids and Diet. International journal of environmental research and public health, 18(3), 1066. https://doi.org/10.3390/ijerph18031066
7. Amelia K Wesselink, Lynn Rosenberg, Lauren A Wise, Michael Jerrett, Patricia F Coogan, A prospective cohort study of ambient air pollution exposure and risk of uterine leiomyomata, Human Reproduction, Volume 36, Issue 8, August 2021, Pages 2321–2330, https://doi.org/10.1093/humrep/deab095
8. Sohn, G. S., Cho, S., Kim, Y. M., Cho, C. H., Kim, M. R., Lee, S. R., & Working Group of Society of Uterine Leiomyoma (2018). Current medical treatment of uterine fibroids. Obstetrics & gynecology science, 61(2), 192–201. https://doi.org/10.5468/ogs.2018.61.2.192