But Why? The Mystery of Fibroids Part 1: Estrogen Dominance

 

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By now we all know that up to 30% of all women will be diagnosed with uterine fibroids by the time they’re 35 , and up to 80% of all women will be diagnosed with uterine fibroids by the time they’re 50. African American women suffer more severe symptoms, they grow more quickly, and happen at a younger age.

The real question is ‘Why?’

Is it genetics? Food? Environmental factors? Cosmetics? Estrogen dominance? Some combination of these?

When I was first diagnosed with fibroids, I wondered “how?” How were there so many? How did they grow so large? How did I not know? What caused them?

Now, three years later, there is no sign of them (thankfully) at this point. What’s changed? I haven’t had a relaxer since 2005. I haven’t been on birth control since about that same time. But, my diet  and exercise routine now is actually worse than it was prior to 2013.

I took some time to dig into some factors and theories regarding uterine fibroids. There’s a lot more to dig through than I thought there would be, so I am breaking this into a series, with each possible cause getting its own post.
First up: Estrogen Dominance

 

Estrogen dominance: A condition where a woman can have deficient, normal or excessive estrogen, but has little or no progesterone to balance its effects in the body.

Estrogen dominance is more of an imbalance, in the sense that usually its not that someone’s body is making an abundance of estrogen (though that could be the case), just that the balance of estrogen and progesterone in a woman’s body is off.

Our Hormones in Blance (graphic courtesy of fibroidelimination.com/)
Our Hormones in Balance
(graphic courtesy of http://www.fibroidelimination.com/)

Before I go deeper, let’s first review some basics of a woman’s biology. You’ll need the review to get a full understanding of Estrogen Dominance.

As we all know, women have menstrual cycles. A cycle starts the first day of your period, to the first day of the next period. The average menstrual cycle is 28 days long, but can vary form woman to woman.

The two main sex hormones in women are estrogen and progesterone. They work together to maintain balance in our body at all times. 

Estrogen regulates menstrual cycles, promotes cell division, and in puberty, the development of breasts, growing pubic hair, etc.

Progesterone maintains the health of a fetus. It protects us against the  effects of estrogen by stopping further ovulation the second half of the menstrual cycle if a woman is pregnant.

Estrogen is highest in the first half of your cycle. It reaches its highest levels during ovulation, then drops and progesterone rises. Progesterone is released during ovulation. Some testosterone is released around the time of ovulation as well. If you do not get pregnant, you have a period and everything starts all over.

 

Now that the review is out of the way, let’s get little more into ED.

Because our bodies need estrogen and progesterone to maintain our body’s reproductive cycle, it is important that they stay in balance.  They counter each other. If/when that balance is upset, even on the smallest level, there can be problems.

How do you know you have a hormonal imbalance of any kind? Some symptoms of hormonal imbalances may include:

  • Irregular Periods
  • Sleep Problems
  • Acne
  • Foggy Memory
  • Digestive issues
  • Fatigue
  • Rapid Weight Gain/Loss
  • Vaginal Dryness
  • Headaches
  • Breast Tissue Changes
  • Loss of Libido
  • Infertility

 

Some symptoms or conditions thought to be the result of Estrogen Dominance specifically may include:

  • Fibrocystic breasts
  • Endometrial (uterine) cancer
  • Polycystic ovaries
  • Uterine Fibroids

 

What causes the imbalance?

Several possible things:  Low progesterone levels/production,  chronic stress, synthetic estrogen (birth control pills, HRT [Hormone Replacement Therapy]), as well as environmental hormones and hormones found in food(diet)

 

Some hormone levels naturally drop with age, so as we get older, hormone imbalance of some sort is inevitable. So if our progesterone levels decrease, and our estrogen does not decrease at a comparable rate: Estrogen Dominance.
Of course, taking any hormonal birth control or HRT will alter the body’s balance. Birth control is made to fool our bodies prevent a true period. These two factors seem like obvious reasons for the body to be out of balance.

But what about food and environment?

In foods and the environment, we are exposed to Xenoestrogens.  Xenoestrogens are are a type of xenohormone that imitates estrogen. They can be either synthetic or natural chemical compounds. (Wikipedia)

With so many processed foods, genetically modified foods, pesticides, hormone injected meats, and foods with soy (which is a known natural xenoestrogen) its no wonder that our hormone levels are affected by what we consume. There is a big movement for less additives, and preservatives in foods: clean eating. It makes sense. With so many additional chemicals on and in food, the long term affects can’t be good for us. Does ingesting so many additional hormones from meats and chemicals in foods not initially meant for human consumption hurt us? I’m sure is doesn’t help. Do they contribute to an increase or decrease of hormones? Its very likely.

On the same road as food is environmental factors. Many of these, we have very little to no control over. Many environmental chemicals are also xenoestrogens. Many of which are found in daily beauty products (Post number two in the series). The main culprit is plastics. Remember the whole BPA in plastic bottles thing? The compound is found in everything from drink can coatings, to DVDs, to water bottles. It can disrupt or mimic natural hormones.

 

So what can you do?

You need testing to determine your hormone levels, which can only be done by your doctor. They will be able to determine if your levels are within the range of “normal”.

Outside of medical intervention, things can be done on your own to help balance your levels.

Changing the diet is the biggest thing, and probably the hardest for many. Let’s be real: fruits and grilled veggies are very tasty, but sometimes, a big ol’ cheeseburger and fries just tastes and feels sooo good.

Modifying diets to eliminate or greatly reduce soy, meats such as beef, and processed foods decreases exposure to additional estrogens or estrogen-like compounds. Of course, increasing exercise and being more active will also help.

There are various diet programs out there geared towards fibroid elimination. I don’t make it a habit of publicly endorsing programs/people/things that I haven’t personally tried on this blog. I would say if you’re going to try one of these programs, do your research.

Beware of your plastics use. Try not to warm up items in the microwave in plastic containers. The warmed plastic molecules can possibly seep into and contaminate your food. This is in very, small amounts, but over time, this could increase estrogen in your body. Don’t drink out of bottled water bottles that have been sitting in a hot car (same principal as microwaving in plastic), and try to buy water bottles (and bottles for babies for that matter) that are labeled BPA Free.

 

There is really a lot more to say on Estrogen Dominance, its part of the reason this post look literally months for me to get up. I kept researching and trying to figure out what to write and what to leave out. At the same time, I kept discovering more stuff!

I hope this was a good first step to learning more. I definitely recommend taking the time to do more research on your own. You can start here:

butternutrition.com/estrogen-dominance-hormonal-imbalance/

www.ecopedia.com/health/estrogen-dominance-how-food-affects-men-and-women/

www.drlam.com/blog/estrogen-dominance-part-1/1704/

 

Next post in the series: Beauty Products and Fibroids

I’m talking relaxers, lotions, nail polish, makeup, hair glue…..errthang.

 

So a Woman Thinketh, So is She

 

It is Mother’s Day. Again. Last year for Mother’s Day, I unplugged, and I was able to lift my spirits and cross off a major bucket list item by going to see Prince in concert. Alone. It was one of best days EVER!

This year, Prince has passed away, I am still sad about it, and I skipped going with my Husband to brunch with my Mother In Love (Law) because I just wasn’t in the mood. She doesn’t yet know about our struggle, and I just didn’t feel like pretending I was in a good place. I sent my card with my husband.

Instead, I’m home with the cat, listening to Prince, and blogging, which is perfect.

Of course, this week, I’ve been thinking about and dreading Mother’s Day, like many of us Maybe Mamas do. The past month or so, a lot of things have happened on the road to possible motherhood. In April, I had a final hysteroscopy to check out my uterine cavity, to see if the balloon used in the November procedure helped in minimizing/preventing scar tissue. A few days before I went in, my husband and I had a conversation where I questioned if I even wanted to have kids at all. I went on about how our time would not be our own, how all the moms I know (with kids under 5) are so boring now. They’ve completely lost their sense of self. All the money we’d now have to spend on the child’s needs, how uncomfortable and unpleasant pregnancy seems….
But in the next breath, I answered my own question: “But I guess, if I didn’t want to have a baby, I wouldn’t spend all this time and money making sure I could”

“True”, hubby responded.

Let's be real for a second, this ish does not look fun.
Let’s be real for a second, this ish does not look fun.

So I really started thinking: What do we tell ourselves to make this all hurt less? I’ve come to realize my main coping mechanism has been a denial of sorts. I’ve tried to convinced myself that I don’t really want to be a mom. I see all the negatives in parenting: The screaming toddler in Target, the sleeplessness, the projectile vomiting, constant worry if you’re doing right by your child.  Never having a life. These things are real, and a part of motherhood, but that’s not all that it is.

I truly have come to terms with the fact that I may never be a biological mother, or a mother at all. I think that is part of the infertility journey. Keep hope alive, but acknowledge all possible outcomes. What I have done over time is beyond that.

I’ve tried to shield myself from disappointment and hurt by trying to convince myself it doesn’t matter. Motherhood is not something I really want.

Its like Cinderella when when she realized she wasn’t going to the ball, despite doing everything her step mother said she had to do. She did her best (for all of 5 seconds) to convince herself that that Ball was going to suck, and she wasn’t missing anything.

"Oh, well, what's a royal ball? After all, I suppose it would be frightfully dull, and boring, and completely... completely wonderful."
“Oh, well, what’s a royal ball? After all, I suppose it would be frightfully dull, and boring, and completely… completely wonderful.” ~Cindy

But the reality is, I do want to be a mother, and its painful to think that I may never be. Some days, its too much to think about, so I don’t. The best I can do is try to convince myself that like the Royal Ball, Motherhood sucks. Except, much like Cinderella, I’m not doing such a great job of fooling myself.

 

I chose the title of this post based form Proverbs 23:7, which most people interrupt as a verse cautioning us to be mindful of our thoughts, as they become who we are. Reading the whole verse, and the verses before and after, and other translations, that’s not what is meant at all.

The verse is referring to a person who says one thing out of their mouth, but doesn’t mean it. They invite you to come over, eat and enjoy, but inside, they’re hoping you don’t. The full scripture:

Do not eat the bread of a miser,[a]
Nor desire his delicacies;
For as he thinks in his heart, so is he.
“Eat and drink!” he says to you,
But his heart is not with you.

Now, I’m no “miser”, but I am being insincere with my words when I say I don’t really want to have a baby. I say I’d much rather just O and I be the “cool auntie and uncle”, that way we have our time, money (and my body) to ourselves. The ultimate proof that its all bs is not the myomectomy, or the three procedures I’ve undergone to remove scarring (and recently endometriosis), and the months of hormones I took to try to restore my uterine lining. Its not the research I’ve done on adoption. Its the consult we had this past week with a fertility doctor, and the tests we’re about to take, and the IVF journey we are about to start. Someone who doesn’t want it would not bother with any of this.

So on this Mother’s Day, I give myself the gift of acceptance, and permission to feel and experience all of the emotions that come with this journey. Some days are hopeful. Some days are depressing, and that’s OK.

Its OK to want something that seems just out of reach, and its OK to feel the creep of that green-eyed monster when it seems everyone else but me is enjoying that which is illusive: Motherhood.

I want to give this gift to you too. My sisters in this battle. Give yourself permission to feel how you feel, today and everyday.

 What have you been telling yourself?

Dear Tyra: An Open Thank You note to Tyra Banks

 

Dear Tyra,

Hey girl! I wanted to drop you a quick note today because, you were “on my heart” as the church ladies say.

I guess you can say I’ve been a fan for years. In the 90s, when you were in your modeling prime, I was in high school, and it was always nice to see a brown girl doing fashion, slaying. Giving us #blackgirlmagic before we had a name for it. You jumped into acting on Fresh Prince, and in Higher Learning, and who can forget that TV movie where you were  a life sized doll come to life (I don’t think  I actually watched that one though), oh, and the slightly bitchy fiancée in Love and Basketball.

Of course, you had your shows: The Tyra talk show, and America’s Next Top Model. When ANTM started, I was newly out of college, and my friend/roomie and I made sure we were off the phone from moms and boyfriends, and had our snacks on deck so we could watch. In the later seasons, I stopped watching, but my mom “discovered” the show and took all the modeling tips to heart. She smizes in damn near every picture now.

I was also a fan of the talk show. It was fun. Informative. Honest. I know you took some criticism when you dressed as a fat person, or went as homeless. But one of the moments I loved, was when, after paparazzi got some pics of you on the beach and the “Tyra’s getting fat” articles and comments began, you told them all to kiss your fat ass. Classic.

You started your foundation (TZONE) for girls to empower and inspire. When you decided you wanted to be an entrepreneur, you enrolled in classes at Harvard Business school.

I bring up all of the things you’ve done in your career just to highlight that you have been a role model to women and girls, especially Black women. I think your place and accomplishments are often overlooked. You lay low. You say what you want. You keep it classy. Thank you for being an example of girl power.

 

A few weeks back, I saw segment on FABlife, where Chrissy Teigan talked about her difficulties  getting pregnant, and you also took that moment to share:

I want to co-sign what Chrissy is saying and say ‘You have no idea what people are going through’. Why am I crying? You just have no idea what people are going through, so when you ask Chrissy [why don’t you have kids] or me that or anybody that, it is none of your frigging business, okay?  And for any women, it is none of your business what somebody is going through. Whether they want to have a child or don’t ever want to have a child or may have a child on the way, it’s none of your business, okay? Until somebody wants to make it your business

Exactly.

I loved this whole moment, because, I too, am one of those women. The 1 in 8 couples who struggle to get pregnant. I too, am tired of people asking about “when?” or “why?” when it comes to having a baby. Its not their business, and you don’t know what I’m going through or how hard I’m trying to get pregnant.

I love when those who have a platform use it. You, Gabrielle Union,  Tamar Braxton, and other celebrity women have come out and said pregnancy has been a challenge. I love even more that as a Black woman, you’ve said something. We just keep acting like this is not a problem in “our” community, when it is. Just as much as it is in any community.

 

Tyra, the point is: Thank You for sharing you journey to motherhood! Thank you for putting a face to infertility. Thank you for being open and vulnerable. Thank you for sharing your  son with us.

There are hundreds, maybe thousands of every day women, who share, or try to inspire others with their journey. (Like myself), but you are able to speak to more people with one post than many of us can all year.

 

Thank you again, Tyra for being someone who has consistently taken risks, taken a stand, and been yourself.

 

Congratulations on your new baby boy!

 

via @tryabanks instagram
via @tyrabanks instagram

Monica, Robin, and Anna, but not Whitley, Aunt Viv, or Mary Jane: Why aren’t Black Characters in the Infertility Narrative?

tv watcher

 

Last Sunday night, I was curled up in my bed for the season premiere episode of the final season of Downton Abby. (At this point, if you haven’t yet watched that episode, spoiler alert ahead!)

Within the first 15 minutes, Anna reveals (implies) that she’d recently suffered a miscarriage, and that this wasn’t the first time. (Lord knows, if you watch Downton, Anna’s been through enough!) This got me to thinking about how these pregnancy and fertility issues come up in TV and movies. So much so that I tuned out a bit from the episode for a few minutes. It also made me think about working conditions and society expectations of the time. She had a miscarriage, but got dressed and came to work. Those types of things were definitely not discussed openly at that time. The shame that was probably associated with not getting pregnant in that era was Much, much more than it is today, though so many of us still feel, or are made to feel ashamed.

I kept on down this rabbit hole of thoughts, and I began to think about how infertility and difficulty maintaining a pregnancy has never, as far as I’m aware, been addressed on any Black TV show, comedy or drama that are not medical drama.

I know two shows (that happen to be some of my favorites) that had characters who suffered from infertility: Monica Geller from Friends and Robin Scherbatsky from How I Met Your Mother. But, I cannot think of any Black character who dealt with this issue. The closest I can think is Maxine Shaw from Living Single and Mary-Jane Paul from Being Mary Jane, who did not suffer form infertility, but made “alternative” choices to attempt motherhood.

Now of course, I haven’t seen every episode of every TV show, so if you know of a Black show, or even character that did go through this, please feel free to comment and school me.

Anyone that is or was a fan of Friends, knows that Monica and Chandler got married in season 7, and found out later (season 9) that could not have a baby naturally. Both Monica and Chandler had factors contributing to their infertility. In the end, they decided to adopt and ended up with twins.

Of course, Friends was a sitcom, and dealt with the issue in a light way, but it did manage to address this very real issue. In fact, the Monica and Chandler story is the second fertility related story line in the series. In Season 4, Phoebe acts as a surrogate for  her brother and his wife.

The great part about both of these story lines is at the time, there was even less of a profile on IVF, surrogacy, and infertility. To even address this at all, especially in a sitcom format, was a bit ahead of its time.

The only slight counter part to this as a Black character that I can think of is Maxine Shaw from the 90’s sitcom Living Single. In the final season, Max decides to become a mother via a donor (who she later finds out happens to be Kyle). Its never said or implied that it is because she is having any difficulties, but just because she is ready to have a child, and with her independent nature (“Maxine Shaw: Mavrick”), she just does it. It was more about being in control of her life as a woman, not the physical ability.

Max's attitude about life. I love her
Max’s attitude about life. I love her

I will give credit for the Living Single writers for even bringing up the idea of sperm donation as a pathway to motherhood for a Black woman into the story line. Again, in the 90s, assisted pregnancy was still a mystery to most people and there was a lot of negative attitudes surrounding those processes. The idea of a baby created outside of the body, or having a doctor insert sperm in a woman to impregnate a woman was still a little taboo and considered weird. And in the Black community?! Forget about it! If that’s how you got pregnant, you better lie to your friends and family and either make an agreement with a guy friend that he’s the “father”, or say the father disappeared. At that time, either of those was better than telling your Gram-Gram that you picked a guy from a binder and had doctor impregnate you. The fact that Max was choosing a sperm donor was a huge f’n deal. Max, as was the characters personality, was unashamed of her choice.

The other popular, recent, and I would say more well done infertility story is Robin. In season 7, Robin thinks she’s pregnant with Barney’s baby. After she’s told she’s not (and they do a quick celebration dance), her doctor calls her back in a few days later to discuss other test results. The doctor delivers the unfortunate news that she cannot get pregnant. The HIMYM episode has the benefit of happening in the current era (season 7 aired in 2011-2012), where there is a better space to to discuss infertility. The episode walks the fine line of a sitcom and a bit of drama dealing with a serious topic. Its a great episode. When I see it on re runs, I usually cry, because the range of feelings and emotions you see her go through are so real.

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MJ preps for the fertility process. Robin deals with unexpected disappointment

Again, there is no counter part that is Black to this story line anywhere that I am aware of. The closest I can come, again, is a non traditional choice (key word choice) into motherhood, and that would be Mary Jane Paul of Being Mary Jane*.

Mary Jane is a complicated character, which is the charm of the show. She has these brilliant moments, then does something impulsive, selfish, and dumb. Like we all do. Without getting too bogged down into details, Mary Jane “steals” sperm form a lover, and keeps it in her freezer. She convinces her doctor bestie to inseminate her at home with a baster. Obviously unsuccessful.

Later, as a kick off to a new season of her news show, she undergoes fertility treatments to have IVF with donor sperm, and documents it for the world to see. However, the implantation was unsuccessful. Ultimately, she decides to leave the issue and not try another cycle.

Again, I credit this show for even going there, and bonus points for going deeper. Her fertility process wasn’t just mentioned, it was documented. We saw her have hot flashes. Give herself injections. Have second thoughts. Be disappointed. Have questions. But, at this point, this was a choice, not a necessity for Mary Jane. If there is ever a show with a Black cast and Black female lead that would tackle this issue head on, it would be Being Mary Jane. I would not be surprised if this issue comes back around and MJ has to face known infertility, and has to try a second round with a little more purpose and urgency. The writing team on this show is amazing, and if any team can bring this to life, it would be them.

Art is truly imitating life. Even in a parallel TV universe, we’re still not fully able to discuss infertility in Black families as a real issue that real Black women deal with. I am hopeful that this will soon change. With so much innovative programming, not just on TV, but on line and streaming, the possibilities are endless. Think of the impact a major show with a character, a Black Woman character, going through infertility could have. How it could shift perceptions and help remove the shame women feel. It can be done in a smart and funny, and culturally relevant way.

Imagine if Aunt Viv (the original), who got pregnant, at one can assume, well past 40, even briefly mentioned having a hard time getting pregnant.

What if Rainbow and Dre talked about the baby they lost before getting pregnant with Jack and Diane?

We could get into the further and deeper issue of the broader representation of women in media and Black people/Black women in media, but that is definitely a whole ‘nother post!

Black people want smart, relevant, diverse content and stories, as the numbers for recent shows like Black-ish, Empire, and How to Get Away With Murder prove. We need this infertility narrative in our stories too, because it is happening. I am thankful for the attention and story lines that do feature infertility, no mater who the subject is, but I’m waiting to see my sistas shine and use their art as a platform to change, even start the conversation.

 

black-women-tv_400x295_93
Sistas are doin’ It for Themselves. So many Black women on TV, and yet… Photo: Essence Magazine Online

*2018 FYI- Gabrielle Union who played Mary Jane Paul, is an infertility warrior in real life. She has suffered 9 miscarriages and gone through numerous IVF cycles.

Doin’ Too Much: Surgery, Change, and my Holiday

Most people’s holiday seasons are filled with family, food, drinks, and relaxation. Mine had some of that, but also included hysteroscopy, estrogen, moving, and bed rest.

 

In short, I’ve been having issues with my cycle, and my RE and gynecologist both suggested going back to my surgeon to get a better look at what is happening. My GYN suspected Asherman’s Syndrome.

The Monday after Thanksgiving, I went in for a laproscopy and hysteroscopy. The surgeon did find some scar tissue that formed since the last procedure and removed it. He also found a tear that he repaired. I was put on a two month regimen of low dose estrogen (to be followed by 15 days of progesterone) to help restore my thinned lining. He also inserted a cook ballon to try to minimize scarring and adhesion inside my uterus. I had to keep the balloon in for 7 days. It was not the most comfortable thing in the world. I went the office the following week to have it removed. Having it taken out was uncomfortable more than it was painful.

The estrogen so far has given me headaches (the first week or so), and had my face broke out like I was 13. Right now, nothing major in terms of side effects, but the first two weeks…….

20151210_142313.jpg
This picture does my breakout no justice. My skin was horrible. I haven’t had a breakout like that since I was 13 or 14. Yay estrogen.

The procedure seemed to go pretty well, and I recovered well that day, but I didn’t bounce back like I thought I would. When I had this same thing done in 2013, I flew out to Atlanta the next day for work. Was I 100%? No, but I was at least at 75% This time, it took me about four days to feel back to normal. By the time I was feeling close to normal….it was time to pack up to move…to an entirely new city. I was limited in what I could do in terms of lifting, but I did move a suitcase that was a little heavier than I thought, and immediately felt weird. I knew I needed to sit my ass down and not lift anything. Which I did…for a few days, then I did it again. My doctor said I irritated the muscles in the pelvic area, take it easy.

I did….a little, but then it was Christmas. I had done no Christmas shopping, my mom was coming to stay with us for two days, which means I had to clean, and I had to cook my contributions to Christmas dinner. Which means, not much rest, but a lot of 800mg ibuprofen.

Finally, I was able to rest for a few days, and I do feel mostly better, after a month.

This procedure was important for me because this is the set up work to see if I can carry a baby. Aside from my left tube being blocked (not such a big deal), my lining is thin and my uterus is small. These things might keep me from carrying my own baby. I go back in April for another scope, to see if the hormones have made my lining thicken at all, and if having the balloon in for 7 days helped with the adhesion/scarring. As much as I try to downplay this as a minor procedure, it is a big deal, and I’m a little worried that all that I had going on immediately after the procedure may affect the final outcome.

We do this a lot, those of us who struggle. We don’t want to break down in front of those who know what we’re going through(or even those who don’t). We don’t want to admit the stakes even to ourselves sometimes in order to keep our peace and a little sanity. But, we need to. We have to come to terms with what is happening with our bodies and what is our options are.

 

The good news in all of this is: NO Fibroids were found! Two years fibroid free since my June 2013 Myomectomy.

 

Happy New Year