# Early reproductive aging: stress and uterine fibroid risk among black women

> **NIH NIH R21** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $226,776

## Abstract

Project Summary (Abstract):
The racial disparity in uterine leiomyomata (fibroids) is profound among African American women (AAW) – with
an earlier age of onset of 10-15 years, a significantly higher incidence, and greater rates of hysterectomy, a
major surgical procedure compared to Caucasian women (CW). The impact of fibroids is significant for
reproductive age women, especially AAW who experience more symptomatology such as excessive bleeding,
pain, and reproductive problems, and research on the risk factors for the condition is important. Earlier onset of
fibroids among AAW may explain their larger size of fibroids and more symptomatology. Our central hypothesis
is that the disproportionate burden of fibroids and the surgical disparities associated with the high fibroid
morbidity result, at least in part, from the unique stress AAW experience. Specifically, racist societal and
structural pressures that AAW experience may influence how AAW cope with stress, including their access to
resources needed to mitigate such stress. Data from the National Institute of Environmental Health Sciences's
Study of Environment, Lifestyle & Fibroids (SELF), the first prospective study of 1693 young AAW ages 23-34
years with fibroids assessed using standardized ultrasound examinations, will be analyzed. We will evaluate
the hypothesis by pursuing three specific aims: 1) Examine the association between each baseline stress
measure (i.e. life events, racial discrimination, daily stress, perceived stress, medical financial strain, and
financial strain) and 5-year cumulative fibroid incidence and growth; 2) Create, describe, and explore 5-year
trajectories of daily stress, perceived stress, medical financial strain, and financial strain and the life course
trauma trajectories on 5-year cumulative incidence and growth of fibroids; and 3) Investigate the potential
modifying effects of social support, spirituality/religiosity, socioeconomic status, coping, and early life
conditions such as food insecurity, low financial status, etc., on the associations between stress and 5-year
cumulative fibroid incidence and growth in Aims 1 and 2. This proposed ancillary research study will be the first
study to bring fibroid incidence and growth data for more than 300 women and a range of stress measures
including psychosocial resources and coping data and stress variables together to comprehensively investigate
the stress experience in relation to fibroids in young AAW. Fibroids pose a major public health concern with the
total associated cost (medical, work-related, etc.) estimated to be up to $34.4 billion annually. Determining risk
factors for fibroids, such as stress which is modifiable, will advance our understanding of stress as a risk factor
for fibroids and provide key information for improving the quality of life for African American women, who are
more likely to experience missed days from work and disruption in physical activities and social relationships.
It will als...

## Key facts

- **NIH application ID:** 9872685
- **Project number:** 1R21HD105461-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** ANISSA I VINES
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $226,776
- **Award type:** 1
- **Project period:** 2020-09-16 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9872685

## Citation

> US National Institutes of Health, RePORTER application 9872685, Early reproductive aging: stress and uterine fibroid risk among black women (1R21HD105461-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9872685. Licensed CC0.

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