Vitamin D Deficiency and Fibroid Risk: A Potentially Overlooked Connection in Black Women’s Health
Fibroids occur globally and affect women of all races and ethnicities, but their burden is not evenly distributed: Black women in the United States develop fibroids earlier, more frequently, and with more severe symptoms than women in any other group. Although many fibroids are asymptomatic, those that do cause symptoms can trigger heavy and prolonged menstrual bleeding, anemia, pelvic pressure or pain, and fertility challenges. These symptoms lead to substantial real-world consequences, including missed workdays, chronic fatigue, and the social isolation that often accompanies unpredictable bleeding. Despite the range of available interventions, hysterectomy remains the most common definitive treatment, and Black women disproportionately undergo this procedure. Many women endure symptoms for years before seeking evaluation—not only due to reluctance toward surgery, but because their suffering is often normalized or minimized within both clinical settings and communities. Although research into etiology and non-surgical treatments continues to evolve, progress has been slow relative to the scale of the problem and the populations most affected.
Despite the high prevalence and substantial impact of fibroids, Black women’s symptoms—especially heavy bleeding and anemia—are frequently minimized or dismissed within healthcare encounters. Diagnostic delays are common, with these symptoms too often treated as “normal” rather than as indicators of significant morbidity. Even after diagnosis, counseling on the full spectrum of medical and procedural options is inconsistent. Many Black women report receiving limited information beyond hysterectomy. This reflects not simply individual biases but broader structural patterns: inadequate research funding, minimal attention to non-surgical management, and longstanding racialized assumptions that normalize Black women’s pain. The magnitude of suffering is not matched by an equivalent sense of urgency in clinical care or scientific investment. Recognizing these gaps is essential for understanding why so many women struggle for years without effective, equitable support.
The slow pace of fibroid research does not reflect the scale of the condition but rather long-standing gaps in scientific prioritization. Research investment is often guided by mortality rather than morbidity—yet high-burden conditions that cause disability, lost productivity, and profound quality-of-life disruption also demand robust investigation. Despite affecting millions of women and creating significant social and economic impact, fibroids have historically received limited funding for research on etiology, prevention, or durable non-surgical options. Several structural factors reinforce this stagnation: conditions labeled “benign” are deprioritized; conditions disproportionately affecting Black women have progressed more slowly due to underrepresentation and insufficient stratification in clinical studies; and interventions lacking strong commercial incentive attract less attention than procedural treatments. As a result, therapeutic innovation has lagged behind the lived reality of women most affected.
One striking example of this research gap is the limited attention paid to vitamin D as a potential modulator of fibroid risk and progression. Vitamin D deficiency is widespread among women of African descent due to biological, environmental, and structural factors, yet this disparity has rarely informed mainstream approaches to fibroid management. A growing body of evidence suggests that vitamin D may exert protective effects by reducing fibroid cell proliferation, modulating hormone receptor expression, and influencing pathways such as TGF-β signaling. Observational studies consistently show inverse associations between serum vitamin D levels and fibroid presence or size. Small interventional trials suggest that supplementation may slow fibroid growth, particularly among women with smaller lesions or profound deficiency. Despite these biologically plausible mechanisms and early clinical signals, this area has not progressed to large-scale trials or guideline recommendations. The gap between what is scientifically possible and what has been rigorously studied mirrors broader patterns in women’s health, where low-cost, accessible interventions receive far less attention than high-revenue procedural options.
Despite the clear need for better non-surgical strategies, the role of modifiable factors—particularly vitamin D deficiency—remains under-explored. Several studies demonstrate that vitamin D deficiency is highly prevalent among Black women and independently associated with increased fibroid risk, larger fibroid burden, and more rapid progression. Yet these findings rarely inform clinical practice. Most women with fibroids are never tested for vitamin D deficiency, and few receive counseling on emerging evidence. To address these gaps, a structured national survey launching in January will gather data directly from women with fibroids—especially Black women—to assess patterns of vitamin D testing, clinician counseling, treatment options offered, and the daily impact of fibroid symptoms. These insights are crucial because scientific literature alone cannot capture lived experience or unmet needs. Findings from this survey will inform future research—including the development of a randomized clinical trial evaluating vitamin D supplementation as a low-cost, accessible, and potentially transformative adjunct to fibroid care.