July is Fibroid Awareness Month, but for many Black women, fibroids are a year-round concern. According to the National Institutes of Health, Black women are three times more likely to develop fibroids than other women. They also tend to get them at younger ages and often have larger, faster-growing tumors with more severe symptoms. For decades, Black women felt trapped between two options: endure ongoing pain or undergo a hysterectomy. Now, fibroids treatment has expanded, though navigating the choices can feel daunting.
In an exclusive interview with The Root, Dr. Pierre Johnson, a board-certified OB-GYN known as the “Fibroid Slayer,” emphasized that women should feel empowered to ask questions and find a solution that fits their life. Johnson gained national attention after removing a 27-pound fibroid while preserving a patient’s 17-week pregnancy, an approach that reflects his patient-first philosophy.
Start With Your Goal
Johnson’s approach flips the script on how fibroid treatment is typically discussed. Rather than starting with a specific procedure, he begins with what matters most to the patient. “It usually comes down to two priorities: pregnancy or symptom relief,” he said. Once a woman identifies her primary goal, the treatment options come into focus much more clearly.
The Watch-and-Wait Option
Most fibroids are small and don’t require treatment. Some women live comfortably with mild symptoms, while others are advised to monitor their condition since fibroids often shrink naturally during menopause. That’s the straightforward path.
For Black women, though, it’s more complicated. Many have been taught to normalize heavy periods and pelvic pain as standard parts of menstruation, which can delay both diagnosis and treatment. When symptoms escalate to exhaustion, anemia, pelvic pressure, or fertility challenges, continuing to wait can exact a real cost on health, quality of life, and reproductive options.
Lifestyle Approaches
Some women opt for diet changes, supplements, and herbal remedies before considering medication or surgery. Eating high-fiber foods like apples and broccoli, adding vitamin D-rich options like salmon, and exercising regularly may help manage symptoms, according to the Cleveland Clinic. Johnson acknowledged that lifestyle changes allowing women to “live life without constant bleeding and changing pads” deserve recognition, but he cautioned that many marketed remedies ease pain without actually shrinking fibroids.
Prescription Medications
When symptoms start disrupting daily life, medication becomes an option. Hormonal birth control, tranexamic acid, and progestin-releasing IUDs can lighten periods but won’t shrink fibroids. NSAIDs help with pain but not bleeding. Some prescription medications temporarily shrink tumors by blocking hormones, though they often come with menopause-like side effects including hot flashes or bone loss.
Myomectomy and Fertility
If having children is the priority, protecting the uterus becomes essential. Johnson often recommends a myomectomy, which removes fibroids while preserving the uterus. He uses a house metaphor to explain why location matters: submucosal fibroids that push into the uterine cavity cause the most symptoms, even when small, and are commonly linked to infertility. Fibroids on the outer surface, by contrast, are less symptomatic.
For complex cases, Johnson prefers open surgery over robotic approaches, believing it allows more complete fibroid removal. “The only way that I can assure that I can remove a pebble-sized fibroid that is stuck in deep muscle is actually feeling it,” he explained. While a 2025 study in the American Journal of Obstetrics and Gynecology found a 20 percent reintervention rate over 11 years, Johnson reports that none of his patients have required repeat surgery.
Hysterectomy as a Choice
For women finished having children or seeking complete relief from years of heavy bleeding and pain, hysterectomy to remove the uterus can work effectively. For Black women, the decision often feels personal and identity-laden. Johnson believes compassionate care means giving women space to explore options and separate today’s procedures from the painful surgical histories that disregarded Black women’s bodies and recovery.
Modern hysterectomy isn’t the major open surgery of decades past. Johnson often uses robotic surgery through small incisions, with most patients going home within 24 hours and returning to work in about a week.
Speaking Up at Your Doctor’s Visit
Women can take control of fibroid conversations by clearly stating whether their main goal is pregnancy or symptom relief. Ask what type of fibroids you have and where they’re located relative to the uterus, as location affects treatment options. If surgery is suggested, ask why that approach, whether other surgical options exist, and specifics about incision placement, recovery time, and recurrence risk. If you don’t feel heard, seek a second opinion without hesitation.
What Matters Most
The best treatment aligns with your goals. As Johnson said, “The ultimate goal isn’t fibroid eradication. The ultimate goal is to live healthy lives and not have your quality of life impacted.” That philosophy puts control back where it belongs: in your hands.
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