Fibroids are some of the most common diseases in women of reproductive age and can present in upto 70 % of Caucasians and 80 % of Africans in their lifetime . Please note that African women are more prone to having fibroids than any other race . Anecdotally even in symptoms women of African decent tend to present with bigger fibroids and more acute symptoms . This has been speculated to be due to lack of education , poverty and compounded by poor health seeking behavior .
Risk factors associated with developing fibroids include : Age ( older women are at higher risk than younger women ), African race , obesity , family history of uterine fibroids , high blood pressure , no history of pregnancy , vitamin D deficiency and not limited to food additive consumption .
I would particularly like to emphasize on not having children as communities which don ’ t have children such as nuns have a very high prevalence of fibroids . Also for women who stop child bearing early this can be a complication . Moral of story especially if you have a strong family history of fibroids is to get children and space them out nicely to protect yourself from getting fibroids .
Though Ariana did not present with the classical symptoms of fibroids I talked about her because of the course and eventual success of her treatment . The most common symptoms of fibroids is abnormal bleeding . The menstrual cycle normally follows its regular flow for those who have regular cycles but it is noted over time that period become heavier and last longer than normal .
Our distinguished nominated Senator Gloria Orwoba may consider visiting her gynae if the issue was related to heavy flow though media reports indicate that she stained herself for impact .
Other symptoms for fibroids include lower abdominal pain or back pain , bladder symptoms - frequency of urination , inability to pass urine , rectal pressure making it difficult to defecate in some women or feeling of incomplete defecation or urge to defecate all the time . Some women experience pain during intercourse and in the case of Ariana some women have a challenge conceiving especially those with submucosal fibroids .
Symptoms for fibroids vary from one woman to the next and this is largely because of the size and location of the fibroid . A patient may have a very large myoma but have absolutely no symptoms of the tumor . Such fibroids are normally located on the outer surface of the uterus what we call serosa , which we will identify as a subserosal fibroid .
The fibroids that grow in the inner lining of the uterus are referred to as submucosal fibroids as that lining is called mucosa . Even a very tiny submucosal fibroid can cause havoc in the name of very heavy menstrual flow . Another category of fibroids are the intramural fibroids . Mura in latin means wall . Such fibroids are located within the muscular wall of the uterus . In any society there must be special members and these are the fibroids that traverse all three layers .
As there are no two women with fibroids of the same size in exactly the same location it is difficult to compare the two . The reason why some people are very satisfied with treatment , while others trying to copy their friends may use similar medication without success . Moral of story again if you and your friend both have fibroids you are not the same and treatment should be on an individual level .
Treatment of fibroids depends on the symptoms . The vast majority of women do not have symptoms i . e . they are asymptomatic . Only 30 % of women with fibroids do require treatment for their symptoms . This will be anything from pain management and in pain management the list has ‘ n ’ items where ‘ n ’ is a very large number . The most common are non-steroidal anti-inflammatory drugs ( NSAIDs ) such as ibuprofen or diclofenac . These also have a role in reducing the amount of flow . Blood boosters and even blood transfusion can be
given in those with severe bleeding along with specific drugs to reduce the bleeding .
Some colleagues give drugs to shrink the fibroids and we can even do uterine artery embolization that will shrink the size of the fibroids and cause some of them to be expelled .
In some cases , surgery is offered and it can involve removal of the fibroid ( s ) alone - myomectomy or removal of the entire uterus . For surgery the approach can be abdominal via open surgery and / or key hole / laparoscopic surgery or vaginal .
The only definite treatment would be removal of the uterus as no new fibroids can grow without the uterus . However the surgery has potential serious complications , but we thank the Lord for giving us knowledge to make several advances in surgery and anaesthesia so these are not common . In all other instances the patient should be aware that after treatment symptoms can recur , or get worse . With adequate information most patients are satisfied with their treatment .
Hoping you have a blessed Lent or Ramadhan , whichever faith you profess but as I am truly Christian wishing you all a Happy Easter .
Dr . Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi . You can commune with her on this or related matters via email at : Drmaureenowiti @ gmail . com .