Toru, a 34-year-old married hardworking accountant with a top-notch hospital was recently diagnosed with uterine fibroid. For as long as she knew, her menstrual periods had been extremely painful and in more recent times she experienced very heavy flows which led to anaemia. She was constantly taking time off work for her menstrual flow which was often prolonged. She had believed that once she gave birth, the situation would improve but since her marriage four years ago, she had been waiting on the Lord to get pregnant. It was not until she joined the hospital about a year ago, after observation by some of the medical personnel at work, that she succumbed to investigations and examinations that led to the diagnosis. She then discovered that uterine fibroids are very common among women (particularly those of childbearing age – menarche to menopause) and presents itself in different ways. After a course of medication to control the pain and help shrink the fibroid, she has been scheduled for surgery – myomectomy to remove the fibroid.

What exactly is Uterine fibroid also known in medical parlance as leiomyoma? It is a benign growth in the uterus (womb) that is common, not deadly, but can be disruptive featuring various types of discomfort. Some of its symptoms include heavy menstrual flows, prolonged flows, pelvic pressures, frequent urination, painful intercourse, distended stomachs, etc. It is more prevalent in women of African descent occurring in over 50 percent of women. It can however be asymptomatic needing no treatment and many women live their lives oblivious of its existence.

In mental preparation for her surgery, Toru approached one of their patients – Adeline – to enquire about her experience. Adeline, a young mother with a 3-month-old baby had done a myomectomy at the hospital prior to delivering her bundle of joy through normal delivery at the hospital. Adeline shared her story as follows: “Toru, rest assured a myomectomy is pretty much standard procedure today and has a high success rate. In my case, I did not experience any symptoms except for some pelvic pressure which I suppressed with over-the-counter drugs. However, 5 years into marriage, I kept experiencing miscarriages and initially assumed it was a spiritual problem which took me to various churches for deliverance. At one of such churches, I met Nurse Bimpe who works in your hospital, and she asked if I had considered that it might be a medical challenge and not spiritual. After consultation with the gynaecologist and a series of tests, she informed me that both the size and location were responsible for the seeming lack of symptoms I experienced but that the fibroids which were multiple but small in size, deterred the foetus from developing to maturity and were responsible for the abortions and miscarriages experienced. She assured me that after removal through surgery, I could have a normal delivery. She in fact stressed the need to get pregnant soon after as fibroids tend to grow back after a while if pregnancy does not occur. To the glory of God, I took in and today I am a proud mother”. Adeline also referred to the case of her sister, Paulet, who had her children despite fibroids, without surgery.

Some of the hard facts regarding fibroids are:

1. It is commonplace especially among women of African descent.
2. It usually occurs in women of childbearing age.
3. It could be disruptive and prevent conception and or carrying a baby to term. It can also be responsible for complications in pregnancy.
4. Fibroids can re-grow after a myomectomy, but not after a hysterectomy.
5. Risk factors include vitamin D deficiency, obesity, early menarche, deficiency in diet, genetics, high hormonal levels etc.
6. It can be treated by medication e.g., oral contraceptives, surgery and in more recent times, hormonal antagonists (GnRH) and minimally invasive gynaecological (MIG) surgery such as UAE (Uterine Artery Embolism) and MRgFUS (MRI guided Focused ultrasound).

In conclusion, Uterine fibroids cannot be prevented but the risk may be mitigated by maintaining a healthy lifestyle and regular pelvic examinations and monitoring. Where diagnosed, appropriate treatment will depend on the individual patient’s age and her desire to retain her fertility as well as the size, location, and number of the fibroid(s). However, in these times, medical advancement has enabled women receive proper treatment with minimum risk of mortality.

GLOSSARY OF TERMS

HYSTERECTOMY – The surgical process for removal of the uterus of a woman.

HORMONAL ANTAGONIST – A medication which affects the hormones e.g., GnRHA (gonadotropin releasing hormone antagonist which affects the sexual hormones…progesterone and estrogen.

LEIOMYOMA – Uterine Fibroid.

MENARCHE – The onset of menstruation.

MENOPAUSE – The cessation of menstruation.

MRgFUS – MRI guided focused ultrasound is a non invasive and incision free technology that targets and treats tissue and organs in the body without incision or radiation.

MYOMECTOMY – A surgical process for the removal of fibroids while preserving the uterus.

UAE(UFE) – Uterine Artery or Fibroid Embolisation is a minimally invasive procedure that involves cutting off the blood supply of fibroids and causing them to shrink.

Love

Havilah