Fibroid: Cause, Cure, Complications, prevention – The Nigerian case!
Fibroid: I was very busy with my books this afternoon reading, until I overheard my neighbour talking about drinking olive oil, and rubbing it on her Tommy. I knew before now that she has fibroid. She is a 36 year old lady. Not yet married, not yet given birth before. She was discussing with her mum, before I overheard their talk from the window and decided to write about fibroid.
What is fibroid?
In a lay man’s language, fibroid is simply a tumour or growth that usually arises from the smooth muscles of the womb. It is a benign tumor – meaning that it does not kill, unless complicated. My consultant was jokingly describing last time. He said, when you are asking God for the fruit of the womb, you should be specific because a child is a fruit, fibroid is a fruit of the womb too. So permit me to borrow his words:
Fibroid can be described as a “fruit” of a womb that has not been able to take in a baby. This is because fibroid is usually a disease of a nonpregnant womb, though it can still affect a womb that has been pregnant. Infact, it has been estimated that 50% of women that have not been pregnant and are up to 35 years and above have fibroid.
What causes Fibroid?
There basically no pinpointed culprit that is responsible for causing fibroid. But it has been found out that the tumour oestrogen dependent. In other words, it grows when there is oestrogen for it, and regresses when oestrogen begins to go down. That is why it can grow big when pregnant (because there is excess estrogen in circulation) and shrinks when a woman enters menopause because there is no oestrogen for it.
It has also been found to have some genetic link. If your mum or sister suffered fibroid, you stand a very big chance to suffer fibroid too.
What are the symptoms of Fibroid?
In Nigeria, the commonest way patients present is through abdominal swelling. This is when it has become cosmetically a concern. Of course no lady who is not pregnant wants to see her belly protruded like that.
Other symptoms of Fibroid are:
- Abdominal pain
- Bleeidng from the vagina (outside your period)
- Bleeding in between your periods
- Frequent urination – this is because the fibroid mass compresses the bladder and irritates it often, making you to constantly urinate, even though nothing comes out much.
- Constipation – This happens because the fibroid mass compressing your rectum making it difficult for faeces to pass down.
- Pressure in your abdomen
- Infertility – most couples present because they are married for years, and no child.
- Repeated miscarriage – if you are having repeated miscarriage, it’s possible there is a fibroid mass chasing the innocent baby out of the womb.
What are the risk factors for fibroid?
Strongest risk factor is – Having not been pregnant before. Yes. Your womb needs a baby. so once you are reaching 35 years, and your womb hasn’t gotten a fruit from your man, it may produce its own fruit (fibroid).
Other risk factors are
- Age 35 years and above without a pregnancy
- Seeing your first period very early. This is so because you will have a long time to be exposed to estrogen. fibroid is oestrogen sensitive. That is, it grows in the presence of oestrogen.
- Early menopause – for the reason above.
- Obesity
What is the treatment of Fibroid in Nigeria
Myomectomy (that’s surgical removal of the fibroid mass) is the commonest and most effective way of treating fibroid in Nigeria. There is chance of being pregnant. This is best for women that have not completed their family.
Hysterectomy – This is the surgical removal of the womb containing the fibroid. Both the womb and the fibroid mass are removed entirely. This is for those that have completed their families.
Total abdominal Hysterectomy and Bilateral Salpingo-oophorectomy- Here the womb is removed, along side the two fallopian tubes and the two ovaries. The vagina is left, and ends blindly. So copulation is not affected. This is usually for those that have completed their baby making. It is also protective against uterine and ovarian cancer.
Uterine Artery Embolization is another method of treating fibroid. But it is not readily available in Nigeria. Uterine artery Embolization involves blocking the artery that supplies blood to the fibroid Mass. This cuts off the blood supply to the fibroid mass, and it dies.
Endoscopic surgery can also be done, but it is not readily available in Nigeria.
Any Home Treatment for Fibroid?
Just as you have heard already, the best treatment for you in Nigeria as at today is surgical removal. So stop swallowing different pills that won’t help you. Visit your gynaecologist as soon as possible. However, you can manage your pains by massages, warm water compress , rest.
Does Fibroid Affect Pregnancy?
Yes, fibroid can affect pregnancy. But it depends on the position of the fibroid mass in your womb. There is a place it will be, and it will not prevent you from becoming pregnant. But there is also a position it will take, and it will be hard for you to take in.
Is it better to remove fibroid before pregnancy?
In a Study, it was found out that removing fibroid before pregnancy is better. It increases the chances of fertilization. It also helps to maintain the pregnancy.
Complications of Fibroid/ Fibroid Surgery
In a study in Enugu, by H. Ezegwui and O. Okezie, it was found out that Postoperative morbidity was high but there was no mortality. In other words, no one died from fibroid surgery, but it can weigh you down and cause other complications.
Complications of fibroid
- Infertility
- Abdominal swelling, pain heaviness
- Bleeding in between your period
- Painful intercourse
- Urinary tract Infection
- Constipation
- Cancer: Leaving fibroid untreated for years, can make it become cancerous.
Complications of Fibroid Surgery
- Bleeding – leading to anaemia
- Hysterectomy – Removal of the womb. The most painful complication for those yet to complete family. Usually due to uncontrollable bleeding.
- Damage of other organs
- Infections
- Long hospital stay
There is good awareness of Fibroid among Nigerians, but their attitude about its causes and treatment is poor.
M. A. Adegbesan et al
Different Strange ways Nigerians Treat Fibroid
Olive oil – This one I was a witness. The story of my neighbor that inspired my to put up this write.
Herbal leaves and concoctions – So many persons visit native doctors and complicate their matters before eventually coming to the hospital. Fibroid is a common disease. and every quack out there claims to be expert. They prey on these ones.
Prayers: I am not doubting the efficacy of prayers on fibroid. In fact, myself I am a prayer warrior. But give to Caeser that which belongs to Caeser, and to God that which belongs to God. While your pastor burns the midnight candle, head to the hospital. Its not lack of faith, its wisdom.
How Can I Prevent Fibroid
1. Get Pregnant: Pregnancy is protective against fibroid.
2. Oral Contraceptive Pills is also protective
References
2. Effects of the position of fibroids on fertility – Maria Louisa et al.
3. Management of uterine fibroids in Enugu, Nigeria – O. Okezie and H.U Ezegwui
5. Medscape
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