Africa-Press – Uganda. There are global efforts to improve the health of women, which is largely focused on improving sexual and reproductive health. However, the global burden of diseases has changed significantly over the past decades.
Currently, the greatest burden of death and disability among women is attributable to non-communicable diseases (NCDs) most notably cardiovascular diseases, cancers, respiratory diseases, diabetes, dementia, depression, and musculoskeletal disorders.
Hence, to improve the health of women, adequate resources need to be allocated to the prevention, management and treatment of these challenges women are faced with.However, one of the commonest health challenges associated with reproductive health in women is development of fibroids in their abdomen or uterus.
What are fibroids?
Health experts define uterine fibroids as noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids are not associated with an increased risk of uterine cancer and do not develop into cancer.
According to Office of Women Health under the World Health Organisation (WHO) up to 80 per cent of women globally have fibroids by the age of 50. However, many women do not have any symptoms and may never know they have fibroids.
While speaking to Daily Monitor about the risk factors associated with fibroids, Dr Lawrence Kazibwe, the deputy director of Kawempe Referral Hospital, said fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus.
A woman can have a single fibroid or multiple ones, which in extreme cases can expand the uterus so much that it reaches the rib cage and can add weight.Many women have uterine fibroids mainly during the active reproductive period. For some it may extend up to menopause.
In many cases doctors discover fibroids incidentally during a pelvic exam or prenatal ultrasound or any other complications such as long menstrual period say for over a week or for a period of one month. Many women develop it at the age bracket from 25 to 45.
Risk of getting Fibroid and why flowsThe head of the women reproduction section at International Hospital Kampala (IHK), Dr Moses Tiri, explained that any woman can suffer uterine fibroids This, he said, is because all women contain the estrogen hormone.
“Estrogen is one of the two main sex hormones that women have. The other one is progesterone. Estrogen is responsible for female physical features and reproduction. Men have estrogen, too, but in smaller amounts. It helps control the menstrual cycle and is important for childbearing,” he notes.
Estrogen and progestogen hormones are produced by the ovaries. They cause uterine lining to regenerate during each menstrual cycle and may stimulate growth of fibroids.
Dr Kazibwe also said black and Hispanic women are more likely to suffer from the disease than their caucasian counterparts (White).
According to a 2015 publication in the National Center for Biotechnology information US National library by Ann J. Obstet Gynocol, it is stated: “Uterine fibroids, are the most common benign gynaecologic tumours. Ultrasound evidence shows that more than 80 per cent of African American women and approximately 70 per cent of White women will have uterine fibroids by age 50.”
“However, because only 20 per cent to 50 per cent of all women with fibroids experience related symptoms and because screening for fibroids is not routinely performed, the true incidence is difficult to ascertain,” it added.
At Kawempe referral hospital last year alone, out of 300 mothers, who sought maternal health attention, 50 of them were discovered with fibroids.
Other risksDr Tiri said there are other factors that have an impact on fibroid development.It is his contention that in the past, the incidence was not common because women used to marry and produce children at a young age, as young as 15 years.
Secondly they would produce as many children with the biggest number of 12 children and the spacing between each child was a short period of one year.Today, the incidence is common because women delay to conceive and the spacing of children is wide. This renders the uterus idle thereby developing fibroids.
Dr Tiri also said if your mother or sister had fibroids, you are at increased risk of developing them and these is due to genetic predisposition reasons.Obesity, vitamin D deficiency arising from having a diet higher in consuming red meat and less green vegetables, fruits and dairy milk.
Over consumption of alcohol, including beer, appear to increase your risk of developing fibroids and so it is important to avoid as much as one can.
ComplicationsUterine fibroids can cause discomfort and may lead to complications such as a drop in red blood cells (anaemia), which causes fatigue, from heavy blood loss. Rarely, a transfusion is needed due to blood loss.
Fibroids usually do not interfere with getting pregnant. However, it is possible that fibroids especially submucosal fibroids could cause infertility or pregnancy loss.
Fibroids may also raise the risk of certain pregnancy complications, such as placental abruption, fetal growth restriction and preterm delivery.
PreventionAlthough researchers continue to study the causes of fibroid tumours, little scientific evidence is available on how to prevent them.
Preventing uterine fibroids may not be possible, but only a small percentage of these tumours require treatment.But, by making healthy lifestyle choices such as maintaining a normal weight and eating fruits and vegetables, you may be able to decrease your fibroid risk.
Also, some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids.For the slow growing fibroids, once a woman conceives, they will stop growing.
Types
Fibroids diseaseThe scientists said the type of fibroid a woman develops depends on its location in or on the uterus and they are as highlighted below:
•Intramural fibroids. These are the most common type of fibroid. These appear within the muscular wall of the uterus and they may grow larger and can stretch the womb•Subserosal fibroids. They form on the outside of the uterus, which is called the serosa. They may grow large enough to make the womb appear bigger on one side.•Pedunculated fibroids. Tumours develop a stem, a slender base that supports the tumor and when they do, they’re known as pedunculated fibroids.•Submucosal fibroids. These develop in the middle muscle layer, or myometrium of the uterus. They are not as common as the other types.
