THE FIBROIDS MENACE

FIBROIDS

Fibroids have become a real medical dilemma especially among us career women who get into the family way very late either in the mid 30s or early 40s. I have seen patients who have come in and narrated to me how fibroids have totally messed up their lives.


So what exactly is fibroids?? Fibroids or fibromyomas are the most common tumors of the human body. They arise from the muscular wall of the uterus(womb). Their Growth is due to action of the hormone estrogen. They arise during period of menstrual activity and are mostly found in nulliparous women( those who have never had children) or women who have not been pregnant for sometime. They are mostly found in black women and  tend to favor infertility and miscarriage due to distortion of uterus cavity.


There are 4 main types of fibroids. Interstitial,Subperitoneal,Subendometrial and Cervical. This categorization is based on their locations ; within the wall of the uterus, arising from the  outer layer of the uterus, arising from the inner layer of the uterus and from the Lower part respectively. The subendometrial ones are most notorious for causing miscarriages, the interstitial ones cause abnormally heavy menstrual bleeding and the cervical ones may cause obstruction of labour during normal delivery.


Fibroids tend to grow more during pregnancy and to shrink or atrophy during the post-menopausal period.

Patients present with a wide variety of symptoms depending on the size and type of fibroids. These include;  an abdominal mass, Increase in duration and amount of menses,Offensive discharge( if a subendometrial fibroid is undergoing necrosis), Late menopause, Abdominal pains which may be accompanied by vomiting( in case of degeneration of fibroids),Frequent urination and retention of urine (if the fibroids are too big), Infertility,Frequent abortions, Labour obstruction, Mass protruding from the vagina etc.


Fibroids are diagnosed by doing ultrasound scans.  Small fibroids that are not causing symptoms do not require treatment but big or symptomatic tumors require surgical removal.  Indications for surgery include heavy or prolonged bleeding, large tumors most likely to cause urinary symptoms, fibroids causing infertility or miscarriages, fibroids that are likely to obstruct labour and fibroids that tend to increase in size after menopause( these are most likely to get malignant change) e.t.c


Surgery can either be removal of the fibroids or total removal of the uterus depending on the patients need to conceive in the future. Sometimes a surgeon can go in with intention of removing the fibroids only to end up removing the entire uterus if bleeding is uncontrollable during the procedure.


Is there a way to avoid fibroids? Not really!! Remember fibroids also run in families. We can probably avoid them by getting children early ; this way, even if fibroids eventually come         , there will be no harm in removing the uterus.


I'm not against career progress among women, but a 2 year sacrifice to get babies can help a lot in avoiding the fibroid menace and consequences.( I can hear my mother saying AMEN to this). I however agree that other factors are to be considered too.  Let me know if this post was educative.