Uterine fibroids: A silent threat to women
Published On August 23, 2022 » 1494 Views» By Times Reporter » Features
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. Wanki

By JOWIT SALUSEKI-
FEMALE reproductive issues are not a remote possibility, in fact, uterine fibroids are common in women, yet only 20 to 30 per cent will show any symptoms, medical experts say.
However, in Zambia, just like many societies around the world, uterine fibroids are a silent threat to women because in a worst case scenario, they may lead to a woman failing to have a child.
According to medical experts, there are three major types of uterine fibroids namely; intramural fibroids which grow within the muscular uterine wall, submucosal fibroids which bulge in the uterine cavity and subserosal fibroids which project to the outside of the uterus.
Experts say African–Americans are at higher risk of having uterine fibroids.
It is for this reason that most Zambian cultures will even enlist traditional doctors because they normally suspect that their daughter who is of childbearing age but can’t have a baby has been bewitched.
Unlike cervical or breast cancer which has of late received prominence through awareness, little information on uterine fibroid is known by most women.
It is against this backdrop that Generation Alive Zambia Executive Director Womba Wanki who heads a movement of young feminists is urging relevant authorities in Zambia including the Ministry of Health to upscale sensitisation on uterine fibroids.
“There is a need for stakeholders including the Government through the Ministry of Health to embark on sensitising people on risk factors, complications, prevention and treatment of uterine fibroids. Because unlike diseases such as cancer, most women are unaware about what causes uterine fibroids,” Ms Wanki said during a recent BBC programme dubbed She Word which was discussing uterine fibroids.
Meanwhile, in an interview, obstetrician/gynecologist Kayombo Soneka explained that uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years.
Dr Soneka said the fibroids which are also called leiomyomas or myomas, aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.
“Without warning, the size of the lump may increase to the point that it affects other nearby organs, resulting in worsening symptoms or more complicated treatment.
Paying attention to the warning signs and being aware of this disease is important,” he said.
Dr Soneka said uterine fibroids are a disease of the uterine muscles, in which non-cancerous growths develop in or around the uterus.
He said the growths are made up of muscle and fibrous tissue and vary in number and size.
“The condition is most common in women aged 30 to 40 years.
It is still unknown what causes most uterine fibroids, but the hormones estrogen and progesterone, which are produced by the ovaries, can stimulate the growths to increase in size.
Consequently, growths that occur near or after the onset of menopause are generally smaller,” he explained.
Dr Soneka said a woman should see a doctor if they have pelvic pain that doesn’t go away, overly heavy, prolonged or painful periods, Spotting or bleeding between periods, difficulty emptying the bladder and unexplained low red blood cell count or anemia.
The British medical journal, the Lancet further adds that fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus.
The journal states that a woman can have a single fibroid or multiple ones.
Many women who have fibroids don’t have any symptoms.
In those that do, symptoms can be influenced by the location, size and number of fibroids.
In women who have symptoms, the most common signs and symptoms of uterine fibroids include, heavy menstrual bleeding, menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation, backache or leg pains.
Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die.
Fibroids are generally classified by their location.
On causes, doctors don’t know the cause of uterine fibroids, but research and clinical experience point to these factors such as changes in genes that differ from those in typical uterine muscle cells.
Some of the known factors are estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.
Fibroids tend to shrink after menopause due to a decrease in hormone production.
Other growth factors include substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
Other factors include Extracellular matrix or ECM.
The ECM is the material that makes cells stick together, like mortar between bricks.
It is increased in fibroids and makes them fibrous and also stores growth factors and causes biologic changes in the cells themselves.
Doctors believe that uterine fibroids develop from a stem cell in the smooth muscular tissue of the uterus or the myometrium.
A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue.
The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own.
Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to its usual size.
There are few known risk factors for uterine fibroids, other than being a woman of reproductive age.
Factors that can have an impact on fibroid development include race, heredity and starting periods at an early age.
Other factors include obesity; a vitamin D deficiency; having a diet higher in red meat and lower in green vegetables, fruit and dairy and drinking alcohol, including beer, appear to increase the risk of developing fibroids.
In terms of complications, although uterine fibroids usually aren’t dangerous, they can cause discomfort and may lead to complications such as a drop in red blood cells, which causes fatigue, from heavy blood loss.
On pregnancy and fibroids, doctors say fibroids usually don’t interfere with a woman getting pregnant.
However, it’s 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.
On prevention, although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them.
Preventing uterine fibroids may not be possible, but only a small percentage of these tumors require treatment.
But by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, a woman may be able to decrease the fibroid risk.
Also, some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids.
Medical experts say the best way to prevent or treat uterine fibroids is to have a yearly gynecological examination.

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