Uterine fibroids are the most common non-cancerous tumours in women worldwide and Nigerian women are disproportionately affected. Studies consistently show that women of African descent develop fibroids more frequently, at younger ages, and with more severe symptoms than women of other ethnicities. Yet in Nigeria, fibroids remain widely misunderstood, frequently undertreated, and sometimes managed with myths rather than medicine.<\/p>\n\n\n\n
If you have been told you have fibroids or you suspect you might, this article gives you everything you need to understand what they are, what they cause, and what your options are.<\/p>\n\n\n\n
Uterine fibroids (also called leiomyomas or myomas) are non-cancerous growths that develop in or around the uterus (womb). They are made up of muscle and fibrous tissue and can range in size from as small as a seed to as large as a melon. A woman may have a single fibroid or multiple fibroids at once.<\/p>\n\n\n\n
The critical point: fibroids are not cancer and do not become cancer.<\/strong> Having fibroids does not increase your risk of uterine cancer. However, they can cause significant symptoms that seriously affect quality of life and in some cases, fertility.<\/p>\n\n\n\n The location of a fibroid within or around the uterus largely determines what symptoms it causes:<\/p>\n\n\n\n Intramural fibroids<\/strong>: grow within the muscular wall of the uterus. The most common type. Can cause heavy periods and pelvic pressure as they enlarge.<\/p>\n\n\n\n Submucosal fibroids<\/strong>: grow just beneath the inner lining of the uterus (endometrium), bulging into the uterine cavity. Even small submucosal fibroids cause heavy bleeding and are most strongly linked to fertility problems and miscarriage.<\/p>\n\n\n\n Subserosal fibroids<\/strong>: grow on the outer surface of the uterus, pushing outward. Can grow very large before causing symptoms. More likely to cause pressure on nearby organs (bladder, bowel).<\/p>\n\n\n\n Pedunculated fibroids<\/strong>: attached to the uterus by a stalk (like a mushroom). Can be subserosal or submucosal. Pedunculated fibroids can twist on their stalk, causing sudden, severe pain.<\/p>\n\n\n\n The exact cause of fibroids is not fully understood, but several factors are well established:<\/p>\n\n\n\n Oestrogen and progesterone, the female hormones that regulate the menstrual cycle; stimulate fibroid growth. Fibroids have more oestrogen and progesterone receptors than normal uterine muscle. This explains why:<\/p>\n\n\n\n Fibroids run in families. If your mother, sister, or aunt has had fibroids, your risk is significantly higher. Specific genetic changes in uterine muscle cells are found in many fibroids.<\/p>\n\n\n\n Women of African descent including Nigerian women have a 2-3 times higher lifetime risk of developing fibroids compared to white women. They also tend to develop fibroids younger, have larger and more numerous fibroids, and experience more severe symptoms. The reasons are not fully understood but likely involve a combination of genetic, hormonal, dietary, and environmental factors.<\/p>\n\n\n\n Emerging research suggests vitamin D deficiency which is surprisingly common in Nigeria despite abundant sunshine, partly due to indoor lifestyles and skin pigmentation may be linked to higher fibroid risk. Vitamin D appears to inhibit fibroid cell growth in laboratory studies.<\/p>\n\n\n\n Diets high in red meat and low in green vegetables, fruits, and dairy have been associated with higher fibroid risk in some studies. Obesity increases oestrogen levels (fat tissue produces oestrogen) and is linked to larger and more symptomatic fibroids.<\/p>\n\n\n\n Up to 50% of women with fibroids have no symptoms at all<\/strong>; their fibroids are discovered incidentally during a routine scan or examination. For those who do have symptoms, they vary depending on the size, number, and location of fibroids:<\/p>\n\n\n\n The most common symptom. Periods become significantly heavier than normal, soaking through pads or tampons every hour or two, passing large blood clots, or having periods that last longer than 7 days. Heavy bleeding leads to iron deficiency anaemia in many Nigerian women with fibroids causing fatigue, weakness, dizziness, and breathlessness that they attribute to other causes.<\/p>\n\n\n\n Periods that last 8 days or more, sometimes with bleeding or spotting between periods.<\/p>\n\n\n\n A feeling of heaviness, fullness, or pressure in the lower abdomen or pelvis. Larger fibroids can cause a visible bulge in the lower abdomen. Pelvic pain may be constant or occur mainly during periods (dysmenorrhoea).<\/p>\n\n\n\n Fibroids pressing on the bladder cause a constant urge to urinate, frequent trips to the bathroom at night, or difficulty fully emptying the bladder.<\/p>\n\n\n\n Fibroids pressing on the rectum can cause constipation, a feeling of incomplete bowel emptying, or bloating.<\/p>\n\n\n\n Particularly with fibroids located near the cervix or in the lower uterine segment.<\/p>\n\n\n\n Large fibroids pressing on nerves or the spine can cause persistent lower back pain.<\/p>\n\n\n\n Fibroids, particularly submucosal fibroids inside the uterine cavity can interfere with implantation of a fertilised egg and increase the risk of miscarriage. Fibroids blocking the fallopian tubes can prevent conception entirely. This is one of the most important reasons for Nigerian women experiencing difficulty conceiving to be investigated for fibroids.<\/p>\n\n\n\n Fibroids can cause complications during pregnancy including pain (from degeneration of the fibroid as it outgrows its blood supply), preterm labour, abnormal baby positioning, placental abruption, and increased likelihood of caesarean delivery.<\/p>\n\n\n\n The most common and accessible diagnostic tool. An ultrasound scan of the pelvis visualises the uterus and can detect, measure, and map fibroids. A transvaginal ultrasound<\/strong> (probe inserted into the vagina) gives a more detailed view than an abdominal scan.<\/p>\n\n\n\n Provides the most detailed imaging of fibroids; their number, size, exact location, and relationship to surrounding structures. Used when surgery is being planned or when ultrasound results are unclear.<\/p>\n\n\n\n A thin camera inserted through the cervix into the uterine cavity directly visualises submucosal fibroids and the uterine lining. Can also be used for treatment.<\/p>\n\n\n\n Saline is injected into the uterus during an ultrasound to better visualise the uterine cavity and identify submucosal fibroids.<\/p>\n\n\n\n Full blood count to assess for anaemia from heavy bleeding. Hormone tests may be done to rule out other causes of heavy periods.<\/p>\n\n\n\nTypes of Fibroids – Where They Grow Matters<\/strong><\/h2>\n\n\n\n
What Causes Fibroids?<\/strong><\/h2>\n\n\n\n
Hormones<\/strong><\/h3>\n\n\n\n
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Genetics<\/strong><\/h3>\n\n\n\n
Race and Ethnicity<\/strong><\/h3>\n\n\n\n
Vitamin D Deficiency<\/strong><\/h3>\n\n\n\n
Diet<\/strong><\/h3>\n\n\n\n
Symptoms: What Fibroids Feel Like<\/strong><\/h2>\n\n\n\n
Heavy Menstrual Bleeding (Menorrhagia)<\/strong><\/h3>\n\n\n\n
Prolonged Periods<\/strong><\/h3>\n\n\n\n
Pelvic Pressure and Pain<\/strong><\/h3>\n\n\n\n
Frequent Urination and Bladder Pressure<\/strong><\/h3>\n\n\n\n
Constipation and Bloating<\/strong><\/h3>\n\n\n\n
Pain During Sex<\/strong><\/h3>\n\n\n\n
Lower Back Pain<\/strong><\/h3>\n\n\n\n
Fertility Problems and Miscarriage<\/strong><\/h3>\n\n\n\n
Complications in Pregnancy<\/strong><\/h3>\n\n\n\n
How Fibroids Are Diagnosed<\/strong><\/h2>\n\n\n\n
Pelvic Ultrasound<\/strong><\/h3>\n\n\n\n
MRI (Magnetic Resonance Imaging)<\/strong><\/h3>\n\n\n\n
Hysteroscopy<\/strong><\/h3>\n\n\n\n
Sonohysterography (Saline Infusion Sonography)<\/strong><\/h3>\n\n\n\n
Blood Tests<\/strong><\/h3>\n\n\n\n