By Gift Kalikulali
Women diagnosed with uterine fibroids should not immediately assume that they cannot have children, according to Dr Denis Lutabi, a gynaecologist at Mukono Church of Uganda Hospital.
Dr Lutabi says fibroids affect women differently, depending on their size, location and whether they cause symptoms. He explained that some women have small fibroids and do not know it because they may not cause any noticeable problems.
“Most of them are asymptomatic and small, and they don’t need treatment,” he says.
Fibroids are non-cancerous growths made of muscle and connective tissue that develop in or on the wall of the uterus. The exact single cause of fibroids is not known, but Dr Lutabi says they are mainly influenced by the female hormones oestrogen and progesterone.
Prevalence
He adds that fibroids are common among women in Africa, although specific data on their prevalence in Uganda remains limited. He estimates that about four in 10 women may have fibroids, with some cases remaining undiagnosed because the growths are small and do not cause symptoms.
According to Dr Lutabi, having fibroids does not automatically mean a woman will become infertile. Some women with small fibroids are able to conceive and carry pregnancies successfully.
However, larger fibroids can sometimes cause problems during pregnancy. Depending on where they are located, they may occupy space in the uterus, affect implantation or cause pain as the pregnancy develops.
“The commonest symptom you see in ladies having fibroids and pregnancy is pain,” Dr Lutabi says, explaining that a growing baby and a large fibroid may compete for space in the uterus.
He noted that pregnancy with fibroids is different for every woman. While some may experience pain or other complications, others may carry their pregnancies to full term without major problems.
Common symptoms of fibroids include heavy menstrual bleeding, persistent pelvic pain and an unusual mass or swelling in the abdomen or pelvis. Dr Lutabi encourages women who notice such symptoms to seek medical attention instead of depending on social media information or unverified herbal treatments.
How to treat fibroids
Treatment depends on the woman’s symptoms, the size and location of the fibroids and whether she wants to have children in the future. Women with small fibroids that do not cause problems may only need regular monitoring.
For women with symptoms, treatment may include medication, procedures or surgery. One option is a myomectomy, which removes the fibroids while leaving the uterus in place. The procedure can be done through open surgery or minimally invasive surgery.
For women who have completed childbearing or are in menopause, hysterectomy, which involves removing the uterus, may be considered in some cases.
Dr Lutabi also warns that fibroids can return after treatment because some very small growths may remain.
He encourages women to have regular health check ups and seek professional medical advice when they notice unusual symptoms.
Treatment, according to the doctor, should be carefully planned because every operation affects the body, and decisions should consider the woman’s health, symptoms and future plans for having children.
Rather than assuming that every fibroid requires immediate treatment, Dr Lutabi urges women to first seek proper medical assessment so that they can understand their condition and choose the most suitable care.
