Fibroids in Women: A Silent Struggle

Did you know that nearly 20% of all women by the age of 30 have fibroid in their wombs? Women incur a lot; both financially and psychologically. 

Fibroids ( Leiomyomas) are the commonest benign (non-cancerous) tumours of the uterus. 

The tumours are predominantly dependent on oestrogen (a hormone responsible for development of female sexual characteristics). Due to this, their growth is increased during periods of high oestrogen levels in the body such as during pregnancy.

 Fibroids do not occur at an age before one has gotten their first period and following menopause, their growth stops with no new growth.

Who is at risk?

• Nullipara (women who have not given birth before): these women have un-opposed oestrogen.

• Early menarche : girls who get their first menstrual period before the age of 12 years are at risk. Factors contributing to this include an increased BMI (body mass index) and subcutaneous fat.

• Late menopause; length of time that one takes to reach menopause (stops getting their menstrual periods) correlates to their duration of exposure to oestrogen.

• Black race; studies have found higher prevalence and more severe symptoms in Black women compared to those of other races.

• Oestrogen-only oral contraceptive pills increase oestrogen supply to your body, which increases your risk for developing fibroids.

• Stress: one study found a direct correlation between psychological stress and risk for development of uterine fibroids.

• Chronic inflammation: conditions such as endometritis provide a conducive environment for growth of fibroids.

• Genetics also have a role to play in this; the risk is higher in people with a family history of fibroids.

How do fibroids present?

Fibroids can grow at any site within the smooth muscle layer of the uterine wall. Luckily, 75% of those affected stay without any symptoms. The symptoms however, are dependent on the site and size of the tumour:

• Abnormal vaginal bleeding

Heavier than normal menstrual periods which are due to an increase in the surface area of the endometrium (during menstruation, it is this layer of the uterus that gets shed off).

This, as well as bleeding in between periods are among the most characteristic presentation of fibroids.

• Painful menstrual periods

These may be a result of pelvic congestion or extrusion of polyp with consequent expulsion from the uterus.

• Painful sexual intercourse

By virtue of their position and size, fibroids can cause pain which may either be at the start of penetration or last throughout, even after intercourse.

• Lower abdominal pain

Fibroids are usually painless however; pain may arise due to a complication to the tumour. Twisting of the fibroid or its degeneration are common complications that cause pain.

• Pressure symptoms

When the fibroid grows to a larger size, there is a risk of compressing neighbouring structures which ultimately results in conditions like constipation in case the rectum is compressed. Compression of the urinary bladder or urethra may cause painful urination or even urinary retention.

• Pregnancy related problems

This is due to disruption in the smooth continuity of the uterine wall impairing implantation of the placenta. Additionally, there is reduced space for the growing foetus and placenta as well. 

The commonest arising problems are intra-uterine growth restriction, abortions and preterm labour

What happens if fibroids are left untreated?

• The tumours can get infected with consequent spread of infection throughout the body.

• Continued blood loss can result in anaemia, a condition in which haemoglobin, an oxygen carrying component of blood is reduced, leaving body tissues with insufficient oxygenation.

• Infertility; depending on the location, fibroids may block the fallopian tubes causing impairment of gamete transport. 

• Rarely, fibroids can become cancerous

Treatment for fibroids

Treatment is dependent on the size, location, number of the tumours, as well as fertility requirements of the patient.

In most cases, fibroids are found incidentally during another surgical procedure involving the pelvis. If the fibroids are small, your doctor will prescribe some medications to help shrink them or control other complications.

 However, if the tumours are large or causing major symptoms, you might need surgery in which a part of the uterine wall is removed, or the entire uterus. Talk to your gynaecologist if you notice any of the signs above.

Ashwagandha

A natural remedy _ Ashwagandha

Ashwagandha has been found to be effective in management of fibroids.  The unique herb has been noted to possess strong stress relieving properties particularly through inhibition of cortisol (stress hormone) production.

Women encounter lots of stressful events in their daily struggle. Prolonged exposure to stress has been found to potentiate growth of fibroids. Additionally, more stress is likely to step in upon being diagnosed with the tumour.

Ashwagandha’s role is therefore to deal with the stress enabling you to heal and prevent re-growth of fibroids following treatment.

Additionally, the herb has anti-inflammatory properties. So, in the setting of chronic inflammatory conditions such as endometritis which promote fibroid growth, the herb serves as a growth inhibitor.

Choosing to use natural herbs for management of your symptoms is rewarding in many aspects; these are more affordable and have a safe profile.