By Stella Naigino and Violet Nabatanzi
It started like a small pain in the stomach, which I took for granted and thought it would disappear with time. But little did I know that I would be hit by a disaster that would make me childless for the rest of my life, laments Hadijah Namuyomba.
After a short while, my stomach started expanding and this brought a smile on my face because I thought I was pregnant.
After a short time, I started belching a lot and upon visiting a doctor, an examination was carried out and this is how I discovered that I had fibroids in my uterus.
I started feeling too much pain and heat in the body and stomach. My husband, Fred Nakiraba, felt bad that I was going through so much pain, but he could not do much because of financial constraints.
Eventually, the situation forced me to consult traditional healers because I really wanted to bear a child for my husband. Traditional healers advised me to continue taking local herbs because, they argued, I would get a baby after taking many herbs. Nothing happened, so I gave up.
After four years of experiencing too much pain and bleeding almost half a bucket of blood during my periods, I was helpless yet my husband kept asking me to bear him a child.
One day, there was a women’s function in Luuka district so I narrated my story. Fred Bahati, a pastor of Light Temple Ministry in Nsambya offered me transport to Mulago hospital because he was touched.
I left my home in Bumanya village in Luuka district and went to Mulago hospital for an operation. I was operated on in September, but I was told that I had lost my uterus.
I now spend sleepless nights because I know that I will never hold my own child in my arms.
What are fibroids?
According to Dr. David Kiggundu, a senior gynaecologist in Mulago hospital, Fibroids are balls of muscle and fiber that grow within the wall of the uterus.
“The uterus is made of a powerful thick muscular wall which can contract in an involuntary manner when pregnancy is complete. It’s in this wall that the fibroids grow,” Kigundu explains.
He says fibroids normally grow in women during reproductive time, pregnancy or when a woman is using family planning pills. They mostly develop towards the later part of a woman’s reproductive years, although they may come earlier.
Signs and symptoms of fibroids
Kiggundu notes that many women find out that they have fibroids after carrying out a routine gynaecological examination.
He adds that fibroids do not always come with pain and symptoms until the uterus grows to the size of a 14-week pregnancy, which explains why most women take long to discover that they have them.
“They tend to grow in the wall of the uterus, meaning they tend to stretch the uterus lining and result in heavier abnormal menstrual bleeding,”Kiggundu reveals.
He adds that sometimes a woman may present to her doctor with tiredness due to anaemia from heavy bleeding and the fibroids are found later, after a full history examination is performed.
He says fibroids can press against other structures and if they are large enough, they cause abdominal swelling.
Some victims pass urine all the time due to pressure exerted on the bladder. Others face difficulty when they go for long calls due to pressure on the bowel.
He reveals that they are a nightmare to many women, especially in cases where women find it difficult to conceive due to the squashing of the fallopian tube.
However it is important to note that these symptoms do not always mean that one has fibroids, so any or all of them may be due to something other than fibroids.
Who is prone to fibroids?
It is estimated that between 30-50% of women between 35 –50 will have one or more fibroids. After menopause, growth slows with the drop off in natural oestrogen production.
Are fibroids dangerous?
Much as they are not painful in their early stages of manifestation, they can vary in size from a pea to a grapefruit or even larger, which complicates the situation.
Commonly fibroids are suspected when an enlarged uterus is detected during physical examination in a woman who is not pregnant. The diagnosis is generally confirmed by an ultra sound.
The growth is normally attached to hormones and the hormones that favor its growth are mostly embedded in the uterus, hence their growth in this area.
Why the stomach expands
When fibroids grow in the uterus, it expands so it is the bulkiness of the uterus that causes the stomach to expand and makes a woman look like she is pregnant.
Some even feel heavy.
Causes of fibroids
Several researchers have tried to find out the causes of fibroids without much luck. Studies, however have found that the following factors can promote fibroid growth:
Genes: Researchers found that fibroids have gene alterations that are different from the normal genes in the uterine muscles.
Hereditary factors: You are three times more likely to get fibroids if your mother had them. You are also at risk if your sister had them.
Hormones: The hormones oestrogen and progesterone, which prepare the uterine lining for pregnancy.
Other chemicals that help with tissue maintenance in the body.
Race: Some studies suggested that blacks have a higher risk. In fact, eight in every 10 black women will develop fibroids.
Pregnancy and childbirth, according to studies can keep fibroids away.
nObesity: Some studies suggest that obese women have a two to three times higher risk of getting fibroids.
Oral contraceptives: Strong evidence shows a lower risk for all women on the pill.
However, they don’t protect girls between 13 and 16 years.
Age: Women between 30 and 40 years are at risk because of the higher levels of oestrogen in their bodies. After menopause, when the levels of estrogen drop, the risk also drops and fibroids usually shrink or disappear.
Your diet can protect you from fibroids
By Elizabeth Namazzi
Your diet, some studies suggest, can offer some protection against fibroids. One study reported that fibroids thrived in women who eat ham and beef. Eating lots of vegetables can keep fibroids away. Other studies have also linked alcohol to fibroids.
A study conducted in 2010 found that eight in every 10 black women are prone to fibroids.
The researchers studied more than 22,000 black women of reproductive age (premenopausal women) over a period of 10 years.
The researchers narrowed their research on the consumption of dairy products and whether it has any effects on the growth of fibroids. The researchers sought to find out if an intake of dairy products like milk, cheese, yogurt, and ice cream may lower one’s risk of developing uterine fibroids.
They found that women who took more dairy products had a lower risk of developing fibroids. This could be because of the calcium found in dairy products. Another 2010 study suggests that foods high in carbohydrates may promote fibroid tumour growth.
Such foods included white rice, white bread, rice, cakes, French fries (commonly known as chips) and scones. On the other hand, soyabeans can inhibit fibroid growth as well as Vitamin D.
Another study published in 2011 showed that a diet rich in fruits, vegetables and Vitamin A also offers some protection from fibroids.
However, research about the link between one’s diet and the growth of fibroids is still ongoing. Still, this does not stop you from incorporating the suspected protective foods in your diet.
Ask the expert
Dr. David Kiggundu, a senior gynaecologist in Mulago hospital
Q What treatment is available for fibroids?
A Treatment depends on many factors. If the fibroids are not causing any symptoms and the woman is not planning a pregnancy, a watchful approach may be taken.
This involves having regular ultrasounds to keep an eye on the progress of growth. Sometimes hormone preparations are used to turn off periods and so give some relief from the heavy periods.
Are there treatments that can shrink fibroids?
Yes, such treatments are available. Women close to menopause may opt to take drugs which induce a temporary false menopause, which literally turns the ovaries (that is oestrogen production) completely off, while the woman takes the drug. This tends to cause the fibroids to shrink.
Does this treatment come with any risks?
The drug can only be taken for six months because of potential side effects like loss of bone density (osteoporosis) and after this time the fibroids usually regrow anyway.
Some women decide to go for surgery depending on what their gynecologist advices them to do. It is advisable that when a girl starts having monthly periods, they start visits gynecologists for checkups before things get out of hand.
Would you advise women against taking oral contraceptives if they can use other methods?
Before a woman is put on contraception, all options should be discussed and her risks with a particular method should be assessed.
There is no broad spectrum advice for women to use pills.
Do you know the particular pill that can put one to the risk of getting a stroke?
All pills are a risk to particular women so it is the selection which is important.
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