…Growth can be removed without surgery, experts say
Menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina.
For some women in their reproductive age, menstruation is normal and comes with ease every month.
But for some women with uterine fibroids, it is a burden they have to contend with every month owing to heavy blood flow, passing blood clots and experiencing excruciating pelvic pain which sometimes results in hospital admission.
For over 10 years before seeking a permanent solution, Mary Peters struggled with fibroids in tears and agony.
Life was hell for the Rivers State Indigene each month she was observing her period owing to her encounter with severe pelvic pain and heavy bleeding which she said impacted her health negatively.
Mary told our correspondent that she suffered anaemia after observing her period every month, making menstruation traumatising for her, unlike her peers without the condition.
The digital marketer who is in her late 30s said while some people had fibroids and still got pregnant and had the baby; the reverse was her case as she ended up having a miscarriage.
Mary said she had a close shave with death in 2017 when the fibroid led to the miscarriage of her five-month-old pregnancy which later resulted in complications that almost took her life.
According to the American College of Obstetricians and Gynaecologists, fibroids are benign (not cancer) growths that develop from the muscle tissue of the uterus. ACOG says the size, shape, and location of fibroids can vary greatly.
“They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes.
“Fibroids may have the following symptoms: changes in menstruation, heavy menstrual periods, menstrual pain, difficulty urinating or frequent urination, constipation, miscarriages, infertility, etc,” the ACOG said.
Sharing her experience with PUNCH Healthwise, Mary said fibroids made life difficult for her until she eventually got it removed without surgery after trying so many herbs and concoctions that worsened her condition.
Herbal treatment worsens condition
She said, “I battled fibroids for 10 years. I was diagnosed with fibroids in 2010. But I was taking herbal treatment which never worked and instead worsened my problem by making the fibroids grow bigger. It was a terrible experience living with fibroids until it was removed by experts in 2021 without surgery after years of excruciating pain and trauma.
‘If I am on my period, the pain is terrible. Even if I take pills, it will still be a horrible experience. If I take the pills before the periods, the pain will still be there. It was that bad. I bleed heavily and pass blood clots like someone that just gave birth.
“ So, every five days in a month when I have to see my period is hell. I go through hell because of the too much blood flow and the serious pelvic pain that I have to go through.
“ I have to always carry a pad along with me and I have always been conscious of myself in everything. When I am menstruating, if I sit for a few hours, I will be stained. When I go to the toilet to clean myself, the moment I bend down to ease myself, the blood clots will start falling off like balls, like a liver.
“ So, it was terrible. I suffered from anaemia. There were some days I was not able to go to work because of too much flow. The bleeding was really heavy and scary. Let me not even talk about the pain, it was crazy. I was also having headaches, lower back pain and dizziness. It impacted my well-being generally.”
The single lady said she was always terrified when the day of her menstrual cycle approached.
“When the time of my period comes, I will just fall sick. I go through psychological trauma of what I would experience once my period is approaching. It was indeed traumatising.
Five months pregnancy lost
“I was in a relationship in 2017 and when I became pregnant, I was always having pain below my abdomen.
“When my stomach was gradually getting bigger, I then felt the pregnancy would stay and that there was nothing to worry about.
“ But I lost the pregnancy and the pain persisted between my abdomen and my thighs until it became unbearable. The shock of losing that pregnancy complicated matters for me because I thought I would not be able to get pregnant in the first place.
“ I later broke up with my fiance because he felt I was going to be a liability to him. That affected my quality of life. I went through those years of trauma and pain because I was afraid of going for surgery.
“I have been having this cold feet about going for surgery or any knife. I know of a woman that lived in my area in Apapa that went for fibroid surgery and died.
“ The woman was married and the fibroid could not allow her to get pregnant. So, the doctor told her that unless she removed it, she would not be able to get pregnant because hers was very big. If you see her, you may even think she is nine months pregnant because of the size of her stomach. When she eventually died during the operation. I vowed not to go through the knife.”
Mary told our correspondent that fear of undergoing surgery forced her into taking herbal treatment even when it adversely compounded her problem.
Continuing, Mary said, “So, I was going for herbal treatment which was not working. Instead, the fibroid was growing bigger and started disturbing me the more. My doctor repeatedly asked to come for surgery to remove it but I refused.
Removal without surgery
“So, I kept on looking for a solution without surgery until I stumbled on reports online that there are new procedures now that can be used to remove fibroids with surgery.
“ I read of women that have undergone fibroid removal without surgery through a non-invasive process known as High-Intensity Focused Ultrasound –HIFU.I went for the procedure which lasted less than one hour and 30 minutes in 2021.
“When I came down from the machine, I realised that the breathing in my stomach had stopped. When someone has a fibroid, the stomach will be breathing. It is the fibroid that is breathing like a human being.
“ So, my hands were on my tummy for 20 minutes after the procedure and I noticed the breathing had stopped automatically. It was a painless procedure and I had no complications nor any blood loss. “
The marketer went on, “Life has become beautiful after the procedure. I don’t know what heavy flow and pelvic pain are anymore.
“ My menses is normal and comes with ease, unlike the torture I usually go through before it was removed. I never knew we have better treatment options out there.
“ So, women battling fibroids who are afraid of going through the knife should seek help from the experts. They can have it removed without surgery and still have their womb intact.
“It works by burning off the fibroid without harming or affecting the surrounding tissues, and at a cost comparable to normal surgery.”
Fibroids curable
Given the pain, trauma and infertility caused by fibroids among women in their reproductive age, it is worthy of note that it is curable, even without surgery, experts have said.
Maternal health experts say HIFU is a bloodless or non-invasive surgery for the treatment of fibroids and adenomyosis.
It uses real-time ultrasound and high-intensity ultrasound waves to generate localised heat to specifically target individual fibroids and destroy the cells.
A fertility expert and Managing Director of Nordica Fertility Centre, Lagos, Dr Abayomi Ajayi, says fibroids are among the commonest malignant growths in women of reproductive age.
The gynaecologist pointed out that women might have fibroid before the age of 50, lamenting that it impacts the quality of their life.
Dr Ajayi noted that fibroid could also be associated with infertility for a long time because of the fear of surgery.
He said HIFU is a safe method of removing fibroids without surgery. HIFU safe method of removing fibroids without surgery
“HIFU is about safe care. We are not saying that HIFU is the only way to treat fibroids, what we are saying is that it is a method that is safe.
“If well trained, a single surgeon can do up to 200 fibroid removals in a year. There is no need for anaesthesia or admission because it is a day case.
“ The process is so easy; all that you do as a patient is to lie down for about an hour and a half to two hours and the procedure is over. You are observed for about two hours after which you can then go home.
“By the next day,you can eat anything and 48 hours afterwards, you can do anything. The convenience to the patient and physician is huge. There is no blood transfusion, even on the day of the procedure the doctor does not touch you at all, he is just using software, and it is wonderful”, he explained.
25 percent of Nigerian women with fibroids unaware
The Nigerian Society of Interventional Radiology says about 25 per cent of Nigerian women in their reproductive age living with uterine fibroid are unaware.
Another woman that had a horrific experience living with fibroid before it was removed is 45-year-old businesswoman, Mrs Deborah Oparah.
The Imo State indigene narrated, “Fibroids made life unbearable for me at one point. I battled fibroid for over 13 years because I was diagnosed with it early.
I wasn’t able to get pregnant until I had it removed.
“The doctor told me that it was very big and that it will not allow me to carry a pregnancy to full term unless I have it removed. I had three miscarriages before it was eventually removed. After I had a miscarriage the third time, my husband insisted that I must remove it.
“ But I was afraid of going through surgery because of the negative times I was hearing about fibroid surgery. I was even told by some friends that I will not be able to get pregnant after the surgery and so I was scared. I took a lot of concoctions and traditional medicine but they didn’t work.
“For fear of surgery, I visited different hospitals and experts until I got a facility that used non-invasive procedures to remove it. And was able to give birth a year after the procedure and eight years after my marriage.
“But before it was removed, the pain was my second name.
“, Fibroid made sex unpleasant for me because of the pain. It made me anaemic, and I also suffered weight loss which severely affected my energy level.”
Deborah also recounted her ordeal with heavy and prolonged menstrual bleeding.
“My periods were extremely heavy and lasted seven to nine days.
It got worse and worse. There was a time I was transfused after observing my period due to heavy bleeding.
“Living with fibroids from my experience is not a common condition as people think. The trauma and pain that women with the condition battle is unimaginable. I started leading a meaningful life when it was removed.”
11 years of heavy bleeding
Similarly, a 38-year-old mother of two, Mrs Agnes Falade also shared her experience with PUNCH Healthwise, noting that living with fibroids becomes a burden when it begins to affect the life of the individual.
“Fibroid plagued me for over 11 years and made menstruation a nightmare for me because of the heavy bleeding. I stay indoors whenever I am observing my period. Everybody in the family will know even my boss will know because I will not be able to go to work.
“I, however, summoned courage and went for surgery after many years of fear. I was lucky the surgery was successful and I had two children two years after the surgery. Life became worth living after I removed it.”
Recent studies have shown that the condition is almost three times as likely to occur in the bodies of blacks than in any other race of women in the world.
A 36-year-old lady who simply identified herself as Joy recounted, “Before treatment, I suffered from back pain, severe bloating, exhaustion, heavy blood flow during my period and pain during sex.
“Besides the chronic pelvic pain, you are uncomfortable going anywhere when menstruating because you are going to be embarrassed with pain and stain.
“ It was eventually removed without surgery and the pain disappeared.
“The procedure doesn’t bring the fibroid out, there is nothing like cutting or scraping, the fibroid is killed by the heat and over time, the dead fibroid is passed out or absorbed by the body. It depends on the position of the fibroid. The one that is in the system is passed out, while the one in the muscle is absorbed by the system.
“After the surgery, the first thing that I noticed was that the persistent back pain I had been feeling had disappeared. As soon as I got up from the table, I discovered that I didn’t feel the pain anymore. Before the surgery, I was feeling the fibroid, but now afterwards
I have not had any complications for over two years since I did the surgery”, Joy said.
Other women who spoke with PUNCH Healthwise shared similar experiences.
Symptoms of fibroids
Consultant Obstetricians and Gynaecologists who spoke with PUNCH Healthwise said abdominal pain; anaemia and increased bleeding and miscarriage during pregnancy indicate the presence of fibroids.
They said there might also be pain during intercourse (penetration), depending on the location of the fibroid while affirming that the condition can now be effectively treated without surgery.
Dr Ajayi speaking further on the problem of fibroids noted that the only way to stop the recurrence of fibroids is to remove the uterus.
He pointed out that in comparison to surgery with HIFU, the recurrence rate of fibroid is higher with surgery.
“HIFU is the only way to treat adenomyosis without affecting the uterus, and it also does not affect the ovarian reserve, so that the woman can get pregnant and does not need to undergo cesarean section”, he added.
“We have been trying to see how we can save our women from the complications of invasive surgery which sometimes ends in death. When a woman dies in the household, it is a serious issue, so many things are involved, but I’m sure that we will be able to save one or two women with uterine fibroids from this ordeal and then improve their quality of life.”, he said
The fertility specialist noted that although fibroid surgery could lead to infertility, the problem is usually more with the surgery itself.
For women who prefer to undergo surgery, he counselled.”If you are going to undergo surgery, choose a safe hospital, and one that has what it takes to manage the condition itself if anything goes wrong.
Erroneous beliefs
Also, an Associate Professor and Consultant Obstetrician and Gynaecologist at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Dr Uche Agu, stated that there are reasons why some women who have fibroid can have babies while others do not.
Dr Agu cautioned against using drugs to shrink the fibroid, noting that women who have fibroid and are desirous of having children should seek treatment from maternal health experts.
The gynaecologist said, “Some people have erroneous beliefs about fibroid; that fibroid should not be operated upon and that anybody that goes for surgery will never be pregnant again.
“Some people have an erroneous impression that once you do fibroid surgery, you will not be able to conceive, but that is wrong.
“If the surgery is conducted by an experienced and good hand, the person will achieve pregnancy faster and safely.
“The best option for a woman who wants to get pregnant is to have it done by an experienced gynaecologist.
“Women should access care from a good gynaecologist that would do it properly. Surgery is good but it depends on who did the surgery and where it was done.”.
An Abuja-based gynaecologist, Dr Chiemezie Chiebonam, warned women plagued with fibroids against unnecessary surgery.
Complications of fibroid surgery
Dr Chiebonam explained that surgical removal of fibroid could adversely affect the general health of the affected persons.
According to him, at an early stage of fibroid, mere treatment and therapy could prevent the growth and thereafter cure it.
“Fibroid surgery ought to be the last intervention in a woman as it may result in infertility if not properly handled except for women whose fibroid growth was close to the fallopian tube.
“Though it is largely the lot of every woman, it can be corrected through hormonal therapy, radiological intervention, laser therapy and endometrial ablative therapy, among others.
“There are possible complications following fibroid surgical operation that can cause infertility like fibrous adhesion which can obstruct the fallopian tube causing infertility,’’ he said.
Untreated fibroids can cause heavy blood loss
Another associate professor of obstetrics and gynaecology at the College of Medicine, University of Lagos, Dr Ayo Olamijulo, said untreated uterine fibroids can cause heavy blood loss and miscarriage
The consultant gynaecologist who gave insight into the risk factors for fibroids said, “Age is a risk factor, especially for women in their reproductive age group, particularly in their 20s, 30s, and 40s. The older the woman is within the reproductive age, the more likely they are to have fibroids.
“This is a risk factor for blacks than whites. Even in other countries where you have negroids, that is blacks and whites, you find out that the black population tends to have more fibroids.”
Researchers say poorly managed surgical treatment is the major cause of complications of fibroid surgery in Nigeria.
They noted that proper therapeutic options are paramount to secure the reproductive potential of the patient and reduce complications.
Women sensitisation
A 2021 study published in the African Journal of Health Sciences, the researchers said fibroids frequently cause abnormal menstrual bleeding and are thought to be involved in infertility. Hence there is a need to identify the mode of presentation and management.
According to the researchers, early childbirth, female education and empowerment, training and utilization of modern management options and closer support and training of unspecialized attending surgeons, will go a long way in reducing complications associated with surgical management of fibroids.
They noted that uterine fibroid is among the most common problems encountered by obstetricians and gynaecologists in Nigeria.
“Fibroids are a frequent cause of abnormal menstrual bleeding and are thought to be involved in infertility.
They are the most frequent indication for hysterectomy before menopause.
The prevalence rate varies from 20-50 per cent of reproductive-aged women, depending on the age, ethnicity, parity and method used to assess their prevalence
“African American women are having fibroids of clinical significance. Genetic factors and familial predisposition are blamed for increased frequency as well as the prevalence of pelvic inflammatory disease and obesity in black women.
“Though the majority of fibroids are asymptomatic, a few may cause distressing symptoms such as menstrual abnormalities, pelvic pressure or pain, obstructive symptoms, infertility or pregnancy loss. Very large tumours have been known to cause pelvic discomfort, respiratory failure, urinary symptoms and constipation”, the researchers said.
