Uterine Fibroid

Uterine fibroids are abnormal growths (tumours) that are found in the uterus of reproductive-age women. This tumour is not cancerous (benign) and may or may not cause any symptoms. Fibroids can be of different sizes and can grow at different locations within the uterus and this is used to classify the types of fibroid. The main types of fibroids are subserosal, intramural, submucosal and pedunculated fibroids

Prevalence
Research indicates that African American women are much more likely to develop fibroids than women of other racial groups. In the U.S., about 25% of Black women aged 18 to 30 have fibroids, compared to 6% of white women, with the prevalence rising to 60% by age 35. By age 50, up to 80% of African American women are expected to develop fibroids, compared to around 70% of white women. Additionally, Black women are two to three times more likely to experience recurring fibroids or complications and tend to develop them at a younger age, often with larger and more numerous growths.
Similarly, the prevalence of uterine fibroids in Nigeria differs across regions and age groups, with particularly high rates seen in women aged 26-45 years. In Southern Nigeria, a study revealed that 51.9% of women aged 26-35 years and 44.6% of those aged 36-45 years had fibroids. Among asymptomatic women, ultrasound scans showed a prevalence of 12.1%, which is higher than the 6.83% observed in South-Western Nigeria but slightly lower than the 13.6% in South-Eastern Nigeria.
These findings highlight the importance of implementing targeted awareness, screening, and management efforts among black women.

Causes
It is still unknown what the real cause of fibroid is. However, experts suggest that the hormones estrogen and progesterone play a role. According to studies, fibroids grow whenever these hormone levels are high, like during pregnancy, and tend to drop when the hormones are low, like when approaching menopause. Additionally, there are some risk factors which tend to increase the chances of getting fibroids, these include;
- Obesity
- History of fibroids in the family
- Having few or no children
- Early onset of menstruation
- Delayed menopause
- Being Black or African-American

Some suggestions are that consuming red meat, alcohol, and caffeine also contributes to the risk of fibroids.

Signs and Symptoms
As stated earlier, fibroids grow to different sizes. In many cases, small fibroids do not cause any symptoms so treatment might not be necessary. However, larger fibroids occur with symptoms which may include;
- Heavy or painful bleeding during the period
- Bleeding between periods
- The feeling of fullness in the lower abdomen
- Abdominal distention
- Frequent urination
- Painful intercourse
- Low back pain
- Feeling pressure on the rectum
- Constipation
- Chronic vaginal discharge
- Inability to urinate

Most uterine fibroids do not cause serious complications. But when they do, the most common complications are chronic pain, abdominal or pelvic area swelling, anaemia, and sometimes infertility.

The stages of treating fibroid and chances of recurrence

Usually, small fibroids with no symptoms may go on their own, especially when the woman is approaching menopause, so treatment may not be necessary. But in cases where there are symptoms and these symptoms persist, then there is a need for treatment. Stages of treatment include:
1. The first line or stage of treatment is usually treatment with medications which will help make the symptoms subside. However, the treatment plan will depend on factors such as the number and location of fibroids, the size of fibroids, and related symptoms.
2. The second line or stage of treatment includes surgeries known as myomectomy to remove this fibroid. This stage is usually carried out in women who want to get pregnant again.
3. The next stage of treating fibroids involves the surgical removal of the uterus, known as hysterectomy, and other procedures like uterine fibroid embolization and radiofrequency ablation. This stage of treatment is considered for women who are not willing to get pregnant again and it is the most effective.
The chances of uterine fibroid recurrence after treatment depend on the treatment approach. Medications can lead to recurrence once stopped. Uterine artery embolization may result in recurrence or new fibroids in about 10-25% of cases within five years.
Myomectomy has a recurrence rate of 10-30% within five years, depending on whether all fibroids are removed. Hysterectomy offers the lowest risk of recurrence since it removes the uterus entirely. Factors such as the type and size of fibroids and individual health conditions also impact recurrence risk.

When To Get Help
It is always advised that you go for regular medical check-ups even when there are no symptoms of illness. These checkups can help to uncover fibroids in their early stage and help take the necessary action. You are advised to go for a regular, especially when you have two or more of the risk factors of fibroids, or when you have the symptoms of fibroids as stated above.
This regular monitoring is important to manage and reduce this risk.

References
https://www.usafibroidcenters.com/blog/are-african-american-women-more-likely-to-get-fibroids/
https://www.yahoo.com/lifestyle/80-black-women-experience-fibroids-190805243.html?guccounter=1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874080/
https://mdcan-uath.org/article.asp?issn=2250-9658;year=2019;volume=8;issue=13;spage=24;epage=29;aulast=Lawal#:~:text=In%20this%20study%2C%20a%20prevalence,in%20South%20Eastern%20Nigeria.