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An idle uterus is a fibroid’s workshop

Reproductive Health
 Doctor in white medical lab coat shows and indicates to the patient the uterus. [Courtesy]

Jacinta Mueni, a mother of two from Machakos County, started experiencing heavy bleeding at 49. She could not bend, wear her favourite skirt. Her stomach was growing bigger and painful by the day. Simple chores like doing laundry or cleaning her house was an uphill task.

Little did she know that she had fibroids, those non-cancerous growths on the smooth muscles of the womb caused by the estrogen hormones in a woman’s body. Mueni’s menses, heavy and clotty, lasted more than two weeks. The gynecologist confirmed she not only had fibroids, but cervical cancer as well. Mueni, now 60, was devastated.

The doctors advised that her uterus be removed, but they could not do it since she had cancer-which they were afraid would spread, cause more harm. They offered her drugs to quicken her into menopause, which proved to be a temporary solution to make the fibroids smaller and stop them from further growth.

This was to prepare her for cancer treatment before removing the fibroids.

Any young girl aged between 14-19 years to the time she conceives has an empty, idle uterus. And the phrase is commonly believed to be a gynecological proverb that an idle uterus is the fibroids workshop, but it doesn’t mean that she should conceive to avoid fibroids.

Dr Kireki Omanwa, an obstetrician/gynecologist, says that fibroids can grow on women in their reproductive ages between 17-40 or before menopause and “between 40-60 per cent of African women can get fibroids in their reproductive period.”

Some women may experience different symptoms while in some, there are no symptoms.

Dr Kireki explains that some women experience heavy, clotty periods, some lasting for many days and due to this, there is low hemoglobin which may result in dizziness or nausea. Other women may experience pain in the lower abdomen as well as pain during intercourse.

"There will also be pressure symptoms which occurs when the fibroids press on the bladder making a woman feel extremely pressed,” offers Dr Kireki, “but when she goes to relieve herself, only a small amount  of the urine comes out and this may repeat itself after a short while” and such symptoms means seeing a doctor for testing and treatment.

A scan is usually done to check where the fibroid is, the size and the numbers since sometimes they can be more than one, in some cases, 20, 70, or even 100 and “once it is confirmed it is fibroids, treatment is started depending on what the woman wants,” says Dr Kireki adding that treatment plans are different for women desiring to have children unlike those who don't want or have had enough.

Surgery is recommended for those who have stopped siring or have no interest and for those planning to have children, surgery can be the best course depending on severity or position of the fibroids.

“During surgery, we remove the fibroids alone, but in other cases, we remove the entire uterus and the fibroids as well,” he said.

What happens when one has both fibroids and cancer? Dr Kireki explains that having fibroids and cervical or uterine cancer depends on the stage of the cancer as “each stage has different courses of treatment, for instance where the cancer has reached stage 2A, we cannot operate. We first take the woman through chemotherapy or radiotherapy” to reduce the size of the fibroids to allow for cancer treatment, before removing them to prevent further spread of the cancer.

Fibroids are known to cause barrenness in a woman, although one can still conceive and give birth when they have fibroids, says Dr Kireki, but it depends on where the fibroids have grown and the size. 

Barrenness occurs when fibroids attach themselves on the fallopian tube preventing the flow of the ovum into the uterus for fertilisation “or when the fibroids have grown on the cervix, acting as a coil preventing the entry of the  sperm into the uterus for fertilization, hence causing barrenness,” he explains.

However, there is no prevention for fibroids-which are also not brought about by lifestyle and as Dr Kireki puts it, it is not the end of life. They usually reduce in size and number after menopause since there is reduction of production of estrogen in the ovaries.

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