What Are Fibroids? A Condition Impacting Two in Every Three Women
Fibroids represent non-cancerous growths that develop within or around the womb, medically known as the uterus. Remarkably, many women remain unaware of their presence due to a lack of symptoms, making this a silent yet prevalent health issue.
Lupita Nyong'o's Personal Battle with Over 50 Fibroids
Academy Award-winning actress Lupita Nyong'o recently took to Instagram to share her personal journey with fibroids, revealing she has had 77 uterine fibroids throughout her lifetime. The largest of these growths were comparable in size to an orange. By sharing her story, Nyong'o aims to raise awareness about this common condition that affects countless women globally.
The Nature and Prevalence of Fibroids
Fibroids are composed of muscle and fibrous tissue, with their growth primarily driven by hormones such as oestrogen and progesterone. These growths can vary significantly in size, ranging from as small as a pea to as large as a watermelon. While some women may only develop a single discrete fibroid, others, like Nyong'o, experience numerous growths. Fibroids are also referred to as uterine myomas or leiomyomas in medical terminology.
It is estimated that fibroids affect approximately two in every three women, though many do not realise they have them due to asymptomatic cases. This highlights the importance of regular health check-ups and awareness.
Risk Factors: Age and Ethnicity
Age and ethnicity stand out as the strongest risk factors for developing fibroids. Research indicates that approximately 70-80% of women will develop fibroids by the age of 50. Women of African ancestry face the highest prevalence and earliest onset, with around 60% of black women affected by age 35. Additionally, fibroids in black women tend to be larger, more numerous, and cause more severe symptoms compared to other ethnic groups.
Symptoms and Complications of Fibroids
The symptoms of fibroids can be diverse and vary from woman to woman. The most common symptom is heavy periods, medically known as menorrhagia. Other symptoms include prolonged bleeding lasting more than seven days, bleeding between periods, and anaemia resulting from heavy blood loss, which can lead to tiredness, shortness of breath, and lightheadedness.
Pain is another significant symptom, which may occur during menstruation, intercourse, or as constant pelvic pain. This discomfort often arises from fibroid degeneration or pressure on nearby organs such as the bladder, rectum, or ureters, causing frequent urination, urinary retention, or bowel dysfunction.
Fibroids can also impact fertility, increasing the risk of miscarriage due to distortion of the uterine cavity. Pregnant women with fibroids are at higher risk of preterm birth, requiring caesarean sections, and experiencing postpartum bleeding.
Treatment Options for Fibroids
Fibroids typically shrink after menopause as oestrogen and progesterone levels decline, though they may continue to grow in women using hormone replacement therapy (HRT). Treatment depends on factors such as symptoms, fibroid size and location, and fertility wishes, as some options can affect future pregnancy ability.
Pharmaceutical treatments include medications like tranexamic acid and combined hormonal contraceptives to reduce bleeding, or GnRH agonists to shrink fibroids by lowering hormone levels.
Surgical options encompass:
- Uterine artery embolisation, which blocks blood supply to fibroids to reduce bleeding and shrink them.
- Ablation, removing the womb lining.
- Myomectomy, surgically removing fibroids.
In severe cases, a hysterectomy—surgical removal of the womb—may be considered, particularly for large fibroids and heavy bleeding. However, ablation and hysterectomy prevent pregnancy, so they are only suitable for women not wishing to have children.
While treatments can alleviate symptoms, fibroids often recur. Nyong'o noted that despite having 25 fibroids removed, over 50 continue to grow inside her. Recurrence rates are approximately 50-60% within five years post-removal, as underlying causes persist.
Conclusion: Awareness and Ongoing Research
Fibroids are a very common condition, with some women experiencing no symptoms while others face debilitating effects. Ongoing research aims to develop better treatment options, including non-hormonal therapies and less invasive surgical techniques, to improve quality of life for those affected.
This article is based on information from The Conversation, authored by Nicola Tempest, a Senior Lecturer and Consultant Gynaecologist at the University of Liverpool.
