Uterine fibroids: Dr. Ayertey shares valuable insights

By Daniel NONOR, Accra

DR. Padi Ayertey, a renowned gynecologist and specialist in women’s fertility,at  Elimas Health and Community Aids, has shared valuable insights into the complexities of uterine fibroids and the implications of modern lifestyle choices on women’s reproductive health.

What are uterine fibroids?

Dr. Ayete defined uterine fibroids as “growths in the uterus made of fibrous tissue and smooth muscle.” These growths develop when a single muscle cell in the uterus begins to multiply uncontrollably.

“Normally, the body regulates estrogen and progesterone levels each month, but one cell might decide, ‘I’m not following the rules anymore,’” he explained. This process leads to the formation of a fibroid, which can start as small as a pinhead and grow significantly if the hormonal environment supports its development.

How fibroids impact reproductive health

The presence of fibroids in the uterus can significantly affect a woman’s ability to conceive and carry a pregnancy.

“Depending on where the fibroid is located, it can interfere with conception or pregnancy,” Dr. Ayete noted.

Fibroids can sometimes occupy space meant for the embryo, acting as a natural contraceptive if positioned unfavorably.

Dr. Ayete elaborated on the types of fibroids: Submucosal fibroids grow inside the uterus and can affect conception. Intramural fibroids are embedded within the uterine muscle and may cause shifts in the uterine lining, impacting pregnancy but not always preventing it. Subserosal fibroids grow on the exterior of the uterus and may cause symptoms like frequent urination or constipation due to pressure on adjacent organs.

Prevalence and risk factors

Fibroids are notably prevalent among women in Ghana, affecting between 66% to 80% of them, with a higher occurrence among Black women.

Dr. Ayete noted that , “Fibroids can be tiny and go unnoticed, or they can grow large. It is more common among black women, and they tend to grow larger compared to white women.”

Genetic predispositions and early onset of menstruation (around 11 or 12 years old) are significant risk factors.

The impact of delayed childbirth

Dr. Ayete pointed the need for awareness which include encouraging early child birth  “We encourage our children to finish their master’s degrees or even obtain their PhDs before starting a family. This delay can unintentionally create problems.”

 He explained that delaying childbirth, especially when combined with an early onset of menstruation, can foster an environment conducive to fibroid growth. “The longer you delay having children, the more challenging it becomes,” he said.

The doctor emphasized the biological limitations women face as they age. “Women are born with about 2 million eggs. By puberty, this drops to around 400,000. Each month, thousands are lost, and no new eggs are produced.” By age 35, egg quality and quantity diminish significantly, making conception more difficult.

While acknowledging the challenges of delaying childbirth, Dr. Ayete also recognized the benefits of waiting.

“Many people find joy in having children later, once they’ve achieved personal and professional goals,” he said. For some, the joy of traveling or having more meaningful experiences with their children later in life can be a rewarding outcome.

Dr. Ayete emphasised the importance of being informed and making deliberate choices regarding reproductive health.

“Education and understanding the implications of your choices are crucial,” he emphasized. Whether choosing to have children early or late, awareness of the potential consequences allows individuals to align their decisions with their life goals effectively.

Symptoms

Many people who have uterine fibroids don’t have any symptoms. In those who do, symptoms can be influenced by the location, size and number of fibroids.

The most common symptoms of uterine fibroids include:

• Heavy menstrual bleeding or painful periods.
• Longer or more frequent periods.
• Pelvic pressure or pain.
• Frequent urination or trouble urinating.
• Growing stomach area.
• Constipation.
• Pain in the stomach area or lower back, or pain during sex.

Rarely, a fibroid can cause sudden, serious pain when it outgrows its blood supply and starts to die.

Often, fibroids are grouped by their location. Intramural fibroids grow within the muscular wall of the uterus. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids form on the outside of the uterus.

When to see a doctor

See your doctor if you have:

• Pelvic pain that doesn’t go away.
• Heavy or painful periods that limit what you can do.
• Spotting or bleeding between periods.
• Trouble emptying your bladder.

Ongoing tiredness and weakness, which can be symptoms of anemia, meaning a low level of red blood cells.