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Uterine Fibroids: Patient Information for Sub-Saharan Africa

Author's details

  • Dr. Khashau Eleburuike
  • MBBS (Ilorin) MSc. Global Health Karolinska Institute.
  • Resident doctor in family medicine in Northern Sweden.

Reviewer's details

  • Dr. Solaja Olufemi. Augustine
  • (MBChB, FWACS)
  • HOD, Department of Obstetrics and Gynaecology, General Hospital Mushin. Lagos, Nigeria.
Uterine fibroids are non-cancerous growths that develop within the uterus (womb), as suggested by the name uterine fibroids.
  • Date Published: 2025-06-03
  • Date Updated: 2025-06-03

Uterine Fibroids: Patient Information for Sub-Saharan Africa

Introduction

What are Uterine Fibroids?

Uterine fibroids are non-cancerous growths that develop within the uterus (womb), as suggested by the name uterine fibroids. They are common among women of childbearing age, especially those between 30-50 years old. While they are not life-threatening, they can cause significant discomfort, some form of body shaming and occasionally may affect fertility in some cases.

Discussion

Causes of Uterine Fibroids

The exact cause of fibroids is unknown, but factors such as family history, hormonal changes (especially oestrogen that occur during puberty), and age, have been associated with an increase in the risk of developing it. Furthermore, African women tend to develop fibroids more often, and sometimes at a younger age, compared to women in other parts of the world.

Signs and Symptoms

Some women with fibroids may not experience symptoms, but common signs include:

  • Heavy or prolonged menstrual periods.
  • Pain in the lower abdomen or pelvis.
  • Frequent urination due to pressure on the bladder.
  • Difficulty in conceiving or complications during pregnancy.
  • Abdominal swelling.

Diagnosing Uterine Fibroids

A medical doctor or gynaecologist can diagnose fibroids after a thorough history, general examination, abdominal and a pelvic examination. Imaging investigation like an ultrasound scan can aid the diagnosis and can be used to make diagnosis in those without symptoms. 

Early diagnosis can help manage symptoms and reduce complications.

Treatment Options

Treatment depends on the age of the patient, the size, number, and location of fibroids, as well as the severity of symptoms:

It can be categorised into medical and surgical

Medical treatment includes medications and non-surgical treatment

Medications: These include hormonal treatments that can help control symptoms, such as heavy bleeding and reduce the size. 

Others include analgesics and non-hormonal drugs to also reduce bleeding

Non-surgical treatments: In some cases, procedures like uterine artery embolization can shrink fibroids.

Surgery: For large or symptomatic fibroids, surgery may be required. This includes myomectomy (removal of fibroids) or hysterectomy (removal of the uterus) and these could be done by Minimal Access Surgery (MAS) or by Laparotomy (Open surgery).

Surgery may be more challenging in areas with limited healthcare facilities.

A number of women may delay seeking treatment (especially women in sub-Saharan Africa), due to lack of awareness or fear of surgery, leading to complications; as it continues to grow bigger, leading to e.g. severe anaemia from heavy bleeding, amongst others.

Living with Uterine Fibroids

In Sub-Saharan Africa, managing fibroids can be difficult due to limited access to specialized care. However, early medical attention can help control symptoms and reduce complications. 

Community health workers and education programs can play a crucial role in raising awareness and providing guidance on managing fibroids.

Conclusion

If you experience heavy menstrual bleeding, low abdominal pain or discomfort or difficulty getting pregnant, it is important to seek medical care. Early intervention can improve quality of life and prevent long-term health problems.

References
  • Ginindza V, Nyirenda M, Hlongwa M, Ginindza TG. Mapping evidence on the distribution of uterine fibroids in sub-Saharan Africa: A scoping review protocol. Plos one. 2024 Jul 3;19(7):e0298246.
  • Adawe M, Sezalio M, Kanyesigye H, Kajabwangu R, Okello S, Bajunirwe F, Ngonzi J. Prevalence, clinical presentation and factors associated with Uterine fibroids among women attending the Gynecology Outpatient Department at a large Referral Hospital in Southwestern Uganda. East Africa Science. 2022 Mar 31;4(1):48-53.
  • Stewart EA. Uterine fibroids. The Lancet. 2001 Jan 27;357(9252):293-8.
  • De La Cruz MS, Buchanan EM. Uterine fibroids: diagnosis and treatment. American family physician. 2017 Jan 15;95(2):100-7.