SOURCE:The Namibian
SO common are these benign (non-cancerous) swellings that one in every four females who is of reproductive age has them (fibroids)in their uterus.
The uterus (womb) is an exclusive female structure which provides sanctuary to the unborn baby for nine months. The unoccupied uterus is located in the lower abdomen and is comprised of 3 main layers, the innermost of which provides anchorage to the growing infant.

In times when it is not providing these hospitality services, the uterus will by default then shed off this superficial pregnancy supportive layer in a monthly fashion. It is the middle layer which is called upon during labour - its muscular nature providing strong propulsive forces which see the baby out into the free world. On the outside of the uterus is a protective covering.

Fibroids can find comfort in any of these different uterine layers. Their location, size and number may determine the type of symptoms (complaints) the patient will experience. Thus patients with fibroids normally have heavy and painful monthly periods - maybe more so in those where the swellings are affecting the inner and muscular layers.

Infertility is also common because the fibroids literally 'compete' for space with the developing fetus; the latter usually losing the battle resulting in an abortion - which is often recurrent. Because of the fibroids' size and number, the uterus may assume a very big size - simulating a pregnancy.

The cause of fibroids is not exactly known. However, they have been found to be more common in some females than in others. They normally occur after puberty and are reportedly seen more in women who get their first pregnancy late in life; in those in whom there is a long space between pregnancies and in the ones who never get pregnant at all (generally - "the good girls").

Females of the black race are at a higher risk than their white counterparts. Fibroids may occur singly or may be very numerous. The sizes also vary from as small as a peanut to as big as an adult's head. When they overstay, they may become as hard as stone.
An abdominal examination by the doctor will establishe the presence of these masses. An ultrasound scan is likewise used as an additional investigation tool.

Treatment for fibroids is generally by surgical removal. The location and number of these masses will determine the extent of the surgery. The fibroids may be excised out of the uterus if they are accessible, but on occasion cutting them out one by one may be challenging to the operating doctor who then opts for total removal of the uterus - this is particularly in women who are beyond their reproductive period and may not need the uterus any more.

Sometimes the fibroids do not cause any symptoms or maybe too small and no treatment is needed at all.
When the fibroids have been removed, they are ultimately sent to the pathology laboratory to confirm their benign nature.

• Namibia