What Every Woman Should Know About FIBROIDS - Dr. ABAYOMI AJAYI

Dr Abayomi Ajayi, the MD of Nordica Fibroids Care Center in Lagos has revealed that it is dangerous for women who want or still want to have children to treat Uterine Fibroids with drugs. He stated this while speaking with Hajia Saratu Kassim, the founder of Fertility Support Group on his popular Dr Abayomi Live programme on Facebook and Zoom.

However, the vastly experienced gynaecologist has revealed 5 ways women suffering from uterine fibroids can be treated. He said it can be treated via Laparoscopy, Hysteroscopy, Uterine axis embolisation and HIFU.

He described HIFU which stands for High-Intensity Focused Ultrasound as the newest and by far the most effective method of treating uterine fibroids, because it is a non-invasive method and surgery is not required.

The essence of the interview was to look at the Causes and Treatments of uterine fibroids from the patients’ perspective. Hajia Kassim, who mentioned that she’s had fibroids was a good representative of the patients.

Although the time wasn’t sufficient to answer all the questions, Dr Abayomi announced that he would be in Abuja on June 11, 2022, to hold a hangout on Infertility and Fibroids and he enjoined everyone chanced to participate.

Brands Editor, DAMILARE SALAMI (08155134152) monitored the proceedings and here are excerpts.

 

What is Uterine Fibroid?

Fibroids are growths in or on the uterus and they are so common. One thing I need to say straightaway here is that it is not all fibroids that need to be treated. So the fact that you found out that you have fibroids, is not the end of the world. Even if it needs treatment, in 2022, there are several options that are available for you. Why a lot of people think fibroid is the end of the world is that they believe that the only solution is surgery and they are afraid. They don’t want to go through the knife and that’s one of the things that we would like to correct now.

Every woman below the age of 50 stands the risk of about 70-80 per cent of having fibroids in her lifetime. But it’s not every fibroid that needs to be treated.

What are the types of fibroids that need to be treated and when is it necessary to seek treatment if you are diagnosed with fibroids?

Maybe we should talk about those who are at risk because Age is a very important factor in Fibroids. The older a woman gets, especially when she doesn’t have children, the riskier it becomes for her to have Fibroids. I thought I had seen a lot of Fibroids but in the recent past, I’ve seen quite a number of Fibroids because this Fibroids care centre started about a year ago and the only thing we do there is treat Fibroids. What I’m saying is that there’s a twenty-something years old lady that’s carrying a very big Fibroid and she’s afraid of surgery. The fact that you are black puts you at the risk of having uterine Fibroid. People who see their periods earlier on in life are more pre-disposed to Fibroids. It doesn’t mean that they will or will not have it; rather it simply means that they are at risk of having Fibroids. People who are using birth control pills are at a higher risk of having Fibroids. Of course, the most important factor is family history. If you have a mother or sister with Fibroids, you stand a very high risk of having it.

When you have Fibroids, there are 4 factors that the doctors look at. One, your Age. Two, do you have symptoms at all? 3, do you still want to have children and 4, where exactly are these Fibroids located?

We doctors used to say that there are three or three and a half Fibroids but three main types. We have the one that stays where the baby is supposed to be, which is the endometrium, which is what we call the submucous fibroid. We have one that’s in the muscle of the uterus, we call it the intramural fibroid and the one outside the uterus, we call it subserous fibroid. The doctor needs to look at all these factors before deciding if the woman needs to be treated or not. For instance, a woman is 45 and she’s done having children,  and she had an incidental finding, no symptom at all and the fibroid is about 2 to 3 cm in diameter, you don’t need to do anything about such fibroid. All you need is just monitor and see because hopefully when she reaches menopause, the fibroid is going to start shrinking. There’s no point doing anything about such a fibroid, it’s not every fibroid you perform surgery on, there’s something we call expectant management. So that’s one way.

There are some drugs that we can use, but the thing is that you cannot use these drugs if you still want to have a baby because the drugs will not allow you to ovulate and once you don’t ovulate, you cannot get pregnant. But for people who have probably stopped having babies and they are nearing menopause, drugs can be used for them. And now the commonest way of treating which is surgery. But surgery also has been simplified. There are so many ways and it is not compulsory any longer that you cut the patient with a knife. There is Q.O surgery and now we have one that you don’t even cut anything at all, what we call HIFU.

How does a woman know that she has fibroids?

This is also another very important question because some women don’t have symptoms at all And it is very tricky because the only way they find out is by doing a scan and that’s always accidental just as I said earlier on. But for people who have fibroids, the commonest symptom is with the menstrual flow. It’s either the flow is heavy and the number of sanitary towels such a person uses increases or the menstruation becomes prolonged. So if you’re bleeding for 5 days before suddenly it becomes about 7 days and it’s heavy or sometimes, some people even bleed in-between periods and for some, they just notice that there’s a swelling in their abdomen. Sometimes this swelling becomes very painful and at times, because the swelling is compressing the bladder and rectum, the woman will start urinating very frequently. I’ve seen women who will not even be able to urinate at all, you know what happens to men and prostrate, sometimes it happens to women with Fibroids too. And for some, it’s that they have constipation, they are not able to empty their rectum because of the presence of the Fibroid. Those are some of the things that may make a woman suspect that she might have Fibroids.

Can a woman get pregnant with Fibroids?

Yes, people do get pregnant with fibroids but remember that when we were looking at different kinds of Fibroids, we talked about location. It depends on the location of the Fibroids. There are some Fibroids that have effects on pregnancy and there are some that don’t. If you have a Fibroid that is outside the uterus, usually, it doesn’t have any effect on pregnancy except if it’s so big that the uterus cannot expand. If the Fibroid is as big as a 3month or 4-month-old baby, once the pregnancy gets to about 5 months, the woman might be forced to have a premature delivery. But if the Fibroid is where the baby should be, it’s a different ball game entirely, that could make the woman miscarry or it could even prevent her from getting pregnant if it’s occupying the whole space. However, for either intramural or subserosal, the woman can get pregnant without any effect at all. For intramural also, sometimes you could have what we call red degeneration of pregnancy which could be very painful and also lead to admission before it subsides and so on… So people can get pregnant with Fibroid but it’s better the Fibroid is dealt with before you attempt getting pregnant.