Academy Award-winning actress Lupita Nyong'o recently shared on Instagram that she has fibroids. The actress revealed that she has had 77 uterine fibroids over the course of her lifetime – the largest of which were the size of an orange. The actress took to social media to share her story in a bid to raise awareness for the common condition.
Fibroids are non-cancerous growths that develop in or around the womb (uterus). They’re thought to affect two in every three women – though many women won’t even realise they have them as they won’t have any symptoms.
Fibroids are made up of muscle and fibrous tissue. Their growth is driven by hormones such as oestrogen and progesterone. They can vary massively in size, from pea-sized to the size of a watermelon. Some women will only have one discrete fibroid – while others, like Nyong'o, will develop numerous fibroids. They’re also sometimes known as uterine myomas or leiomyomas.
Age and ethnicity are the strongest risk factors for fibroids. Approximately 70-80% of women develop fibroids by the age of 50. Those of African ancestry have the highest prevalence and earliest onset of fibroids, with 60% of black women affected by age 35. Fibroids also tend to be larger, more numerous and cause worse symptoms in black women.
Symptoms of fibroids can be many and varied. Heavy periods (menorrhagia) are the most common symptom. Prolonged bleeding (for more than seven days) and bleeding between periods can also be common. Heavy bleeding can also lead to anaemia (low iron), which may result in tiredness, shortness of breath and lightheadedness.
Pain can also occur with fibroids. For some, this pain only happens while they’re on the period or during intercourse, while for others the pelvic pain is constant.
This pain is usually related to the degeneration of the fibroids or pressure from the fibroids pressing against the bladder, rectum or ureters (the tubes that transport urine from the kidneys to the bladder). Pressure symptoms typically include feeling like you need to urinate often or being unable to urinate and bowel dysfunction.
Fibroids can also cause problems when trying to get pregnant. Miscarriage may also occur, due to distortion of the uterine cavity (the place where a pregnancy would implant).
People with fibroids that become pregnant are also at higher risk of giving birth early, requiring a caesarean section to deliver and having a bleed following delivery.
Treating fibroids
Fibroids usually shrink after the menopause, since levels of oestrogen and progesterone decrease. However, they may still continue to grow in women who take hormone replacement therapy (HRT).
Treatment options for fibroids will depend on a variety of factors, including the sufferer’s symptoms, the size and location of the fibroids and their fertility wishes, as some treatment options can affect a woman’s ability to become pregnant in the future.
Pharmaceutical treatment options can help reduce bleeding (such as tranexamic acid and the combined hormonal contraceptive) or reduce the size of the fibroid by decreasing the amount of hormones present (such as GnRH agonists).
Surgical options can include uterine artery embolisation, which blocks the blood supply to the fibroids and effectively decreases bleeding and shrinks the fibroids, ablation (which removes the lining of the womb) and a myomectomy, in which fibroids are surgically removed.
Some women may also opt for a hysterectomy, where the womb is surgically removed. This is usually done in cases where a woman has large fibroids and severe bleeding. Both ablation and hysterectomy will make pregnancy impossible, so it’s important these options are only considered if you do not wish to have children.
All of these treatment options should help to improve symptoms. However, surgery doesn’t always prevent fibroids from growing back. This is something Nyong'o informed her followers of, saying that despite having 25 fibroids surgically removed, more than 50 are still growing inside her today.
It’s very common for fibroids to return following removal, as the underlying causes remain. At five years after removal, there’s an approximately 50-60% chance of fibroids recurring.
Fibroids are very common. While some women will have no symptoms whatsoever, others may find symptoms to be debilitating. Research to uncover better treatment options for those with fibroids is ongoing, especially looking at non-hormonal treatment options and less invasive surgical options.
Nicola Tempest does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
This article was originally published on The Conversation. Read the original article.
