For three years, I had heavy menstrual bleeding (at times with blood clots) and my menstrual periods lasted longer than normal. I also urinated more often than usual and experienced a lot of pain during sexual intercourse,” Darlene Zaninka, 35, says.

Zaninka, who was an expert at self-medication, resorted to painkillers and antibiotics hoping that the ‘discomfort’ would be reversed but she was wrong.

"I knew almost nothing about fibroids. I thought it was a common infection which could be treated but I was surprised when the pain kept increasing,” she says.

When the pain became unbearable, Zaninka was forced to visit the doctor for help. She was dumbfounded when she learnt that she had three fibroids in her womb.

According to research, about 30 percent of all women get fibroids by age 35, and about 70-80 percent of them do so by the age of 50. Although Healthy Times could not immediately establish the exact number of people with fibroids in Rwanda, Dr Samuel Kagali, a gynaecologist in Kigali, said he attends to at least 10-15 people suffering from uterine fibroids a month. And the number would most likely be much higher if a survey were to be done across the country.

What are fibroids?

Dr Kagali says fibroids are benign tumours, meaning non-cancerous growths in the womb that sometimes cause heavy menstrual periods and at times prolonged urinary problems and abdominal swellings, miscarriages, failure to conceive and abdominal heaviness.

Although they are composed of the same smooth muscle fibres as the uterine wall (myometrium), they are many times denser than normal myometrium. Uterine fibroids are usually round or semi-round in shape, according to online medical source. Fibroids may grow as a single tumor or in clusters, both of which can vary in size. A single fibroid can be less than one inch in size, or can grow to eight or more inches.

"Fibroids tend to swell when levels of oestrogen are high, for instance during pregnancy. They also shrink when oestrogen levels are low, especially during menopause,” Dr Kagali adds.

What causes uterine fibroids?

It’s not very clear why women develop these tumours. Genetic abnormalities, changes in growth factor expression, irregularities in the blood vessel system, and tissue reaction to injury have all been said to have a hand in the cause of fibroids.

Ones family background is also a risk factor; a woman whose family has a history of catching fibroids is also likely to get them too. Ones racial leaning also seemingly has a huge role, those with an African origin are two to three times more likely to catch fibroids than women of other races.

Women of African extraction also develop fibroids at a younger age and may have symptoms from fibroids in their 20s, in contrast to Caucasian women with fibroids, in whom symptoms typically occur during the 30s and 40s.

Symptoms

Dr. Alphonse Butoyi, a gynecologist at Hopital le Croix, Kigali says many women with uterine fibroids have no symptoms. However, abnormal uterine bleeding is the most common symptom of a fibroid.

"If the tumours are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting between menses. Women with excessive bleeding due to fibroids may develop iron deficiency anaemia. Uterine fibroids that are deteriorating can sometimes cause severe, localised pain,” Dr Butoyi says.

Risk factors

According to the US’ National Women’s Health Network, African American women are more likely to experience fibroids, and do so at a younger age. As women age, fibroid growth rates decline for most women, but not for African American women, notes the study. Furthermore, having a Body Mass Index (BMI) above the "normal” range (e.g., a BMI indicating the individual is overweight or obese) could also cause fibroids.

Dr. Rachna Pande, an internal medicine specialist with Ruhengeri Hospital, says that women on contraceptives, those taking diet rich in red meat and sparse in vegetables, those using alcohol regularly are more prone to develop fibroids.

"Women after menopause have much lower risk due to reduced levels of estrogen. Hereditary factors can also cause fibroids. A woman is more likely to have fibroids if any of her close female blood relatives like mother or a sister have fibroids,” says Pande.

Treatment

Doctors say many people confuse fibroids with other cancerous tumours. However, they can easily be diagnosed by ultra sound scanning by qualified medical personnel.

"Fibroids can also be treated or managed conservatively by managing the symptoms or through carrying out operations mainly to remove the fibroids and sometimes the uterus might be removed,” Dr Kagali explains.

Another method that is non-surgical is the uterine artery embolisation which stops the blood supply to the fibroid, causing it to shrink and eventually die.

Dr Kagali also notes that treatment depends on several factors, including age, type of fibroid, sternness of symptoms and whether one is pregnant or planning to have more children.

He says the severity of signs or symptoms will count on various factors, such as the dimensions/size and location of the fibroids. These mainly occur among women who delay to conceive mostly above 30s.

However, they are also found in women of different ages and those who have already delivered.

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Seven Foods That May Shrink Fibroids

Foods aren’t known to shrink fibroids, but certain foods in a healthy diet may help keep them from growing and minimize your symptoms.

Fruits and Vegetables

Fruits and vegetables provide rich amounts of disease — and inflammation-fighting nutrients and fiber, which help promote appetite and weight control. These factors are important because inflammation and excess pounds can contribute to fibroids. In a study published in "Asia Pacific Journal of Clinical Nutrition” in 2013, researchers analyzed the diets of premenopausal women and found that eating rich amounts of fruits and vegetables lowered the women’s risk of developing fibroids. A high body mass index, on the other hand, increased the risk.

Beans and Lentils

Legumes, such as beans and lentils, are top fiber sources, making them prime choices for weight control. They also have a low glycemic index, or a mild impact on your blood sugar. High-glycemic carbohydrate sources, such as sweets, can cause inflammation and increase fibroid growth, according to Dr. Christiane Northrup, a physician and women’s health expert. Replacing these foods with nutritious, low-glycemic carbohydrate sources, such as legumes, can help minimize your symptoms. As plant-based protein sources, beans and lentils also provide nutritious alternatives to fatty meats, which increase inflammation. Healthy legumes-based dishes include vegetarian chili, black bean and veggie burritos served in whole-grain tortillas and dal, an Indian lentil soup.

Unprocessed Grains

White foods, such as starchy white bread, increase insulin production in your body and influence the way estrogen is metabolized, says Northrup, increasing your risk for fibroid symptoms. Skip refined starches and stick to whole, unprocessed grains for improved uterine health and protection from fibroid growth. Whole grains are also also lower-glycemic and richer in antioxidants, fiber and protein than their processed counterparts. Nutritious examples include oats, brown rice, wild rice, quinoa and barley.

Low-Fat Dairy Products

Uterine fibroids are up to three times more prevalent in black women than white women, according to a "Today’s Dietitian” article by registered dietitian Megan Tempest, published in May 2012. Some evidence suggests this is likely because African-Americans consume significantly fewer dairy products than whites. The protective properties of dairy, according to researchers who’ve investigated this link, lie in the ability of calcium to inhibit cell growth that leads to the tumors. If you tolerate dairy products well, incorporate low-fat varieties, such as milk, yoghurt and cottage cheese, into your diet. If not, choose lactose-free fortified milk or a nondairy equivalent, such as almond milk. Limit high-fat items, such as whole milk and fatty cheeses, which contribute to inflammation.

Soy and Flaxseeds

Soy and flaxseeds contain phytoestrogens — natural substances with estrogenlike properties. Northrup says most women can benefit from phytoestrogens, which block the estrogen receptors on the cells in fibroids, potentially minimizing symptoms and lowering your risk for fibroid growth. Flaxseeds also provide fiber and omega-3 fats, which guard against inflammation and tumor growth and help rid your body of excess estrogen.

For soy, which also offers a lean protein alternative to fatty meats, consume soy milk, tofu or edamame — steamed, podded soybeans. Add ground flaxseeds to smoothies, yoghurt and cereals.

Agencies