Hello Doctor, How can I prevent fibroids? What causes them and what advice do you have for women suffering from them?Jennifer Kabasinga 27,Kicukiro----------------------------------------------Dear Jennifer,Fibroids are the benign tumors that occur in the uterus. This commonly occurs in middle aged and elderly women.  When small, there may be no symptoms at all. But fibroids bigger in size can cause many problems depending on their number and location. Excess and prolonged bleeding is the most common symptom, necessitating surgical intervention. There can be pain in the lower abdomen, backache, constipation, frequency of urination or urinary incontinence. At times, one may have infertility due to fibroids because the location of the fibroid may impede implantation of the embryo. In the case of pregnant women, it can lead to a miscarriage or abortion.The exact cause of fibroids is not known. But they are postulated due to some external factor causing change in DNA of a muscle cell, causing it to grow more which is further stimulated by estrogens (feminizing hormone). Lack of exercise, obesity and using estrogen containing contraceptive pills are some of the risk factors postulated for causing and aggravating fibroids.  Early menarche (beginning of menstrual periods),  alcohol consumption, particularly beer,  urinal infections and high blood pressure are other risk factors associated with the increased risk of having fibroids.Hereditary susceptibility is a key factor in developing fibroids, as fibroids have often been seen in women of the same family. Some racial predisposition also exists as studies show that women of African descent are 2 to 3 times more likely to develop fibroids than women of other races. One cannot modify the genetic and racial susceptibility. But the other risk factors can be taken care of if preventing fibroids. Obesity is prevented through a suitable diet and adequate exercise.  Good control of hypertension by medicines and diet is also useful in this regard. Alcohol is harmful to health in many ways and is best avoided. As one grows older, hormonal contraceptive pills should be avoided as they have many adverse effects and can also induce fibroids. The diagnosis can be made easily by an ultrasound examination. Women suffering from fibroids should know that, small sized fibroids need no treatment except pain killers for the pain. Hormonal treatment on a doctor’s advice can help to reduce the size of the fibroids. Anabolic steroids like danazol can reduce fibroids successfully but the secondary effects like weight gain and hirsuitism are more troublesome.  Diet should include plenty of vegetables and fruits more so those which help improve anemia like beetroot,   green vegetables, passion fruit, guava, e.t.c.   Iron, folic acid supplements are useful to correct the anemia caused by fibroids.If in spite of conservative therapy, symptoms persist, surgical removal of the fibroids or even of the entire uterus remains the only option.If you have a question to ask Dr. Pande email womentoday@newtimes.co.rw