The Sunday Mail
It is rare for women to discuss their reproductive systems.
Yet it is common for women to have unpleasant symptoms accompanying their monthly menstrual periods.
For most women, uterine fibroids and ovarian cysts are sometimes the root causes for untold suffering associated with reproductive health complications, even though figures are not readily available to show the intensity of the problem.
Sadly, most women suffer from these two conditions in silence.
Also due to the high cost of health care in the country, most are not privileged to seek medical help on reproductive health complications.
Mrs Elena Mutape (38) of Mabvuku has had to endure humiliation and shame by her family and relatives due to her 12-year childless marriage.
“I never wanted uterine fibroids or to be infertile. I desired children in my marriage, but God had different plans,” Mrs Mutape narrated her ordeal.
Initially when she could not conceive, Mrs Mutape thought a spell had been cast on her. She and her husband sort spiritual help, all to no avail.
She recalls taking various herbs in her quest to bear children.
After a while, she decided to visit a renowned gynaecologist in the country. This is when she was told that she had uterine fibroids.
The gynaecologist advised her that if she wanted to conceive she would have to undergo an emergency surgery to remove the tumours.
“We decided to go ahead with the surgery last year, even though it was expensive, we had no other choice,” she explained.
“We have confidence in God. The Lord willing, l will conceive. However, we were told that pregnancy is not a guarantee even after surgery, we are just waiting for a miracle.”
Miss Vaida Nyoni of Cranborne (27) suffers from ovarian cysts, she has been feeling a lot of discomfort, even before she was diagnosed of the cysts.
“I have been feeling the discomfort for about a year, l started feeling full, bloated and constipated about six months ago and my doctor said it was just my intestines. It made sense then,” she said.
After a while, she went to her doctor again, this time complaining of sharp pains on the left side of her lower abdomen. The doctor then figured she had a minor ovarian cyst on that side.
The doctor made an appointment for Miss Nyoni to go for an ultrasound scan for further examination.
She was told by the radiologist that her bladder was full.
“When I went to my doctor for an explanation of the results the following day, I was told that I have a 22cm ovarian cyst on the right side and my bladder was flattened against my pelvic bone and it was all because of the cyst,” Miss Nyoni narrated in tears.
Her doctor advised her to have the cysts surgically removed as soon as she could.
“After the surgery, l felt like l had been given a second chance in life,” she said.
Uterine fibroids are benign tumours that originate in the uterus (womb). Although they are of the same smooth muscle fibres as the uterine wall (myometrium), they are much denser than myometrium and they are usually round.
Health experts often describe uterine fibroids based upon their location within the uterus. Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus).
Sub-mucosal fibroids are located inside the uterine cavity beneath the inner lining of the uterus, while intramural fibroids are located within the muscular wall of the uterus.
Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary.
There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two types of functional cysts include follicle and corpus luteum cysts.
Researchers say that during a woman’s menstrual cycle, an egg grows in a sac called a follicle. In most cases, this follicle or sac breaks open and releases an egg. But if the follicle doesn’t break open, the fluid inside can form a cyst on the ovary.
Follicle sacs typically dissolve after releasing an egg. But if the sac doesn’t dissolve and the opening of the follicle seals, additional fluid can develop inside the sac and this accumulation of fluid causes a corpus luteum cyst.
Surprisingly enough, health specialists across the globe do not have an explanation on why uterine fibroids occur.
A gynaecologist, who spoke on condition of anonymity for professional reasons, also could not clarify how fibroids develop.
“We don’t know why women develop these genetic tumours. Genetic abnormalities, alterations in growth factor (proteins formed in the body that direct the rate and extent of cell proliferation) expression, abnormalities in the vascular (blood vessel) system, and tissue response to injury have all been suggested to play a role in the development of fibroids,” she explained.
She added that family history of fibroids is also a key factor, while race appears to play a role as well. Women of African descent are said to be two or three times more likely to develop fibroids than women of other races.
Other factors that researchers have associated with an increased risk of developing fibroids include having the first menstrual period prior to the age 10, consumption of alcohol, uterine infections, and elevated blood pressure.
However, the gynaecologist contacted said that early pregnancies decreases the likelihood of fibroids developing.
“Fibroids have not been observed in girls who have not reached puberty, but adolescent girls rarely develop fibroids,” she added.
Overall, these tumours are fairly common and occur in about 70 to 80 percent of all women by the time they reach the age of 50.
Most of the time, uterine fibroids do not cause symptoms or problems, and a woman with a fibroid is usually unaware of its presence.
Often times, ovarian cysts do not cause any symptoms but the gynaecologist stressed that symptoms can appear as the cyst grows.
“Symptoms may include abdominal bloating or swelling, painful bowel movements, pelvic pain before or during the menstrual cycle, painful intercourse, pain in the lower back and thighs, breast tenderness, nausea and vomiting, among many others,” said the health specialist.
She added that severe symptoms of ovarian cyst which indicate a ruptured cyst that require immediate medical attention comprise of severe or sharp pelvic pain, fever, faintness or dizziness and rapid breathing.
Nevertheless, fibroids can also cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs.
Researchers say that if the uterine fibroids 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. Uterine fibroids that are degenerating can sometimes cause severe, localised pain. Large fibroids can cause pelvic pain, pressure on the bladder with frequent or even obstructed urination and pressure on the rectum with painful or difficult defecation,” said the gynaecologist.
“While fibroids don’t interfere with ovulation, some studies suggest that they may impair fertility and lead to poorer pregnancy outcomes. Occasionally, fibroids are the cause of recurrent miscarriages. If they are not removed, the woman may not be able to sustain a pregnancy.”
Both uterine fibroids and ovarian cysts can be treated through medical surgery. However,surgery is only performed on cysts when there is need.
Most ovarian cysts naturally go away without treatment.
“If one has recurrent ovarian cysts, the doctor can prescribe oral contraceptives to stop ovulation and prevent the development of new cysts,” said the health specialist.
“At times, the doctor may recommend treatment to shrink or remove the cyst if it doesn’t go away on its own or if it grows larger.
‘‘If left untreated, some cysts can decrease fertility.”
