Women should undergo routine screening to help detect uterine fibroids early, as the condition often develops silently without symptoms, health experts say. Fibroids, non-cancerous tumors that grow in or on the uterus, affect an estimated 20 to 30 per cent of women of reproductive age globally, according to Fibroid Institute, a specialised medical center in Texas. While they are most common in women in their late 30s and 40s, studies show that about 1 to 2 per cent of women in their 20s and up to 26 per cent of those in their early 30s are diagnosed with the condition. ALSO READ: Fibroids: A common yet overlooked women’s health issue in Rwanda When fibroids become a concern Dr. Stephen Rulisa, Professor of Obstetrics and Gynecology at the University of Rwanda, said the exact cause of fibroids remains unknown, with many cases only identified during routine medical checkups. When fibroids are not causing symptoms, treatment is unnecessary since they are non-cancerous. However, management depends on severity, as surgical options carry risks, require recovery time, and recurrence is possible. “When the tumors are inside the uterus, the uterine cavity is affected, which can interfere with childbirth. We usually monitor symptoms such as excessive bleeding or painful menstruation,” he explained. “Every woman has what is normal for her. If the flow increases in volume or duration, or if the pain becomes severe and leads to hospitalisation, then there is a problem,” he added. The gynecologist added that fibroids may cause infertility and abdominal discomfort, sometimes making the abdomen appear enlarged. Pressure on the bladder can lead to frequent urination or constipation. In severe cases, removal of the uterus, known as a hysterectomy, may be required. Risk factors, underdiagnosis According to Dr. Kenneth Ruzindana, a consultant at Kigali University Teaching Hospital (CHUK), risk factors include being overweight, early onset of menstruation, low vitamin D levels, not having children, and a family history of fibroids. In Rwanda, he noted, the condition remains underdiagnosed, with many women unaware they are affected. Fibroids are often discovered during routine medical visits, including antenatal care. He explained that fibroids consist of muscle and fibrous tissue, ranging from small nodules to large masses. “They are mainly common among Black women. While exact statistics for Rwanda are unavailable, research from neighbouring countries indicates that over half of women will develop fibroids at some point in their lives,” Dr. Ruzindana noted. Symptoms, complications Symptoms vary widely depending on size, location, and individual sensitivity. Larger fibroids are more likely to cause pain or pressure, while those within the uterus result in heavy menstrual bleeding. According to Dr. Ruzindana, many women remain asymptomatic and discover fibroids incidentally during medical visits. When symptoms appear, they are usually menstrual in nature, including heavy or prolonged bleeding lasting more than seven days or requiring frequent pad changes, including at night. Other symptoms include pelvic pain or pressure, heaviness in the lower abdomen, pain during sexual intercourse, and fertility challenges. In some cases, fibroids may block the fallopian tubes, distort the uterus, or increase the risk of miscarriage, mostly in early pregnancy. He highlighted that heavy bleeding may require changing pads or tampons every two hours and passing large blood clots. Such blood loss can lead to anemia, causing fatigue, weakness, dizziness, and pale skin. Affected women may struggle to work, care for families, or participate in community life due to persistent exhaustion. Dr. Ruzindana maintained that pain and pressure can interfere with daily movement, including walking, standing, or sitting, and may cause lower back and leg pain. Urinary symptoms such as frequent urges and a feeling of incomplete bladder emptying further add to discomfort. Pain during sexual intercourse may also lead some women to avoid intimacy, contributing to emotional strain and relationship difficulties. Fertility and pregnancy concerns Fibroids that block the fallopian tubes or distort the uterus can make conception difficult and increase the risk of recurrent miscarriage. Pregnancy in women with fibroids may also lead to complications such as early labor, abnormal fetal positioning, or severe pain.
