Women of African descent are much more likely to suffer from uterine fibroids and on average tend to develop this potentially debilitating medical condition, a major women’s health issue in southern Africa, at an earlier age than women of other population groups.
So says Dr Andrew Lawson, an interventional radiologist who practises at Netcare Femina Hospital in Pretoria. “Although all women are potentially at risk of developing uterine fibroids, there is much anecdotal evidence from around the world to suggest that women of African descent are at greater risk than Caucasian women of developing this condition and to suffer serious symptoms. This is supported by our own experience,” he adds.
“We are not completely certain what the reasons are for this, but we do know that a family history of uterine fibroids can considerably increase a woman’s risk of developing them. Fibroids in the African population also tend to be more numerous and larger than those seen in the Caucasian population,” points out Dr Lawson.
Uterine fibroids are non-cancerous, benign growths of the uterus occurring in women mostly between the ages of 20 and 55, explains Dr Lawson who uses a procedure that is relatively new to South Africa, called uterine fibroid embolisation (UFE) to treat the condition.
“UFE is becoming an increasingly popular treatment option for women who suffer from symptoms related to fibroids. Some of its advantages over other procedures include a reduced hospital stay, quicker recovery time and preservation of the womb/uterus. The UFE procedure itself is pain-free, although patients do experience pain when the fibroids start to die, which requires pain killers to control,” he adds.
Dr Lawson says symptoms and the severity of symptoms can differ significantly from person to person depending on where the growths are situated in the uterus, what type of fibroids are present, and how large they are. Common symptoms include the following:
- Heavy menstrual bleeding that in many cases also lasts for prolonged periods of time. Some women have a week or even two of menstrual bleeding
- Pelvic pain and/or a feeling of bloating
- Backache or leg pains
- Pain during sexual intercourse
- Anaemia (iron deficiency) as a result of blood loss. This can result in low energy levels and feeling exhausted
- Frequent need to urinate
“Some sufferers feel so exhausted that they are barely able to undertake their daily activities. Many women come to believe that their symptoms must be normal and simply try to live with them as best they can. The net result of all of this is that there are large numbers of Southern African women whose condition goes undiagnosed, and whose quality of life is severely impacted.
“Uterine fibroids are a gravely underestimated women’s health issue on the sub-continent and it is important for us to improve awareness so that it can be tackled appropriately,” points out Dr Lawson.
He says that in the past, treatment for severe fibroids was a hysterectomy, the complete removal of the womb. “This is a major operation and, understandably, many women, particularly those in their childbearing years, are reluctant to undergo it, as they then cannot have children afterwards.
“In other cases the fibroids are removed in a major open surgery called a myomectomy. Unfortunately, patients, particularly those of African descent, who undergo a myomectomy quite often develop a recurrence in their fibroids. New treatment options such as uterine fibroid embolisation are now becoming available, and women should discuss these with their gynaecologists.
“UFE has many other advantages over the other surgical options. For example, UFE is a much less physically traumatic procedure than either a hysterectomy or myomectomy as it is undertaken through just a small puncture wound in the groin or wrist. Patients therefore recover much sooner and are only required to stay in hospital overnight. In addition, the risks involved in the procedure are considerably less.
After UAE the recurrence of fibroids is extremely low. While a second myomectomy for recurrent fibroids is difficult, in such cases a UAE is an effective and safe alternative.
“Of course many women also appreciate the fact that UFE is not only highly effective in reducing the fibroids and their associated symptoms, but provides an alternative to a hysterectomy,” says Dr Lawson.
He explains that a UFE procedure involves advancing a small flexible tube called a catheter through the puncture wound to the arteries that supply the fibroids. The arteries are injected with special particles that block the blood supply to the fibroid, causing it to shrink and die.
Greta Jones, Nursing Manager at Netcare Femina Hospital, says that, as uterine fibroids are such a common problem in Southern Africa, the hospital has established a dedicated treatment centre to assist patients from around the sub-continent. The centre offers UAE as one of its treatment options and these procedures are referred to and performed by Dr Lawson.
“We also offer our patients a choice whether they want the procedure performed via the traditional femoral artery approach through the groin, or via the radial artery in the wrist, which many patients find more comfortable.
Dr Billyy van der Merwe, Netcare’s director, Northwest Region, points out that the gynaecologists at Netcare Femina Hospital, a facility dedicated to women, carefully assess and recommend the most appropriate treatment for each individual fibroid case, every one of which is unique.
“Indeed every aspect of gynaecologic medicine can be handled by the specialists at this single specialised women’s facility, which is becoming a centre for treatment in this regard in Southern Africa,” he observes.
Besides Netcare Femina Hospital, UFE is also offered at Netcare Park Lane, Netcare Linksfield, Netcare Sunninghill and Netcare Sunward Park hospitals in the Johannesburg region, Netcare Unitas Hospital in Pretoria, UCT Private Academic Hospital in Cape Town, Universitas Private Hospital in Bloemfontein and Netcare St Augustine’s Hospital in Durban.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Femina Hospital
Contact: Martina Nicholson, Graeme Swinney or Meggan Saville
Telephone: (011) 469 3016
Email: [email protected], [email protected] or [email protected]