Every July, the global spotlight is turned toward a condition that is seemingly everywhere and yet silenced: uterine fibroids. Despite affecting millions of women worldwide, conversations surrounding fibroids remain restricted to private, painful moments at home.

For many women, extreme period pain, severe bloating, and profound fatigue are brushed aside as “just part of being a woman.” But normalizing suffering is a public health failure. This Fibroid Awareness Month, we need to dismantle the stigma, and empower women to move from silent endurance to active self-advocacy.

What Actually is a Fibroid?

To address a problem effectively, we must first understand it without the clinical jargon that often alienates women.

​Structurally, uterine fibroids (known medically as leiomyomas) are benign, non-cancerous tumors that arise from the smooth muscle layer of the uterus which is the myometrium. 

They can vary drastically in size, ranging from microscopic seedlings to bulky masses that can significantly distort the shape and size of the womb.

One of the most important points to emphasize  is their benign nature. Fibroids are not cancer, and having them does not increase a woman’s risk of developing uterine cancer.

​However, their impact is heavily dictated by where they choose to grow. 

Submucosal fibroids grow just beneath the inner lining and are notorious for causing severe bleeding. 

Intramural fibroids embed deep within the muscular wall, creating persistent pelvic pressure. 

Meanwhile, subserosal fibroids project outward, frequently pressing against neighboring organs like the bladder or bowel.

Unpacking the Statistics

​The scale of this condition is staggering. By age 50, up to 70% of white women and more than 80% of Black women will develop uterine fibroids.

​This stark racial disparity is one of the most critical aspects of fibroid advocacy. Research consistently demonstrates that women of African descent develop fibroids at a younger age, experience larger and more numerous tumors, and suffer from significantly more severe symptoms.

​While the exact medical cause remains under active investigation, linked closely to genetic predispositions and hormonal fluctuations (estrogen and progesterone), the immediate priority is addressing the massive care gap created by late diagnoses and limited public awareness.

Symptoms You Should Never Ignore

​While some fibroids remain entirely asymptomatic (“silent”), many manifest in ways that severely compromise a woman’s quality of life. Recognizing these primary warning signs is the first step toward reclaiming good health:

• ​Menorrhagia (Abnormally Heavy Bleeding) –  Bleeding that routinely saturates pads/tampons within an hour, passing large blood clots, or menstrual cycles that last longer than seven consecutive days.

• Chronic Pelvic Pressure and Pain – A constant sensation of heaviness or fullness in the lower abdomen, persistent lower back aches, or sharp pelvic pain during physical activity.

• ​Urinary Frequency and Constipation – An enlarging fibroid physically pressing against the bladder or rectum, leading to a frequent urge to urinate or chronic gastrointestinal distress.

• Profound Fatigue and Anemia – The systemic consequence of chronic, heavy blood loss, resulting in a bone-deep exhaustion that disrupts daily productivity.

• Reproductive Challenges – Fibroids distorting the endometrial cavity, potentially interfering with embryo implantation or contributing to obstetric complications.

Management Options

Fortunately, identifying fibroids is relatively straightforward with an ultrasound. Once diagnosed, there is a spectrum of individualized options tailored to a patient’s age, symptom severity, and desire for future fertility.

• Watchful Waiting –  For small, asymptomatic fibroids, regular clinical tracking via yearlyl exams is often entirely sufficient, as many fibroids naturally shrink after menopause.

• ​Pharmacological Management: Medications like hormonal contraceptives or tranexamic acid can lightens menstrual flows, while GnRH agonists can temporarily shrink tumors ahead of surgery.

• ​Minimally Invasive Interventions: Techniques like Uterine Artery Embolization (UAE) cut off blood flow to the tumors, while hysteroscopic myomectomies allow surgeons to remove submucosal fibroids with zero external incisions.

• ​Surgical Intervention: A myomectomy removes individual fibroids while leaving the uterus intact, this is the gold standard for preserving fertility. A hysterectomy (complete removal of the uterus) remains the definitive cure for severe cases where fertility is no longer a consideration.

A Call to Action

​Awareness without action is just noise. As healthcare advocates and community members, our goal must be to normalize open conversations about menstrual and reproductive health.

​No woman should have to put her career, education, or personal life on hold because of unmanaged pelvic pain or heavy bleeding. If you are experiencing these symptoms, remember that your pain is real, your quality of life matters, and you have every right to advocate fiercely for your health. Let’s break the silence.

Author:

Favour Attah-Ohiemi 

4th Year Medical Student,

Lagos State University College of Medicine.