In recent times, cases of debilitating uterine fibroids among African women are increasing at an alarming rate. It is estimated that by age 50, as many as 80% of African women will have a fibroid. Uterine fibroids occur much more frequently among women of African descent than among other people groups. The symptoms of fibroid among women of African descent are also known to be more aggressive and to cause more serious discomfort when compared to their counterparts elsewhere. Despite this reality, not much research has gone into the causes, prevention and treatment of uterine fibroids across Africa, especially from the perspective of indigenous remedies. There is, therefore, an urgent need to look into the possible causes of the high occurrence of fibroid among African women, as well as highlight locally available treatments.
What are Uterine Fibroids?
Uterine fibroids are benign tumours that originate from the uterine smooth muscle cells and fibrous connective tissue. Many women with fibroids do not experience any symptoms at all. However, some do experience symptoms, which can include excessive menstrual bleeding, cramps and pelvic pressure that may be excruciating, periods that are longer than seven days, discomfort during intercourse, backache or leg cramps, frequent urination, constant and severe fatigue, lower abdominal distention, swelling, or cramping, rectal pain, bowel issues (constipation or diarrhoea), and other digestive issues, among others.
Prevalence of Fibroids among African Women
The presence of calcified fibroids in the bodies of cave women and Egyptian mummies provides proof that uterine leiomyomas, often known as fibroid tumours, have been a problem for women ever since ancient times. Yet in recent times, cases of fibroids have been on the increase in Africa, as have the size and the severity of symptoms presented by the tumours. In a five-year study conducted in a major referral health facility in Nigeria’s capital city, Abuja, almost a quarter of all major gynaecological surgeries were for the removal of fibroids. Similarly, a cross-sectional research investigation in Ghana found that 36.9% of 244 women who were not pregnant, but were referred for abdominal ultrasonography, had uterine fibroids. Further, a study of pregnant women receiving abdominal ultrasound examinations in two Cameroonian regional hospitals found that 16.8% had uterine fibroids.
In the United States, fibroids affect around 25% of women of African descent between the ages of 18 and 30, but only 6% of Caucasian women in the same age range. By age 35, the percentage of women of African descent affected by fibroid rises to sixty percent. Being an African woman alone is a major predictor of fibroid development. The diagnosis of fibroid tumours occurs at a younger age in women of African descent, and they are more likely to have symptoms and respond differently to therapy than women of other groups. African women have fibroids that are larger and develop at a faster pace, and they are more likely to have them surgically removed.
What Causes Fibroids?
Although the global scientific community’s official position is that no one is quite sure of the precise causes of fibroids, there is a general agreement that the rising case of uterine fibroids among women of African descent could be linked to several common factors, including diet, lifestyle, chemical exposure, mental and emotional stress, as well as other environmental factors.
Many studies are in agreement that a woman’s diet can play a key role in determining if she will develop fibroids. A diet high in vegetables and fruits has been linked to a very low occurrence of uterine fibroids, while a diet high in sugar and other foods such as processed foods, red meat and high-fat dairy products has been linked to both the occurrence of fibroids and the severity of symptoms. For centuries, women across Africa did not have to worry about diet. This is because the average traditional African diet is packed full of nutrients. With increasing westernization, the influx of processed foods and the fact that many families are run by two busy, working parents unable to cook healthy meals regularly, there has been an increase in the number of cases of uterine fibroids across the continent.
Other risk factors include the popular use of stock cubes in cooking. Almost all stock cubes used across Africa contain monosodium glutamate, and the “administration of Monosodium glutamate (MSG) for a long period of time has [been] reported to induce uterine fibroid in female Wistar rats.” Furthermore, smoking and alcohol are also notable risk factors.
With regard to lifestyle,in traditional African communities, women are involved in bodily exercises as a matter of their lived reality. From walking to dancing, women moved their bodies gracefully, joyfully, oftentimes in the company of others, as they connected with each other and with nature. In more recent times, however, be it in their private vehicles or through public transport, across many parts of Africa, people are walking less and riding more. A lower level of physical activity has been linked to an increased risk of developing fibroids. In one study, exercising for about 7 hours per week, which includes jogging, dancing, or walking, significantly reduced the risk of developing fibroids among women. Although a lot of middle-class women try to make up for it by going to the gym, or installing exercise equipment at home, there remains a huge difference and benefit in exercising outdoors, where the level of oxygen is higher and purer and critical vitamin D is ingested through direct sunlight.
Moreover, relationship issues are a major cause of emotional stress among young women today, and emotional stress has been linked to the occurrence of uterine fibroids. In traditional African communities, girls and young women were emotionally and even physically protected by their families. It was not common for girls to be involved in relationships with men out to break their hearts. Women married when they were of age and were spared the trauma of many modern women today, who often suffer heartbreaks and betrayals from their boyfriends and husbands. An increasing number of women are getting involved in non-committal sexual relationships, and with that comes many forms of emotional and physical stress.
Additionally, a lot of young women are going into the workforce and facing tremendous stress at their places of work. Women are compared to men, judged harshly sometimes and even sexually harassed at their places of work. Women are also becoming breadwinners at a much younger age and even when they are married and building careers are burdened with the numerous responsibilities they have at home. All these factors, depending on their degree and context, increase the risk of a woman developing uterine fibroids.
Chemical exposure is also a major concern. Among women in Africa and the African diaspora, hair relaxers and other hair products used to straighten hair have been linked to an increased occurrence of fibroid tumours. As a way of addressing this, African women are more and more opting to go natural and not use these harmful chemicals on their hair. Chemicals found in processed food packages, as well as those found in certain synthetic fabrics and feminine hygiene products such as sanitary towels and pantyliners, also contribute to the occurrence of uterine fibroids.
The use of plastics in food packaging and cooking utensils has also been linked to increased uterine fibroid cases. Perfluorinated substances (PFAS) which are used in nonstick cooking pans and other such products, are also known to be endocrine disruptors and can cause various degrees of harm to the female reproductive system. To address this, there is, therefore, a need for Africans to explore more natural cooking and storage utensils that are not harmful to the human body and the environment.
Chemicals contained in hundreds of home items, including many soaps and shampoos, have been linked to a higher risk of uterine fibroids. In laboratory research, scientists exposed uterine tissue samples to a variety of substances created when the body breaks down a commonly used chemical in household items known as phthalates. The results established that some of the chemicals stimulate certain hormones that result in fibroid tissues forming in the uterine lining. In light of this finding, there is a great need for research on natural and organic cleaning products across Africa, based on locally available materials and packaged sustainably.
There is also the issue of environmental exposure. Air, water and soil pollution have been established to cause increased risks of fibroids in women. Toxins found in soils treated with synthetic fertilizers and pesticides leach into underground water, increasing the risk of uterine fibroids in women. According to a Boston University School of Public Health study, “higher levels of ozone from air pollution are linked to an increased risk of developing fibroids among Black American women.” Air pollution is an issue that many women across African cities live with on a daily basis.
Conventional Treatments for Fibroids
There are quite a few options available in Western medicine for both the management and treatment of uterine fibroids. These include medications, intrauterine devices, surgery to remove the fibroids (myomectomy), as well as surgery to remove the entire uterus (hysterectomy). Other less-invasive or non-invasive options include uterine fibroid embolization, among others. All these options come with diverse, sometimes serious, side effects. And patients will be wise to independently do their research before giving their consent to any of these procedures or treatment options.
Natural Remedies for Fibroids
Uterine fibroid is one sickness where the phrase “prevention is better than cure” applies most significantly. Diet is key to preventing uterine fibroids. African women who have gone after Western diets of processed foods will have to retrace their steps back to traditional African cuisines. To ward off fibroids, women will have to intentionally include a rich and wide array of fruits and vegetables in their diets.
Exercise is no longer a luxury or a concern of only those women looking to lose weight. Every woman should make time to exercise, preferably outdoors, whenever possible. Women should also take steps to avoid emotional exposure to stress, as well as undue physical stress. Women will also need to limit their exposure to various chemicals and environmental factors, as stated earlier in this piece.
There are claims that certain teas and natural products, such as castor oil, can help reduce the chances of developing fibroids. However, there is limited evidence to fully support these claims. Nevertheless, some studies have reported some reduction in the volume of uterine fibroids with the use of certain traditional Chinese medicine, teas and acupuncture: “Gui-Zhi-Fu-Ling-Wan (Cinnamon Twig and Poria Pill) was the most frequently prescribed Chinese herbal formula, while San-Leng (Rhizoma Sparganii) was the most commonly prescribed single herb.” Other studies show that Curcumin “suppresses the growth of several tumor cell lines.”
African Traditional Medicinal Remedies
African traditional medicine has a wide variety of treatments and remedies for uterine fibroids. We shall, however, restrict this section to only three known remedies.
In Burkina-Faso, a popular traditional medical practitioner located in Bobo-Dioulasso, the second largest city in the country, has received a lot of attention for her treatment of uterine fibroids. Her treatment centre receives women from all over West Africa and beyond, who are in search of non-western medicine-based treatments for uterine fibroids. The 57-year-old traditional medical healer has been practicing traditional medicine for over 30 years. She apprenticed under her father, who was a famous traditional medical healer. She noted that her patrons include Caucasians from Canada and France, as well as African-Americans. According to her, a minimum of ten patients visit her centre daily.
Her treatment is aimed at destroying the fibroid mass and getting it absorbed by the body while causing the pelvic pains to disappear. Treatment involves the use of stem bark and roots of four plants: Trichilia emetica Vahl and Cassia sieberiana DC, Trichilia emetica Vahl, Securidaca longepedunculata Fers, Cassia sieberiana DC and, Lannea acida A. Rich. Scientifically, all the herbs she uses contain compounds that hold the potential of destroying fibroids and causing their resorption. At some point during the course of the treatment, the traditional healer uses gloved hands to conduct vaginal cleaning and induce the vaginal delivery of some tumours. Patients testify to having their fibroids destroyed after treatment. Some ultrasound tests conducted after treatment, when compared to the pre-treatment ultrasound, appear to validate that claim.
In the Tana River county of Kenya, the herb, Bignoniaceae, which belongs to the plant species, Markhamia zanzibaricaCK014 and is known by the local name, Mubwoka (Pokomo), is used to treat uterine fibroids.The roots or leaves of this herb are boiled in water and taken orally as specified by the traditional healer.The traditional healer may also recommend that Bignoniaceae be mixed with Salvadora persica and Uvaria acuminata oliv.
In laboratory studies, the leaves of Bignoniaceae increased“the frequency of spontaneously contracting tissues and directly stimulate[ing] uterine contractions.”In a study on the effects of the leaves of Salvadora persica on the female reproductive system, the leaves “caused a significant decrease in the relative weights of the ovary and an increase in uterine weights.”An ethnopharmacological, phytochemical, and pharmacological analysis of Uvaria acuminata Oliv. has shown that it contains compounds with pharmacological activities that “include anti-microbial, cytotoxic, anti-cancer, anti-malarial, and anti-anemic properties, among others.”
Herbal practitioners in Eastern Nigeria advocate taking regular dosages of unripe African oil palm (Elaeis guineensis) kernel seeds over a period of time as an effective method of shrinking fibroids. The preventive and therapeutic benefits of unripe palm kernel seeds on monosodium glutamate-induced uterine fibroid in rats were the subject of research out in a study. After being subjected to monosodium glutamate, these rats were given a treatment consisting of unripe palm kernel seeds, and the results showed that there was no rise in the levels of estrogen or progesterone. In fact, a decrease in the levels of these biomarkers was observed in rats whose levels had previously been high. Based on these data, it is likely that unripe palm kernels possess bioactive components that are helpful in preventing and correcting monosodium glutamate-induced uterine hyperplasia.
At any rate, a number of risk factors that are prevalent across Africa today could be implicated in the increasing rate of fibroid occurrence among women. African women will have to become educated about these risk factors and take preventative measures accordingly. The side effects of some Western medical treatments available for uterine fibroids are a turn-off for many women. Some African traditional medical options exist. African medical researchers will need to invest more effort in searching out even more traditional medicinal options and exploring such options for the safe and effective treatment of uterine fibroids.
Disclaimer: For proper diagnosis and treatment, always consult with your healthcare provider. The author is not a medical doctor or a licensed healthcare practitioner.