• ‘Women with fibroids can carry pregnancies successfully’

Uterine fibroids, non-cancerous growths that affect millions of women, are increasingly drawing attention to treatment options beyond conventional surgery and medication, as experts explore less invasive approaches that could reduce their size and ease symptoms.

The growing interest in alternative treatments comes amid concerns over the cost, availability and potential risks associated with some conventional interventions. Researchers and healthcare practitioners are examining approaches that may offer women additional options for managing fibroids, particularly where the condition affects fertility, quality of life and daily activities.

Uterine fibroids are a major reproductive health concern among women of reproductive age, most commonly between 30 and 50 years. Studies indicate that prevalence can reach 70 to 80 per cent by age 50, with women of African descent experiencing a disproportionately higher burden and often developing fibroids at a younger age.

Recent data from Youterus Health and the White Ribbon Alliance Nigeria indicate that about 45.1 per cent of Nigerian women have uterine fibroids, with some age-group subsets recording prevalence above 50 per cent. Clinical studies have also placed diagnosed prevalence at close to 45 per cent, making fibroids one of the most common reproductive health challenges in the country.

A 2025 report published by the Federation of American Women’s Clubs Overseas identified Nigeria as having one of the highest rates of uterine fibroids globally, although experts say relatively little attention is paid to the growing reproductive health burden.

The Managing Director, Nordica Fertility Centre, Dr Abayomi Ajayi, told The Guardian that despite claims that local herbs could eliminate fibroids, many patients who rely on such treatments eventually seek hospital care.

The consultant obstetrician and gynaecologist said lifestyle measures, including maintaining a healthy weight and eating a balanced diet, could contribute to overall health and influence some risk factors, but should not be presented as proven cures for established fibroids.

Ajayi said fibroids were neither a spiritual affliction nor a punishment from the gods, but common, non-cancerous growths that develop in or around the uterus. He noted that while they could cause significant health problems in some women, many women with fibroids experience no symptoms.

He explained that fibroids are among the most common growths affecting the uterus and could interfere with women’s daily activities and reproductive health. Symptoms may include heavy menstrual bleeding and pain, potentially affecting quality of life and, in some cases, fertility.

According to him, conventional treatment options for uterine fibroids include surgical procedures such as myomectomy and hysterectomy, which carry risks including heavy bleeding, infection and accidental injury to nearby organs.

He explained that depending on the circumstances, surgeons may remove the fibroids while leaving the uterus intact, a procedure known as myomectomy. In other circumstances, removal of the uterus through hysterectomy may be considered.

“There are also other potential surgical complications, including blood clots. A clot that forms in the leg can travel to the lungs, causing a potentially life-threatening condition known as pulmonary embolism. In addition, surgery can result in scar tissue, which in some cases may have implications for future fertility,” he said.’’

Ajayi pointed out that advances in treatment had introduced less invasive alternatives, adding that women with uterine fibroids in Nigeria now have access to treatment options that can remove or reduce fibroid tissue without conventional open surgery.

He disclosed that High-Intensity Focused Ultrasound (HIFU) offers a non-invasive treatment option for some women with uterine fibroids. “Unlike conventional surgery, HIFU uses focused ultrasound energy to heat and destroy targeted fibroid tissue without making a surgical incision,” he said. “The procedure requires no general anaesthesia, blood transfusion or hospital admission, allowing patients to go home the same day.”

According to him, the procedure can preserve the integrity of the uterus and may support future fertility options without the recovery period associated with conventional surgery.

“This procedure can be performed without general anaesthesia and many patients can return to their normal activities relatively quickly, usually within one week,” he said.

Ajayi said more than 900 HIFU procedures had been performed at his centre in Nigeria, with the number approaching 1,000.

He, however, stressed that HIFU was not suitable for every patient, noting that careful assessment was required to determine whether a fibroid could be safely targeted and whether ultrasound energy could reach it without damaging surrounding structures.

Ajayi also identified Uterine Artery Embolisation (UAE) as another treatment option. The procedure involves introducing materials into the blood vessels supplying the fibroid, reducing its blood supply and causing it to shrink over time.

He, however, noted that UAE could have implications for ovarian blood supply in some women, making careful assessment particularly important for younger women who still desire children.

The fertility specialist emphasised that women should have access to safe and effective treatment for uterine fibroids and advocated the adoption of modern medical technologies where appropriate to treat the benign growths without conventional open surgery.

Ajayi explained that age was one of the risk factors for fibroids. Women who begin menstruating at an early age, known medically as early menarche, and those who experience menopause later may have greater lifetime exposure to oestrogen, a hormone that can influence fibroid growth.

Being overweight is another recognised risk factor. The specialist also identified alcohol consumption and having no children among factors associated with increased susceptibility, while family history remains one of the strongest known risk factors because fibroids tend to run in families.

According to him, race also appears to play a role. Fibroids are particularly common among Black women, although researchers continue to study the complex interaction between genetics, hormones and environmental factors that may contribute to the disparity.

Ajayi said there was no evidence that fibroids were caused by spiritual punishment. “There’s nothing spiritual about fibroids,” he said, describing them instead as growths that develop in the uterus.

He observed that having fibroids did not automatically mean that a woman could not conceive, noting that many women with fibroids become pregnant and carry pregnancies successfully. However, he stressed that the location and size of a fibroid could affect fertility.

The specialist explained that fibroids could interfere with fertility when they grow in areas that affect the uterine cavity or the point where the fallopian tube joins the uterus. “Fibroids that distort the space where an embryo should implant may also be associated with miscarriage,” he said.

He said appropriate treatment depended on factors including the woman’s symptoms, age, fertility plans, size and location of the fibroids and the overall condition of the uterus.

On whether fibroids could grow back after treatment, Ajayi said what women often describe as a “recurrence” could involve either the regrowth of a previously treated fibroid or the development of an entirely new fibroid.

“Removing a fibroid does not necessarily remove the underlying tendency of the uterus to develop fibroids. The whole uterus is subjected to the same environment that caused fibroids to grow in the first place. This is why a woman who has undergone one or even several fibroid surgeries may later discover another growth,” he said.

On whether a woman could still conceive after fibroid surgery, he said a history of fibroid surgery did not automatically rule out pregnancy. The specialist noted that even women with multiple previous surgeries could potentially be assessed for HIFU, although previous operations could affect treatment planning.

Ajayi also noted that while prayer remained important to many people, it should not replace medical diagnosis or treatment when a health problem requires professional care. “Prayers can help everything, but medical problems should also be properly evaluated and treated,” he said.

Also speaking, Senior Lecturer at Eko University of Medicine and Medical Sciences, Dr Godswill Iboma, said there was currently no evidence available to him demonstrating that herbal medicines could cure or significantly reduce fibroids.

According to him, anyone making claims about herbal treatment for fibroids should be able to demonstrate the condition of a patient’s fibroids before treatment and document what happened after the herbal medicine was taken.

Iboma, however, stressed that his position should not be interpreted as a blanket condemnation of herbal medicines, noting that some herbal preparations could be useful in managing certain conditions.

He advised women with symptomatic fibroids, particularly those experiencing excessive monthly bleeding, to seek appropriate medical care rather than delay treatment.

Iboma said surgery remained an important treatment option for women requiring removal of fibroids, including myomectomy, in which the fibroids are removed while preserving the uterus.

Laparoscopic myomectomy is a minimally invasive form of the procedure in which small incisions are made in the abdomen to allow a camera and surgical instruments to be inserted for visualisation and removal of the fibroids.

Iboma also referred to HIFU as an alternative treatment for fibroids, saying the procedure could shrink fibroids by reducing their blood supply. According to Iboma, HIFU is available in registered hospitals and forms part of specialist training in obstetrics and gynaecology.

He explained that the treatment could considerably reduce the size of fibroids but said, in his experience, it did not eliminate them in most cases. “HIFU shrinks the size of fibroids most of the time. One of the limitations of that machine is that it does not cure; it does not take away the fibroid completely most times, but it reduces the size considerably,” he said.

He said women who did not want surgery could consider HIFU, although he noted that the treatment was relatively expensive. For women seeking complete removal of a fibroid, however, Iboma said surgery remained the option he considered appropriate based on the evidence available to him.