Dear Allen;
As I type this right now, I have just discharged a 39 year old female who was operated on (Myomectomy) three days earlier after presenting with Heavy Menstrual Bleeding due to Fibroids. This woman last gave birth 13 years ago to the only child she has.
Such and many other cases we keep seeing in medical practice is the support epidemiologicay that being nulliparous (a female of reproductive age who has never had a live delivery) plays a major role in the cause of uterine fibroids and hence listed among the risk factors of getting fibroids.
Parity.
Pregnancy has been found to have a protective effect against the development of uterine fibroids, but the mechanism remains unclear. Indeed, nulliparous women are more often affected by uterine fibroids than multiparous women( producing many children), with each subsequent child lowering the risk.
Prevalence
Fibroids are common, they are present in about 20 per cent of women over 30 years of age; post-mortem examinations to discover the cause of death or the extent of disease in women show that up to 50 per cent of women had fibroids even when the cause of death wasn’t related to reproduction.
Risk factors.
Generally, risk factors for clinically significant fibroids are nulliparity obesity, a positive family history and African racial origin (three times higher risk).
Mutations in women
According to a recent meta-analysis, mutations (any change in the DNA sequence of a cell) occur more commonly in women of african origin than in White populations. However, the molecular basis by which mutations cause uterine fibroids and the high prevalence of mutations are not yet understood. Nonetheless, it is clear that these mutations interact with hormonal and growth regulatory factors to favor fibroid progression.
Questions answered by Dr Molino, Clinical head, Equity Afia
Kimbua(Kenya)
