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After Your Result

What to Do After a
Fibroid Diagnosis

A step-by-step guide

Fibroids are almost always benign (non-cancerous). The vast majority of Nigerian women with fibroids live normal lives — many never need surgery. Your next step depends on your symptoms, fibroid size, and your plans for pregnancy.

What This Result Actually Means

Uterine fibroids (also called leiomyomas or myomas) are benign muscle tumours that grow in or on the uterus. They are extremely common in Black African women — up to 60–70% of Nigerian women will have at least one fibroid by age 40. Most fibroids cause no symptoms and are found incidentally on a routine scan. When they do cause problems, the symptoms depend on fibroid type: submucosal fibroids (inside the uterine cavity) cause heavy bleeding and affect fertility most significantly; intramural fibroids (within the uterine wall) cause pelvic pressure and may distort the cavity; subserosal fibroids (on the outer uterus surface) cause bulk symptoms and pressure on adjacent organs. Not every fibroid needs treatment.

Your Next Steps — In Order

1
Know your fibroid details — size, number, and location
The scan report should state: how many fibroids, their size (in centimetres), their position (submucosal, intramural, or subserosal), and whether any are distorting the uterine cavity. These details determine whether and what kind of treatment is needed. If the report is unclear, ask your sonographer to explain.
2
Check your blood count for anaemia
Heavy periods caused by fibroids are the most common cause of iron deficiency anaemia in Nigerian women. A full blood count (FBC) will reveal whether you are anaemic and guide the urgency of treatment. Severe anaemia (Hb below 8 g/dL) may need iron treatment or transfusion before any fibroid procedure.
3
Assess your symptoms — are they affecting your quality of life?
Small fibroids with no symptoms need only monitoring — a repeat scan every 12 months to check growth. Fibroids causing heavy bleeding, significant anaemia, pressure on the bladder, or fertility difficulties warrant treatment. Rate your symptoms honestly: are they interfering with work, relationships, or daily activities? This drives the treatment decision.
4
Discuss your fertility plans with your doctor
If you want to get pregnant, the treatment approach changes. Submucosal fibroids need to be removed before IVF or natural conception if they distort the uterine cavity. If you are actively trying to conceive, a fertility specialist referral alongside fibroid management is appropriate.
5
Explore treatment options with your gynaecologist
Options range from medical management (tranexamic acid for bleeding, hormonal therapy, GnRH agonists to shrink fibroids before surgery) to minimally invasive surgery (hysteroscopic myomectomy for submucosal fibroids, laparoscopic myomectomy for small accessible fibroids) to open myomectomy for large multiple fibroids. Uterine artery embolisation (UAE) is an alternative to surgery. Hysterectomy is definitive but reserved for women who have completed their family.

❌ What NOT to Do

Questions to Ask Your Doctor

📝 Write these down before your appointment:

Frequently Asked Questions

Will my fibroids grow back after surgery?
Fibroids removed by myomectomy do not grow back — but new fibroids can develop from different smooth muscle cells in the uterus. The recurrence rate after myomectomy is approximately 20–30% at 5 years. Women who conceive after myomectomy have a lower recurrence rate than those who do not. This is why myomectomy is preferred over hysterectomy only for women planning future pregnancy — it is not always a permanent cure, but it preserves the uterus.
Can I get pregnant with fibroids?
Yes — many women conceive naturally with fibroids. The impact on fertility depends entirely on fibroid location. Submucosal fibroids (inside the uterine cavity) significantly reduce implantation rates and increase miscarriage risk, and are usually removed before fertility treatment. Intramural and subserosal fibroids generally have a smaller impact unless very large. An assessment by a fertility specialist alongside your gynaecologist is the best approach if you are struggling to conceive and have fibroids.
What size fibroid requires surgery?
Size alone does not determine whether surgery is needed. A 4 cm submucosal fibroid causing heavy flooding and anaemia needs treatment sooner than a 10 cm subserosal fibroid in a woman with mild or no symptoms. The decision is based on the combination of size, location, rate of growth, symptoms, anaemia, and fertility intentions — not size alone. Your gynaecologist will weigh all these factors.
Are fibroids hereditary?
Yes — there is a strong genetic component. If your mother or sisters have fibroids, your risk is significantly higher. Black African women have the highest fibroid prevalence globally, and this reflects both genetic susceptibility and possibly dietary, hormonal, and environmental factors. Having a first-degree relative with fibroids is a reason to have routine pelvic scans from your mid-20s, even if asymptomatic.

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