Doctor Alphonse Mécas Kimpamboudi Hospital practitioner; Specialist in gynecology obstetrics; Hospital surgeon; Head of department at the Troyes Medical Center; Head of department at the Medical Center of Rouilly, France

Also called Uterine Fibromyomas or Uterine Myomas, fibroids are benign tumors developed from uterine muscles that particularly affect black women and cause infertility. There are of course other factors such as hereditary and hormonal factors. Depending on the location of the fibroids, there can be different action plans:

The Intra-cavity fibroid

Located in the same cavity as the uterus, it causes abundant menstruation sometimes along with the passing of blood clots and exposes to anemia. If it is large in volume, it causes infertility by preventing the pregnancy from developing in the cavity with at times repeated miscarriages. The ideal treatment is surgical by performing a hysteroscopy but the risk of recurrence is non-negligible.

The Submucosal fibroid

Develops under the endometrium and sometimes protrudes into the uterine cavity, it also leads to abundant menstruation (Menorrhagia) with sometimes bleeding out of the normal menstruation time (Metrorrhagia). In this instance, the endometrium becomes thick, followed quickly by an abrasion of the endometrium which makes it unsuitable for pregnancy, hence the infertility. The treatment is surgical (hysteroscopy) or medical.

The Intra-mural or Interstitial fibroid

Inside the uterine muscle (Myometrium, which gives an irregular appearance to the contours of the uterus, even a bumpy one) when this type of fibroid is located near the tubal in the uterine cavity, it can clog the Fallopian tubes, especially if it is big, resulting in infertility.  Its treatment depends on the size of the fibroid, the age of the woman, the desire or not to get pregnant and the overall health of  the woman. The desire for a pregnancy requires a great caution as with the young patient by preferring a medical treatment or even a conservative surgery, therefore the myomectomy , the removing of the fibroid only

The Sub-serous fibroid

Develops outside the uterus with either a large or pedicled implantation base. It does not cause any bleeding outside of the menstruation, which could be of normal duration and abundance. The sarcomatous degeneration (transformation into fibroid cancer) is exceptional but in view of the complications of fibroids (genital hemorrhages, anemia, pelvic pain, infertility), it is especially appropriate when one is of Afro-American or African descent or has a mother carrying fibroids to:

• consult a gynecologist-obstetrician once a year
• undergo a yearly pelvic ultrasound beginning in your twenties
• consider going through your pregnancies, if possible, before age 35
• not neglect the fact that menstruation becomes more and more abundant with passing of blood clots at times
• not disregard the fact that sexual intercourse causes bleeding or even pelvic pain.

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