WOMEN’S HEALTH: Introducing The Column

Globally, women’s health remains a priority for the reason that if the woman is healthy, the family is healthy and therefore the community and by extension the nation is healthy. A healthy nation they say is a wealthy nation. However, in Africa, women’s health is yet to receive the desired attention from the Governments and other parties.  As a result, women in the continent suffer and sometimes die from medical conditions that are entirely preventable. This column is conceived to address the common health issues affecting women in our locality and Nigeria as a whole.

On this platform, we will be discussing health issues affecting women and this will include discussing puberty and related issues, adolescent reproductive and sexual problems, menstruation, and its problems. As a result of the immense psychological effect of the inability to conceive, a special focus will be on fertility to address the problems leading to infertility (inability of a couple to achieve pregnancy) including causes and available treatment modalities. We shall be addressing the misconceptions about infertility. Similarly, pregnancy failures (miscarriages and premature deliveries) which represent lost hopes and may lead to psychosocial distress will be addressed looking at the risk factors, causes, and available treatment modalities. 

There will be in-depth discussions on what our women need to know about antenatal and postnatal care, breastfeeding, and issues around exclusive breastfeeding as well as preconception care. Common gynecological problems affecting women will be discussed largely to address misconceptions and how to identify and treat them. And these include leiomyomas (uterine fibroids), ovarian cysts, and vaginal discharge among others.

Finally, we will be looking at issues affecting older women who have completed her reproductive career. This will include issues around menopause, postmenopausal issues, and maintenance of healthy living during the menopausal life phase. Special attention will be given to gynecological cancers notably cancer of the cervix and breast in terms of preventive strategies and available treatment modalities

We will structure the discussions along clinics/classes to enable readers to make contributions. The clinics will include antenatal class/clinic, gynaecological clinic/class, adolescent reproductive health class/clinic as well as post menopause class/clinic. This will enable us to carry everybody along. We will strive to use the language most of the readers will understand with very little technical terms. The whole essence is to pass information across to both our women and men on how to prevent, identify, and effectively handle health issues affecting our women.

Once again, I want to thank the management and the editorial team of the anaedoonline.com for this wonderful opportunity to improve the health status of our women.

Uterine fibroids

Let’s start the series with a little discussion on uterine fibroids.  In this section, we will discuss what uterine fibroids are, how it presents, how to make the diagnosis, and how to treat it.

So, what is Uterine Fibroid?

Leiomyomas otherwise known as uterine fibroids are benign growths of the smooth muscles of the uterus (womb). The uterus is composed of three walls- the innermost layer termed the endometrium(part of which is shed every month in the form of menstruation), the middle muscular layer that constitutes the bulk of the organ- myometrium as well as the outermost covering of the organ called the serosa. Uterine fibroids involve the smooth muscles of the uterus.  The primary function of the uterus is to receive, house, and nourish the developing baby (fetus) and to successfully give up the baby when the baby is matured through the processes of labor and delivery.  In the absence of pregnancy, the prepared inner lining of the uterus referred to as the endometrium is shed every month in the form of menstruation. As we go on in this section, we will see how the presences of fibroids affect these processes.

What causes fibroids?

The cause or aetiological factors of fibroid is still largely unknown. But what is known is that just as in other growths in the human body, it results from dysregulation in cellular growth.  It is also known to be commoner among the blacks and older women who have not or will not conceive.

How do I know if I have uterine fibroids?

The commonest symptom of uterine fibroids is increased menstrual flow otherwise called menorrhagia. For instance, if you have a normal 4 day – menstrual duration and suddenly notice an increase in the number of days as well as in the volume of menstrual flow(as evidenced by the use of an increased number of pads), then uterine fibroids should be suspected. This finding may be associated with the passage of blood clots during menses and feelings of faintness following each period. 

A woman with uterine fibroids can also notice an abdominal mass which gradually increases in size with some form of mass effect on the bladder and rectum leading to some difficulties and issues with urination and defecation. There may also be dysmenorrhea (painful menstruation). Sometimes, the only manifestation of fibroids will be repeated pregnancy losses.

However, in the vast majority of cases, the fibroids are asymptomatic (ie no symptoms) and only discovered on routine ultrasound scans for other gynaecological problems.

We will end our discussion on this segment here. Next week we will continue with how to make a diagnosis, what to do when you think you have fibroids, and the available treatment modalities. We will also touch on the misconceptions around fibroids.

I wish you a wonderful week ahead.  Do write back to us to seek for more information and clarifications.

Dr Ugboaja Joseph MBBS, FMCOG, FWACS, FICS, FMAS, DMAS, Dip.ART

Chairman, Medical Advisory Committee/ Director, Clinical Services, Research & Training/Consultant Obstetrician & Gynaecologist, Nnamdi Azikiwe University Teaching Hospital, Nnewi

+2348036757293; ugbajaj@yahoo.com; odc0732@gmail.com

ABOUT THE AUTHOR

Dr. Ugboaja Joseph is an Obstetrician & Gynaecologist by training and currently Chairman, Medical Advisory Committee of Nnamdi Azikiwe University Teaching Hospital, Nnewi and Director, Clinical Services, Research & Training as well as chairman, Taskforce on Covid-19 of the hospital. He holds Postgraduate fellowships in Obstetrics & Gynaecology of National Postgraduate Medical College, Nigeria (FMCOG), West Africa College of Surgeons (FWACS), and International College of Surgeons (FICS).  He joined the Hospital management in 2014 as the deputy CMAC, a position he held for 4 years. He was subsequently appointed the CMAC in 2017 for the initial tenure of 2 years which ended in 2019. He was reappointed in 2019 for the final tenure of 2 years as the CMAC of the hospital. His tenure as the CMAC of the hospital brought a lot of innovative changes and improvement in services under the leadership of the CMD, Prof AO Igwegbe. These include the formation of the NAUTH Research Society; the Quality improvement committee; the Clinicopathologic series; the Cancer Society; Laboratory Quality Management system as well as the introduction of the Annual NAUTH Scientific Conferences. 

Dr. Ugboaja has attended several workshops, training, and conferences on Strategic leadership and healthcare management including those organized by the administrative college of Nigeria (ASCON). He is an Associate of the Institute of Management Consultants of Nigeria.(IMCON). He believes in transformational leadership and also believes strongly that leaders should be altruistic, inspiring, motivational, transparent, and accountable.