A tweet by 27-year-old Dr. Solomon Kimera recently stirred intense debate across Uganda’s social media. His message touched on a sensitive women’s health issue that is often overlooked: uterine fibroids.
Dr. Kimera posted on X (formerly Twitter), saying, “Girls today; ‘I want to first be an independent financially stable woman before I get any kids.’ Meanwhile fibroids looking at you like…” He linked delaying childbirth to a higher risk of developing fibroids. This tweet triggered strong reactions, with many criticizing it as insensitive toward women’s goals of financial independence.
Though his words upset many, the medical claim behind the tweet has some scientific basis. Fibroids are benign (non-cancerous) tumors that grow in or on the uterus. They are affected by hormones. Research shows that women who delay having children may have an increased risk of developing fibroids.
Fibroids affect up to 70-80% of women worldwide by the time they reach 50 years old. In Uganda, experts believe the numbers could be even higher, partly due to genetic factors. However, fibroids remain underreported and not well understood by the public.
“Fibroids are the most common tumors in women,” explained Dr. Andrew Chakura, a gynecologist based in Kampala. “Most women do not even know they have fibroids until complications develop.” He said up to 75% of women with fibroids may not show symptoms.
Fibroids can grow in different parts of the uterus. Dr. Chakura described the types: intramural fibroids develop inside the uterine wall; submucosal grow into the uterine cavity; subserosal form on the outside surface; pedunculated hang by a stalk; and cervical fibroids start in the cervix.
Symptoms vary widely. Women may experience heavy or painful periods, pelvic pain, abdominal swelling, constipation, painful sex, or difficulty getting pregnant.
Fibroids are most common in women aged 25 to 40. African women, especially Black women, have two to three times higher risk than white women. Other risk factors include family history, early menstruation, obesity, vitamin D deficiency, and never having given birth.
Dr. Joseph Rwebazibwe, a gynecologist at Mbarara Regional Referral Hospital, confirmed fibroids mostly affect women in their reproductive years and have links to genetics and hormones. Dr. Gracious Nuwasasira from Hoima added that fibroids often go unnoticed until they grow large or cause major symptoms. He said some fibroids can become as large as a watermelon.
Not all fibroids cause infertility. “Out of ten women with fibroids, about three may have trouble conceiving,” said Dr. Rwebazibwe. Fibroids can block fallopian tubes or change the lining of the uterus, making pregnancy difficult or increasing miscarriage risk, but many fibroids do not affect fertility.
Doctors diagnose fibroids using medical history, physical exams, blood tests (to check for anemia), and imaging such as ultrasounds. Treatment depends on symptom severity, fibroid size and location, age, and whether the woman wants children.
Mild or symptom-free cases may only need monitoring. Hormonal therapy can reduce symptoms. Surgery may be needed for severe cases. Options include myomectomy, which removes fibroids but keeps the uterus, and hysterectomy, which removes the uterus and is usually for women who do not want children.
Other treatments like uterine artery embolization reduce blood flow to fibroids and shrink them. Medical experts warn against herbal remedies because they can delay proper care.
If left untreated, fibroids can severely affect a woman’s life, causing anemia, painful sex, and emotional stress. “They can shorten the vagina, cause painful intercourse, and drain a woman’s energy,” said Dr. Rwebazibwe.
The debate ignited by Dr. Kimera’s tweet highlights the urgent need for open, honest discussions about women’s reproductive health. Such conversations should include medical facts but also respect women’s rights and choices.
Dr. Kimera later defended his tweet, writing, “Medicine is studied in medical school for five years, not in five minutes on the internet. My duty is to share facts that save lives.”
As health information spreads rapidly online, the challenge remains to communicate complex medical issues clearly and respectfully.
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