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In Nigeria, a woman with a visibly swollen belly is often assumed to be "expecting." Friends, neighbours, and even strangers offer congratulations, celebrating what they believe is new life. But for thousands of Nigerian women, that swelling might not be a sign of pregnancy -- it could be a symptom of fibroids, GIFT HABIB writes
In many Nigerian communities, a woman whose abdomen swells noticeably is quickly congratulated. Neighbours and coworkers smile knowingly. Relatives begin planning for naming ceremonies. But for thousands of women across the country, that swollen stomach is not a sign of life. It is the outward manifestation of a medical condition that has been normalised for too long -- one that causes physical, social, and psychological pain. It is not a baby. It is a tumour. And it is fibroids.
Uterine fibroids -- non-cancerous growths in or around the uterus -- are common among women of reproductive age. But in Nigeria, they have become a hidden public health crisis. Despite their prevalence and impact, fibroids remain poorly understood, underdiagnosed, and frequently untreated, with devastating consequences. From infertility and social stigma to financial ruin and even death, the burden of fibroids continues to grow -- often in silence.
Susan Okoro's story is one of many. At 42, she had never had a child. Years of abdominal swelling and discomfort were attributed to fibroids, which gradually enlarged her womb to the point that she appeared heavily pregnant. Strangers and friends alike assumed she was expecting. But behind the congratulations was a painful reality. Susan opted for surgery -- a decision that would prove fatal. She never woke up.
News of her death was shared in a blunt message to her former classmates via WhatsApp on June 3, 2025: "With a heavy heart, I announce the passing on of Susan Okoro. Susan is dead." The reactions were filled with disbelief. Some had assumed she was preparing for motherhood. Instead, her life had ended in a way that remains tragically common -- from complications related to a condition that is rarely considered life-threatening.
Another woman, simply identified as Kehinde, recalled her own church experience. "Two church members of mine died during fibroid surgery," she said.
But fibroids kill. They kill slowly, through anemia, chronic pain, reproductive trauma, and, in Susan's case, surgical risk. They also kill silently, buried under layers of misinformation, financial barriers, and cultural indifference.
Understanding Fibroids: A Hidden Crisis
A consultant gynaecologist and a fellow of the West African College of Surgeons, Dr. Azubuike Nkemakolam, explained that "Fibroid is a benign smooth muscle tumours of the uterus. It's very common in reproductive-age women. Many times, it's asymptomatic and only discovered during scans for something else. But when it becomes symptomatic -- heavy bleeding, persistent pain, abdominal swelling -- it becomes life-altering," he said.
In Nigeria, fibroids are alarmingly common. A 2023 clinical study found fibroids in 51.9 percent of women aged 26-35 and 44.6 percent aged 36-45. In teaching hospitals, they account for 20-30 percent of gynecologic admissions, and are the leading cause of hysterectomies.
Despite affecting millions of Nigerian women, uterine fibroids remain a silent crisis -- widely misunderstood, misdiagnosed, and largely ignored in public health discourse. Recent studies indicated in a 2025 report published by the Federation of American Women's Clubs Overseas revealed that Nigeria has one of the highest rates of uterine fibroids globally. Yet, little attention is given to this growing reproductive health burden.
At teaching hospitals across Nigeria, fibroids account for a significant percentage of gynaecological admissions and surgeries. Most commonly affecting women between the ages of 30 and 39, fibroids are influenced by a combination of genetic and environmental factors.
We Operate Fibroids to Help Women Get Pregnant
The Chief Executive Officer of Nordica Fertility Centre, Dr. Abayomi Ajayi, in a recent interview, explained, "There's probably a gene in us. We know some of the risk factors -- early menstruation, obesity, and family history. But the strongest is heredity."
Dr. Ajayi stressed that fibroids often affect women who have not given birth. "What we used to say is that the uterus with a fibroid is a uterus crying for a baby."
He added, "Having a fibroid does not mean you cannot get pregnant. If the fibroid is not disturbing the pregnancy, we just monitor."
Other risk factors include high red meat consumption, obesity, and low intake of fruits and vegetables. Hormonal imbalances -- particularly high levels of estrogen -- are also linked to fibroid growth.
Symptoms vary widely, but can include pain, bleeding, and a sense of something growing inside. "The unfortunate thing is that sometimes you might have no symptoms at all," the fertility physician noted.
For women trying to conceive, the diagnosis can be devastating. "People think if they have fibroids, they will not be able to get pregnant again. But the truth is, we operate on fibroids to improve the chance of women getting pregnant," explained Dr. Qudus Lawal, a gynaecologist.
Most Women Don't Even Know they have fibroids
Dr. Nkemakolam did not mince words. "Most of the time, women have fibroids, but they don't even know. So they live with it. Then they die with it -- and they may not even know."
In an extensive conversation, the gynaecologist said that treatment depends on symptoms and a woman's fertility goals. While medications can offer temporary relief, they're not cures.
"There are drugs to shrink fibroids or reduce bleeding -- used when patients are waiting for surgery or are not fit for it yet. But they can't be used long-term -- less than six months -- because they can induce early menopause," he explained.
Surgery remains the definitive treatment. "Hysterectomy is the cure, but it removes the womb. For women who still want children, we do a myomectomy. But myomectomy is a major surgery. It's bloody. It requires more sutures than even a C-section. And if you've had previous surgeries, the complications rise dramatically," he noted.
The consultant gynecologist explained that medication offers temporary relief but isn't a cure.
"There are drugs to shrink fibroids or reduce bleeding -- maybe used if a patient waits for surgery or isn't fit yet. But they can't be given long-term -- less than six months -- because they can push the woman into menopause."
"If you stop the drug, the fibroid may grow back," he explained.
People Thought We're Pregnant- Women lament
Victoria Richard, a 28-year-old based in Abuja, was diagnosed with fibroids before marriage. At the time, she ignored it thinking it wasn't serious. After marriage, the fibroid grew larger. She recalled that her doctor downplayed the situation: "He told me it was only 10cm and that I should not worry, that I would get pregnant soon." Meanwhile, her neighbours began offering congratulations. "They were already calling me 'mummy' and preparing for a baby shower."
She eventually did become pregnant -- but not without fear. "I ignored it initially. Now, I am pregnant, but I am scared of the fibroid inside of me," Victoria said.
Her story mirrors that of Deborah Chidera-Johnson. A few months into her marriage, she experienced persistent discomfort and was diagnosed with fibroids. At first, it seemed manageable until she lost her pregnancy just two months in.
But the suffering was not over. The fibroid continued to grow, altering her appearance. She was mocked, nicknamed "mama twins." She had to quit her teaching job due to pain. She took a lot of herbal drinks to shrink the fibroids, but to no avail. The thought of surgery never crossed her mind as her monthly salary was just #38,000 and her husband was #80,000.
"A few months into my marriage, I felt discomfort in my stomach, and I was told to run some tests, and I was diagnosed with a fibroid. The fibroid started growing gradually. I took in, but two months later, I lost the pregnancy. I was told by the doctor that the position and size of the fibroid killed my child. But the fibroid kept getting bigger and at one time, I was called 'mama twins," Deborah narrated.
Surgery: A Costly Lifeline
Treating fibroids in Nigeria is often financially overwhelming. According to Nairametrics, surgeries can cost anywhere from N700,000 to N2.5m. With limited access to affordable, quality public healthcare, many women delay or avoid treatment altogether held back by fear, misinformation, and stigma.
For Deborah, the pain eventually became unbearable. She underwent emergency surgery at the Federal Medical Centre in Jabi, Abuja, opting for a VIP procedure that cost N650,000; money she and her husband scraped together with help from friends and family.
"I couldn't sleep or lie down without severe pain. I had to resign from my teaching job. My husband and I decided that I would go for surgery. Because of the severe pain, we booked for a VIP session in Federal Medical Centre, Jabi, Abuja.
"The surgery alone cost us N650,000. I felt very relieved after the surgery. I resumed my teaching job, and I took in shortly. People call me "big belle" but I am very happy because it is a real child that I have in my womb. It was a horrible experience. In fact, a woman I saw in one of the hospitals I visited came for another open up to remove an object a doctor forgot in her womb," she said.
Her experience is not isolated. Many Nigerian women suffer in silence or fall prey to ineffective and dangerous alternatives.
"Some women pay up to N100,000 monthly for concoctions that do nothing. "They don't remove fibroids -- they just distort tissue, making future surgery riskier and more complicated," he said.
Also, Dr. Lawal echoed this concern. "They are not effective. Not only are they not effective, some of them are harmful and they delay the woman from actually seeking the treatment that will be of help to them.
"Eventually, they will still come back to have surgery later on after they have expended time, money, and hope trying to use drugs that usually do not work," he explained.
For Mama Favour, cost remains the biggest barrier.
"All my children are grown. "I'll just wait for menopause. Surgery is too expensive, and I'm just a trader. My husband is a low-ranking officer. I know government hospitals are cheaper, but their attitude especially the doctors' scares me. I've gotten used to the monthly bleeding."
Let the Fibroid Stay
Fear of surgery is deeply rooted. Dr. Lawal stressed the psychological and reproductive impacts of fibroids, noting that "the size on its own can be a burden and can give psychological challenges to women."
Mama Chidinma is one of them. "I've been under the knife three times; two C-sections for my sons, and one surgery to remove fibroids. Three years later, they came back. I won't do it again. Let the fibroid stay."
Others have simply resigned themselves to living with the condition. Mama Plangnang has carried fibroids for years.
"During my second cesarean, they were supposed to remove them. Maybe they forgot. But I won't go for another surgery. It's not disturbing me too much," she said. Strangers often assume she's pregnant. She no longer bothers correcting them.
Public Figures Speak Out
Public figures have also spoken up about their struggles with fibroids, helping to destigmatize the condition. Award-winning filmmaker Kemi Adetiba recently revealed, "I've had surgery twice for this already, and it now seems I might need a third."
Actress Ini Dima-Okojie, in an emotional post, wrote, "We NEED a cure for fibroids. In the meantime, I hope every woman dealing with it is hanging in there. Just know that you are not alone."
Men Feel the Pain Too
Ifeanyi Ugwu shared a deeply personal and rarely told story. His wife silently battled fibroids, hiding her pain until it became too much to bear.
He recalled, "My wife didn't tell me about the fibroids at first. She tried to handle it alone, but eventually, she opened up. It was heartbreaking. At the time, I had lost my job -- how were we supposed to cope?
"She was the sole breadwinner, taking care of our only son. I wasn't ashamed of the changes in her body. We had been saving for rent, but instead, we withdrew the money for her surgery. Life comes before shelter."
Oga Musa also shared his experience with his wife's fibroid condition.
"It's painful to watch my wife struggle with a swollen stomach that carries no child.
"She's a kind and hardworking woman. She doesn't deserve this suffering. The medications haven't helped, and surgery feels out of reach. We simply don't have the money -- and the public hospital system has failed us," he simply narrated.
Way forward
Dr. Ajayi explained that a new, less invasive alternative is emerging. High-Intensity Focused Ultrasound is a non-surgical procedure that uses ultrasound waves to destroy fibroid tissue.
"We have this method of treating fibroids without removing them and without surgery," said Dr. Ajayi. "The patient lies on a bed for about an hour while we target the fibroids with focused ultrasound waves. There's no anaesthesia, no blood loss, and no downtime."
He likened the procedure to changing the nature of a boiled egg. "You throw an egg into boiling water, and the protein changes permanently. That's what we do to the fibroid, it's killed by heat. It cannot 'resurrect.'" But, how many people can afford this?
However, Dr. Azubike's vision is comprehensive. "If you're paying out of pocket, sincerely, it's expensive. National Health Insurance helps to reduce the cost.
"The government should try as much as possible to subsidise the surgeries, especially in government hospitals. Health insurance provides universal coverage, so people don't pay shockingly high sums out of pocket," he said.
Still, tackling the crisis means more than funding -- it needs people. Doctors trained in myomectomy are dwindling as many leave the country, lured by better pay abroad. Subsidies mean little without skilled hands.
He noted, "We're losing trained surgeons. Many are leaving the country. We must improve remuneration so doctors stay -- and women can get the care they need. Government can also improve remuneration so doctors stay and patients get care."
On timing, "If you don't start having your children early, chances are high that fibroids will grow. While pursuing a career, consider family life too.
"Those herbal concoctions don't remove fibroids. Instead, they distort tissue and make surgery harder," he added.
Also, Dr. Lawal highlighted promising advances in less invasive treatments: "Luckily in Nigeria, we have started having those advances that one may not necessarily need to cut with a knife to do procedures for fibroid, especially when they are not so large."
However, he emphasised that affordability remains a significant barrier. "Government should start looking at how to ease the burden on these women who cannot afford the cost of surgery."
Dr. Lawal also called for a broader national awareness campaign to dispel myths and educate the public. "It's not something due to the actions of a woman. It's just a normal part of growth."
To address the issues facing rural and underprivileged women, Dr. Lawal appealed once again to the government and media: "Those women in the rural area are the ones that are more susceptible to this misinformation. They're probably going to sell off the little they have to procure drugs that will not work."
"We need, not just the government, people like us who are healthcare workers, people who are knowledgeable, and people in the media who need to raise their awareness about what fibroids are and how it is to be treated."
Uterine fibroids remain one of the most under-discussed, yet deeply impactful, health crises facing Nigerian women. From death and infertility to shame and silence, the consequences are brutal. But with education, early intervention, health insurance, and government commitment, there is hope.
The time to act is now -- because no woman should have to die from something so common. No woman should have to carry a tumour in her womb and be congratulated for it.