Practice and Predictors of Complementary and Alternative Treatment Use Among Women With Uterine Fibroids in Lagos, Nigeria: A Cross-Sectional Study

TL;DR

Many women in Lagos, Nigeria, use complementary and alternative treatments for uterine fibroids, often due to cultural beliefs and cost concerns.

Contribution

This study identifies predictors and common practices of complementary and alternative treatment use for uterine fibroids in Nigeria.

Findings

56.6% of women used complementary and alternative treatments, mostly oral herbal concoctions.

Older women and those with lower parity are more likely to use these treatments.

Orthodox care was reported as more satisfying than complementary and alternative methods.

Abstract

Background: Uterine fibroids are the most common benign tumors of the smooth muscles of the uterus, which can cause infertility in women of reproductive age and adverse outcomes in pregnancy, and affect the quality of life. The management of uterine fibroids includes expectant, medical, and surgical management options. Many seek alternative means of treatment because of the fear of the possible complications of surgery for uterine fibroids. This is sometimes influenced by sociocultural values and belief systems, financial constraints, or proximity to orthodox health facilities.

Objectives: The study aimed to determine the practice and predictors of use of complementary and alternative treatment among women with uterine fibroids in Lagos, Nigeria.

Methodology: This study was a cross-sectional analysis of 362 women with uterine fibroids enrolled from four publicly owned health facilities in Lagos State. Data were collected using a pretested interviewer-administered questionnaire. The questions asked comprised information on their practice and potential predictors of use of complementary and alternative treatment before seeking orthodox healthcare for uterine fibroids. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25 software (IBM Corp., Armonk, NY). Binary logistic regression analysis was done to identify predictors of use of complementary and alternative treatments by Nigerian women with uterine fibroids.

Results: The mean age of the respondents was 37.5 ± 6.7 years, with 282 (78.1%) married, 244 (67.4%) attained tertiary education, and 339 (93.6%) were employed. Of the women, 205 (56.6%) had used complementary and alternative methods for fibroid treatment, mostly as oral herbal concoctions 161/205 (78.5%) and vaginal inserts 21/203 (10.3%); 82/203 (40.4%) self-reported having had side effects with the use of complementary and/or alternative treatment: mostly abdominal pain 31/82 (37.8%), fever 15/82 (18.5%), and weight loss 12/82 (14.6%). Only 92/196 (46.9%) of the users found complementary and alternative methods cheaper than orthodox care. Significantly greater satisfaction was reported for orthodox care compared to complementary and alternative care (p < 0.001). Older women and those of lower parity are more likely to seek complementary and alternative care.

Conclusion: The use of complementary and alternative treatment methods for uterine fibroids is common among women presenting to the gynecological clinics for the treatment of the same condition. There is a need for targeted and focused health education intervention programs for high-risk women who may delay orthodox care through seeking complementary and alternative care for uterine fibroid treatment.