Hormonal Profiles in Women with Uterine Leiomyoma: A Case-control Study in a Nigerian Cohort

Uterine leiomyomas (fibroids) are hormone-responsive benign tumors prevalent among women of African descent. While ovarian steroids are known contributors, the roles of gonadotropins and prolactin remain less defined in African populations. This case-control study evaluated serum levels of FSH, LH, prolactin, oestradiol, and progesterone in Nigerian women with ultrasound-confirmed leiomyomas versus matched controls. Hormonal assays were conducted using ELISA, and data were analysed using SPSS v26.0 with significance set at p < 0.05. Women with fibroids had significantly higher prolactin (P < 0.001) and oestradiol (P < 0.01), and lower progesterone (P < 0.01), while FSH and LH showed non-significant increases. Among obese leiomyoma patients, the mean levels of oestradiol, FSH, LH, prolactin, and progesterone were not significantly difference across the group (p>0.05). Nulliparous women with leiomyoma had significant lower level of LH compared to multiiparous women with leiomyoma (P<0.05). Ethnically, Igbo women exhibited significantly elevated prolactin (P < 0.05), with no other hormonal differences. These findings suggest a distinct endocrine profile in Nigerian women with uterine fibroids, characterized by elevated estradiol and prolactin, and decreased progesterone. Trends observed with BMI, parity, and ethnicity imply that hormonal modulation in fibroid pathophysiology may be influenced by both metabolic and sociobiological factors. The study emphasizes the importance of considering demographic and ethnic differences in hormonal evaluation and supports the need for personalized approaches to fibroid diagnosis and treatment. Prolactin, in particular, emerges as a potential ethnic-specific biomarker with diagnostic and therapeutic relevance.