March is Endometriosis awareness month. Endometriosis is a silent tormenting monster associated with excruciating pain. I am excited because of the kind of information we have access to now, could actually save and change a woman’s life. According to Planned Parenthood, Endometriosis is a reproductive health condition where tissue similar to the kind that lines the inside of your uterus is found outside your uterus, where it doesn’t belong. It affects more than 11% of women between 15 and 44 years old.
I know you might be wondering, Endo… what? Don’t worry. I will explain what that is in a short while. If I wasn’t a medical doctor, I would probably have no idea what that is either, but thank God I am. Don’t run away, yet I will try to keep the medical jargon away from you and be as simple as I can.
Endometriosis is a chronic gynaecological condition. It happens when endometrial tissue (tissue that is similar to the lining of the uterus/womb) grows outside the uterus. It is almost like the endometrial tissue gets misplaced and grows elsewhere in the body, hence the name ectopic endometrial tissue. The commonest site for endometriosis is the ovaries. Other sites include the abdominal cavity, cervix, vagina, sigmoid colon, fallopian tubes etc. This misplaced tissue usually responds to the monthly hormonal cycles, and that is where the torment is. With every period, the ectopic tissues bleed, resulting in inflammation and scarring.
The commonest site for endometriosis is the ovaries. Other sites include the abdominal cavity, cervix, vagina, sigmoid colon, fallopian tubes etc.
Why are we talking about endometriosis?
1 in 10 women in the reproductive age group are affected by this condition. Pretty common right? This corresponds to about 176 million women worldwide. It has also been found in 70% of women/adolescents with pelvic pain, 40% of adolescents with genital tract anomalies and in 50% of women with infertility. Endometriosis is a common cause of infertility in women. For every 10 women with endometriosis, 4 will have problems with conception. In fact, endometriosis is typically first diagnosed in women who seek treatment due to infertility.
What’s more shocking is the amount of time it takes to diagnose this condition. According to NAEAS, there is a 9-year delay between the time a woman seeks help and gets diagnosed with endometriosis. 9 years before getting a diagnosis! To make matters worse, some women NEVER get a diagnosis. It takes 8 doctors in 10 years to make such a diagnosis.
For every 10 women with endometriosis, 4 will have problems with conception. In fact, endometriosis is typically first diagnosed in women who seek treatment due to infertility.
Misdiagnosis
How does this happen? A disease that is so common takes 9 good years to diagnose. Unbelievable! Misdiagnosis is also very common with endometriosis. It is easily confused with other diseases with similar symptoms or dismissed as just normal period pain (dysmenorrheal). Most women diagnosed with endometriosis report that their primary care physicians thought that they were hysterical.
The prevalence of endometriosis in Kenya is not known. This is because diagnosis involves surgery (laparoscopy). The cost of treatment for endometriosis in Kenya is approximately Sh. 355, 000 per woman per year.
What you need to know about endometriosis
Endometriosis is not just a ‘bad, painful’ period. It is more than that. It is not a life-threatening condition, but it is life devastating and debilitating. Furthermore, it is important to clarify that this disease is not an emotional disease, but a physiological one. Endometriosis can cause emotional turmoil, but the vice versa is not true. Most women have suffered because they were told that period pain is normal, or they were thought to have a low pain threshold or dismissed as being psychologically inadequate/weak.
Periods should not be that painful. Any pain that affects your daily life and your productivity is not normal. A woman shouldn’t have to miss work or school or her daily activities because of her period. Unfortunately, this is how it has been in our culture. Severe period pain is not normal!
The exact cause of endometriosis is not known, but a few theories exist, e.g., retrograde menstruation which in lay terms means that bleeding occurs backwards into the abdominal cavity thus causing endometrial tissue to be implanted there. There are a few factors that can put one at risk of getting endometriosis. This includes; genetics (there’s a 51% hereditability), early age of menarche (first period), heavy periods, long duration of menstrual flow among others.
Periods should not be that painful. Any pain that alters your daily life and your productivity is not normal. A woman shouldn’t have to miss work or school or her daily activities because of her period.
What are the common symptoms of endometriosis?
1/3 of the patients are usually asymptomatic. The level of pain does not always correspond with the severity or extent of the disease. A person with mild endometriosis may experience more pain than one with a severe form. This kind of pain does not usually disappear even with painkillers.
Depending on where the misplaced tissue is, some symptoms include;
- Extremely painful periods (dysmenorrheal)
- Heavy/irregular periods
- Pain during intercourse (dyspareunia)
- Chronic pelvic/abdominal pain
- Discomfort during bowel movement
- Bloating, constipation or nausea during menstruation
- Blood in urine (haematuria)
Do not hesitate to visit a gynecologist if you have these symptoms.
This condition affects relationships in 73% of the cases. Some patients are advised to conceive as soon as they can by their doctors. This kind of pressure can cause the break-ups in relationships and marriages. Others have even divorced due to issues like dyspareunia. One can only survive this if they have an understanding and supportive partner. That is why the information shared this month is not only for women.
Share your story
If you have suffered from this condition, sharing your story can make a huge difference. The goal is to let people know that this disease exists and that their torment has a name so that they can be diagnosed and treated early.
Thank you for stopping by. You can help save a woman from debilitating pain by sharing this article and educating yourself about endometriosis. Don’t hesitate to click that share button and remember, as long as God lives, there is always hope.
