Creating Awareness For Endometriosis

By Bilikis Bakare

It is often common for girls and young women to experience pain during early hours of their monthly cycle, a kind of pain most female can relate with and can be relieved with the typical over- the-counter analgesics. But a situation where the pain will just not go away for days, even after taking analgesics, endometriosis should be suspected. Endometriosis is a gynaecological condition first identified by Baron Carl Von Rokitansky in 1860. In endometriosis, the wall of the uterus (womb) called endometrium appear and grow outside the uterine cavity, especially in the ovaries (the most common site), fallopian tubes, the back of the uterus, the front of the uterus, uterine ligaments and the intestines(the rectosigmoid). Other sites include, pelvis and back wall, urinary bladder, ureters and on the membrane which lines the abdominal cavity (peritoneum).

The endometrial cells are under the influence of female hormones and irrespective of wherever they are located, they respond and change in a way that is similar to those found inside the uterus. It occurs in 6- 10 % of women at a ratio of 1 in 10 irrespective of race during their reproductive years- ages 15 to 55 years. Available data revealed that endometriosis affects 176 million women and girls world-wide. And it is pertinent to note that it could lead to infertility in women because those with this condition have 20% less chances of bearing children normally. It could also affects the woman or girl’s relationship with her family, colleagues at school or at work, employers, friends and teachers.

Symptoms depend on the site but the main one is pelvic pain which may range from mild to severe but often worse during the menstrual cycle, where it can manifest in form of disabling cramps when the condition has become chronic. Although, there are four stages involved in the growth progression of the lesion but these do not determine the level or severity of pain experienced by the patient. For instance, a patient in stage one referred to as the minimal stage may experience severe pain than the patient on stage four termed as the severe stage. The pain can also be in form of painful sex (dyspareunia), urinary urgency, frequency and sometimes painful urination.

Endometriosis lesions react to female hormonal stimulation as mentioned earlier and may bleed at the time of menstruation. The blood accumulates locally causing swelling and triggers inflammatory responses. In addition to pain during menstruation, the pain of endometriosis may occur at other times of the month like during ovulation and bowel movement. Other symptoms that may be experienced by the patient include constipation and chronic fatigue. There are no known causes for endometriosis, but some women are at risk more than the others. Female siblings or children of patients with the condition are at higher risk and also, women who are sensitive to exposure to environmental toxins.

To diagnose endometriosis, the physician takes the patient’s health history and performing of physical examination which in some patients may aid correct diagnosis. Other form of test found to be useful in diagnosing endometriosis is Immunohisto chemistry. But perhaps the only way to diagnose the condition is through laparascopy- a surgical procedure where a camera is used to look inside the abdominal cavity.

Endometriosis has no cure, but two types of interventions can alleviate the sufferings of the patients. These are in form of treatments of the pains and the infertility. In young patients who still want to experience the joy of motherhood, surgical treatment which attempts to remove the abnormal endometrial tissues and preserving the ovaries without damaging the normal tissues is recommended. This serve to restrict the progression of the process of endometriosis, relieve pain and restore or preserve fertility. On the other hand, in many women, menopause, whether natural or surgical will abate the process. In addition, older women who do not wish to conceive, hysterectomy- removal of the uterus is done together with the removal of the endometriosis by excision because pain may continue even after hysterectomy. Doses of the hormone progesterone may be administered on the patient to counteract the effects of the other female hormone- estrogen.

But there is good news for women with endometriosis as they can actually have their own babies through the new innovation called surrogacy, where other women can help them to carry their pregnancies in their womb and hand the babies over to them after delivery.

The symptoms mentioned above may sound familiar and obvious to many women but many do not know they have it or have never heard about the existence of this condition. In Africa, the situation is worse as very little is known about the ailment because it was believed that the condition was not common among the black race. And even in developed countries, it can take many years for correct diagnosis to be arrived at, in which case it could have become chronic.

Therefore, the only way out of this excruciating ordeal is to create awareness for the condition among women of different ages, ranging from the school girls to young adults and women in their child bearing years. And for those living knowingly or unknowingly with the condition, it is important to be aware and get proper treatment because no one outgrows the condition it can only be treated medically.

And as the world marks the global endometriosis awareness month, it is important for those already living with the condition to get help and treatment. Similarly, those that know anyone around them having the condition should be their brother’s keeper by getting help for them. To create awareness for the presence of the disease in the country, a group of women have decided to gather together in Lagos, on Saturday, 8th March, 2014,  to sensitise women on the symptoms and treatments available for the condition. It is expected that the gathering would further enhance responsiveness  towards the disease.

It is imperative to stress that there is no unorthodox treatment for endometriosis, it can only be treated medically. So, women need to be careful of being hoodwinked into believing that herbal concoction can provide a permanent cure for the condition. A word is enough for the wise!

•Bakare is of the Features Unit, Ministry of Information & Strategy, Alausa, Ikeja