‘Why we keep talking about endometriosis’

On 22/Mar/2019 / In Articles

As a woman, do you experience prolonged abdominal or pelvic pains during your menstrual cycle that is so extreme that it stops you from doing your chores for days? If yes, it is advisable you see a gynaecologist because you may be suffering from endometriosis.
 
Described as a medical disorder experienced by women, endometriosis is a condition where patches of the womb’s inner lining are found growing in other parts of the body.
 
According to Dr. Abayomi Ajayi, consultant obstetrician and gynaecologist, the disease occurs when tissues similar to the lining of the womb are found where they are not supposed to be, especially in the bladder, ovaries, among others. The tissue bleeds monthly and can cause  chronic pains for sufferers.
 
A painful disease that affects women during their reproductive years, endometriosis occurs when uterine-lining tissue is found growing outside of the uterus. This usually results in chronic pain during and between menstrual periods, heavy and long menstrual cycles, gastrointestinal upsets, and fatigue. Because symptoms of endometriosis are varied, many doctors continue to miss its diagnosis, said Dr Ajayi, also the Chief Executive Officer (CEO) of Nordica Fertility Centre, Lagos.
 
Endometriosis is associated with menstruation. While the commonest symptom is abdominal or pelvic pains, diagnosis could be like epilepsy and convulsion, said Mrs. Tola Ajayi, clinic manager, Nordica Fertility Centre.
 
While the cause remains unknown, scientists said endometriosis may cause infertility. Although it affects about 176 million women worldwide, paucity of data has made it difficult to know the  number of those suffering from endometriosis in the country. Yet, awareness about the ailment has not gained full traction here.
 
As part of this year’s global campaign against endometriosis, Dr. Abayomi-led Endometriosis Support Group of Nigeria (ESGN) organised a walk in Lagos. The well-attended march began with a five-kilometre walk from the City Mall in Lagos Island to Muri Okunola Park and climaxed with an ‘Endo carnival,’ awards and other activities.
 
Ajayi said the march was intended to create and intensify awareness about endometriosis, besides gathering support and raising funds for research into its cure and management.
 
According to ESGN, Nordica Fertility Centre, and other promoters of public awareness about endometriosis, activities geared towards creating awareness about the disease are necessary to help end the silence around endometriosis. Without breaking the silence around endometriosis, it is impossible to put an end to the disease, they said.
 
Sadly, there is no cure for endometriosis, despite that one in 10 women suffers from it. Doctors added that its symptoms too can be difficult to manage. Its most common symptom is a debilitating pain. The pains come before, during and after menstruation cycle, mostly accompanied with nausea, fatigue, anxiety and depression.
 
Research has also confirmed that endometriosis is the biggest cause of infertility in women because more than half of women that experience it will have difficulty getting pregnant. It is, however, established that endometriosis is a treatable cause of infertility.
 
A woman’s first affair with endometriosis usually starts with her first menstrual experience. But most sufferers bear the pain in silence for years. Many sufferers crave to start a family, but endometriosis often decrees otherwise. Endometriosis is so bad that it prevents women from work, while many have lost their means of livelihood because of the complications it brings into their life. Although it is a disorder that affects many women, the average diagnosis can take about 10 years or more, and with long years of suffering, experts, such as Ajayi, have committed to continue to raise awareness about symptoms of endometriosis until the wall of silence around the disease is broken down completely in the country.
 
While writhing in excruciating pains and feeling sick, constant visits to doctors and tests hardly help until she meets an experienced gynaecologist who can properly diagnose the disease through a laparoscopy.
 
Through diagnostic laparoscopy, endometriosis is revealed in a woman’s uterus, ovaries, bowel or urethra – mostly after having done a huge damage that only a hysterectomy can salvage. Laparoscopy is a minimally invasive procedure that allows a doctor to use a thin telescope to look into the pelvic area and search for visible signs, which helps to confirm diagnosis by examining tissue samples to determine if the disease is present.
 
Many studies have shown that it takes an average of 10 years for women to receive a proper diagnosis of endometriosis. This is because there is a lack of adequate knowledge about the disease. But the fact that many sufferers are unaware of  the key symptoms makes matters worse.
 
That is why experts have warned that if any woman experiences pain that does not seem ordinary or appears so abnormal that it prevents a sufferer from leaving home for about three days when menstruating, she should seek diagnosis without any further delay.
 
An understanding of symptoms also helps. Any woman who bleeds from the navel or rectum during monthly menstrual cycle should cry out, instead of preferring to suffer in silence because doctors insist no woman deserves to writhe in excruciating pains during menstruation.
 
Like the pall of ignorance surrounding the disease among the people, Abayomi said many doctors also have difficulty in diagnosing endometriosis, sometimes leading to misdiagnosis. He blamed training in the medical school where endometriosis is not fully covered; so, doctors hardly consider the condition when examining a patient. Another reason for misdiagnosis is that endometriosis symptoms, such as digestive problems, pelvic pain, and leg pain, are shared with other conditions.
 
Doctors explain further that one problem that fuels endometriosis is the stigma or the unwillingness to talk about it. Because of cultural taboos, women often find it uneasy to talk openly about it; fearful that they may be judged as weak.
 
Doctors insist that continuous conversations about endometriosis are necessary to inform women about the reality of the disease and its impact on their lives to encourage people to speak out.
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