This is a continuation of the Infertility series and this week we will be discussing Endometriosis. The recent increase in awareness surrounding endometriosis and it's challenges has been a welcome change to the norm. A lot of celebrities have come out to share their battles with endometriosis and infertility and I applaud their courage.
What is Endometriosis?
Endometriosis is a gynaecological disorder that occurs when endometrial tissue (normal tissue that lines the womb)grows outside the womb most commonly the ovaries but in reality can be found anywhere!
Endometriosis is a gynaecological disorder that occurs when endometrial tissue (normal tissue that lines the womb)grows outside the womb most commonly the ovaries but in reality can be found anywhere!
It is estimated that Endometriosis affects nearly 176 million women worldwide regardless of their ethnic and social background. Many remain undiagnosed and are therefore not treated.
In developed countries, it occurs in up to 20% of
women of reproductive age and is a common cause of pelvic pain and infertility.
In sub-Saharan Africa, data on endometriosis among African
indigenous women are scarce! In some of the few published studies,
endometriosis constituted the third most common finding at laparoscopies and
was reported in 15.7% of laparoscopies performed for infertility
assessment.(Menakaya et al, 2015)
Symptoms
Common symptoms include but are not limited to:
- Painful, heavy, or irregular periods
- Pain during or after sex
- Infertility
- Painful bowel movements
- Fatigue
- Pain during an internal examination that is disproportionate
The actual cause of Endometriosis remains unknown however it is suggested that it is caused by a combination of different factors which include:
- Retrograde menstruation- This occurs when menstrual blood flows backwards from the womb out through the fallopian tubes and into the abdomen. The deposits of endometrial tissue is said to be deposited as a result resulting in Endometriosis.
- Genetic Predisposition- Some research suggests that some genes passed down through different generations make individuals in the same family more likely to have Endometriosis.
- Spread through the blood stream- Some research suggests that endometrial particles are carried in the blood stream and deposited round the body as a result.
- Immunodeficiency- Some research has shown that endometriosis is more likely to be found in women with reduced immunity. It is unclear however if this causes Endometriosis or if the immunodeficiency is caused by Endometriosis.
- Environmental Factors-This theory suggests that exposure to certain toxins in the environment can make certain women more susceptible to it.
Endometriosis does not necessarily cause infertility but there is a strong association with fertility problems. Even with severe endometriosis, natural conception has been known to occur.
As the severity of the endometriosis increases, scar tissue (adhesions) become more common and the chance of natural conception can decrease.
Minimal to mild endometriosis sufferers have an almost normal chance of conception but some sufferers are infertile for unclear reasons. Some research also suggests that with severe endometriosis, there are more adhesions that can trap the egg and stop it from moving down the Fallopian tube.
Diagnosis
Whilst detailed history, pelvic examination, Ultrasound scans and blood tests are useful, the only definitive way to diagnose endometriosis is by a laparoscopy - an operation in which a camera (a laparoscope) is inserted into the pelvis via a small cut near the navel. The surgeon uses the camera to see the pelvic organs and look for any signs of endometriosis.
Because endometriosis shares symptoms with or can mimic other conditions, diagnosis can be difficult and often delayed. Recent research shows that there is now an average of 7.5 years between women first seeing a doctor about their symptoms and receiving a firm diagnosis . In Nigeria it is suggested that this is increased to 10 years !!!
Because endometriosis shares symptoms with or can mimic other conditions, diagnosis can be difficult and often delayed. Recent research shows that there is now an average of 7.5 years between women first seeing a doctor about their symptoms and receiving a firm diagnosis . In Nigeria it is suggested that this is increased to 10 years !!!
Treatment
Pain Control! Most women with Endometriosis will tell you that it is excruciating. Managing pain is crucial as it has the greatest impact on a woman's quality of life.
Hormonal treatments Endometriosis responds and grows when exposed to the female hormone oestrogen, the aim of hormonal treatments is to block or reduce the production of oestrogen in the body. This halts the growth of the endometriosis and relieves symptoms. There are pros and cons, and the possibility of side effects with hormonal treatments.
Please note that these drugs are not curative and do not help to improve fertility. It is important that treatments are carried out by a qualified practioner and with close supervision.
Surgery can be considered as an option and scale of surgery can range from Conservative (where individual deposits of endometriosis are removed, there is a risk of recurrence with this) to Radical where the uterus and ovaries are removed (This is usually considered in women with severe cases or women who have completed their families). Surgery is not a decision that is taken lightly as it comes with its own risk and could be quite a radical treatment option. Women will need to have thorough and detailed consultations with their doctors to decide on the best treatment option for them.
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| Genea.com.au |
Endometriosis is quite complex and this post is a simplified overview of this condition. It is estimated unofficially to affect 1 in 10 women in Nigeria. Do you have any of the symptoms described above and problems with fertility? I will recommend seeing a specialist for further assessment. More and more women are becoming more aware but we need to continue to spread the word.
Have you or someone you know been diagnosed with Endometriosis, I have found two NGOs online that provide support for Nigerian women. Endometriosis support group, Nigeria and ENDOSURVIVORS, hopefully you find them helpful.
Thank you for reading and all your wonderful comments and E-mails, remember its a movement to take control of our health!
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