The endometriosis enigma
March is endometriosis awareness month.Endometriosis is a complex gynaecological condition characterised by abnormal growth of endometrial tissue outside the uterus. The uterus is a female reproductive organ with the main function of caring a baby during pregnancy.
The uterus consists of two layers: the non-regenerating muscular layer and a regenerating inner layer, the endometrium, which is shed during menstruation in a non-pregnant woman.
The uterus opens into the abdomen through tiny tubes known as fallopian tubes. During menstruation, menstrual blood that contains the endometrium layer may travel into the abdomen through the fallopian tubes.
How endometriosis develops continues to evade medical knowledge, as only some women develop the condition. It is believed that once the endometrium is in the abdomen it has a potential to grow outside the uterus.
Once implanted, the endometrial tissue outside of the uterus responds to hormones, causing menstrual pain. Endometriosis also causes internal organs such as the intestines and the uterus to attach.
Worldwide
According to the World Health Organisation data, approximately 10% of reproductive-aged women (190 million) are diagnosed with this condition globally every year. The peak age of patients is in the time frame between 25 and 45 years.
Endometriosis has a variable range of manifestations - from accidentally found asymptomatic lesions to severe conditions, which does not depend on the size of the lesion. The main symptoms are chronic lower abdominal pain, extremely painful periods, painful sexual intercourse, pain during urination and/or painful defecation, abdominal bloating and constipation.
The other manifestation of endometriosis is infertility without any other symptoms: 40 to 50% of infertile women are diagnosed with endometriosis.
Endometriosis has a significant negative impact on quality of life and social well-being of patients due to pain and other symptoms, e.g., fatigue, severe bleeding or mood swings, having to skip studies or work, or tending to avoid sex. It may also increase the risk of mental health issues, such as anxiety and depression.
Control
While there is no cure for endometriosis, the disease can be controlled using birth control typically the pill, a patch or a vaginal ring, and sometimes a hormonal IUD. The only way to effectively diagnose endometriosis is through laparoscopy, a surgery that involves a small incision in the abdomen. During the procedure, doctors may also remove or cauterize endometrial implants.
Emerging research is investigating what causes endometriosis and why some women may be more susceptible than others.
One of the significant challenges faced by people with endometriosis is receiving a diagnosis. It is estimated that patients experience an average delay of five years from the onset of symptoms to diagnosis, therefore women suspecting they may have endometriosis, are encouraged to seek an assessment by a gynaecologist.
*Dr David Emvula is a Specialist Obstetrician & Gynecologist at OB-GYN Practice.
** Opinion pieces and letters by the public do not necessarily reflect the opinion of the editorial team. The editors reserve the right to abridge original texts. All newspapers of Namibia Media Holdings adhere to the Code of Ethics for Namibian Media, a code established jointly with the Media Ombudsman.