ENDOMETRIOSIS

Endometriosis is a chronic disease of the female reproductive system that causes severe pain during periods, sexual intercourse, bowel movements, or urination. In some reported cases, endometriosis can cause infertility with resulting depression and anxiety.

What is Endometriosis?

Normally, the tissue lining the uterus sheds every month as menstruation, but in endometriosis, this tissue grows outside the uterus causing severe pain during monthly shedding.

In other words, it is a condition in which the ovaries, fallopian tubes, and other pelvic organs, such as the vagina and bladder, develop endometrial tissue. This pain can be very severe, causing a woman to have worsening pain during sex and result in infertility.

Prevalence of Endometriosis

Globally, about 190 million women and girls of reproductive age are affected by endometriosis, according to the World Health Organization (WHO). In other words, 1 in 10 women and girls experience endometriosis worldwide.

In Nigeria, the statistics are higher, with an estimated prevalence of about 48.1% according to a study in 2015. The study also found that endometriosis was more common among women who reported dysmenorrhea and pelvic pain than among those who did not have these symptoms.

Risk Factors and Causes of Endometriosis

Risk factors for endometriosis include:

●    Age between 20- 40 years
●    No history of pregnancy or childbirth
●    Starting menstruation at a young age, that is early menarche
●    Delayed menopause, short menstrual cycle, heavy menstruation, etc.

The exact causes of endometriosis is still unclear, but experts have linked it with:

●    Retrograde menstruation

This theory explains that when menstruation occurs, blood containing endometrial cells sometimes flows backwards and into the pelvic cavity during menses. This leaves the endometrial cells deposited outside the uterus where they start to grow and cause discomfort.

●    Surgical scars

This theory is explained as when endometrial cells attach to scar tissue from a surgical incision around the pelvis and abdomen.

●    Cell Metaplasia

Cells sometimes change from one form to another, a phenomenon referred to as metaplasia. Endometriosis may occur when other tissue cells change into endometrial-like cells and continue to grow as endometrial cells.

●    Stem Cells

Stem cells may give rise to endometriosis in some conditions, which then spreads through the body through blood and lymphatic vessels.

Symptoms of Endometriosis

This condition may or may not occur with symptoms. However, the obvious symptoms in case it occurs include:
●    Severe lower abdominal pain starting few days to menstruation 
●    Painful sexual intercourse 
●    Painful urination and defecation, worse during menstruation 
●    Diarrhoea, constipation, nausea or other digestive problems during menstruation

Prevention of Endometriosis

Endometriosis cannot be prevented or absolutely cured. However, it is important to raise awareness among the population at risk and healthcare workers, especially at the primary level, to ensure early diagnosis and effective management before it leads to complications.

Medical Management

Endometriosis cannot be cured, but the symptoms can be treated with medications and sometimes surgery, depending on the severity.

If you have been diagnosed with endometriosis, consult with your doctor to determine the best treatment based on the extent of the disease.

Complications

Endometriosis if left untreated or when diagnosed late could lead to several complications. Those who have endometriosis may struggle to conceive in up to 50% of cases. Infertility due to endometriosis is often due to painful intercourse, however there have been reports of direct tubal blockage by endometrial cells.

Some studies suggest that endometriosis raises the risk of ovarian cancer. Endometriosis-associated adenocarcinoma is a rare but potentially fatal disease that can develop later in life in patients.

Endometriosis has serious social, public health, and financial consequences, because intense pain, fatigue, anxiety, depression, and infertility can lower the quality of life. Therefore, it is important to consult with your doctor as soon as possible to get proper medical treatment.