So, You Have Endometriosis?

March is Endometriosis Awareness Month. But why do we still hear so little about the disease that affects 200 million women in the world?

Endometriosis affects more than 200 million women all over the world, and on average, more than one in ten women of reproductive age will be diagnosed with endometriosis during their lifetime. 

A whole-body disease which can affect any organ or tissue throughout the body, Endometriosis is a condition where cells similar to the ones lining the womb are found elsewhere in the body, usually within the pelvic cavity. Each month, these cells react to the menstrual cycle in the same way to those in the womb, building up and then breaking down and bleeding. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape, which leads to inflammation, pain, and the formation of scar tissue, known as adhesions. 

Presenting a wide range of symptoms, including pelvic pain, severe cramps during menstruation, heavy irregular periods, painful abdominal swelling, pain during sexual intercourse, fatigue and weakness, gastrointestinal symptoms such as constipation, bloating and diarrhoea, painful bladder and bowel movements, Endometriosis is one of the leading causes of infertility, with nearly 50% of infertile women suffering from the condition, and occurs from puberty to menopause – although the impact may be felt for life.

While the cause of endometriosis is unknown, genetic, environmental and anatomical causes may contribute to its development. Despite there being no way of preventing endometriosis, there are ways of managing symptoms and of managing the disease. 

Master Surgeon in Endometriosis Care – Dr Charles Badr Nagy Rafael

Recently becoming just the second doctor in the world to be certified as a Master Surgeon in Endometriosis Care, Dr Charles Badr Nagy Rafael from Dubai’s Medcare Women & Children Hospital has noted an increase in cases of endometriosis over the decades. “Diagnosis of endometriosis can often take many years, with the average time before accurate diagnosis is achieved anywhere between seven and ten years’, he explains. ‘While the causes of endometriosis are unknown, and there is currently no cure, there have been many theories that have tried to explain the disease – the most prevalent being the retrograde menstruation theory, where some of the cells of the lining of the womb spill into the abdomen during menstruation and stick to the ovaries, fallopian tubes, bowel or bladder – a process thought to cause the condition. Other factors include immunological dysfunction, metaplasia of normal cells of the peritoneum into endometriosis and certain environmental toxins.”

While the cause of endometriosis is unknown, genetic, environmental and anatomical causes may contribute to its development. Despite there being no way of preventing endometriosis, there are ways of managing symptoms and of managing the disease, with some sufferers combining surgical and pain relief treatments with yoga to relieve pain symptoms.

“If untreated, endometriosis can lead to serious health complications, including bowel obstruction, permanent damage of the ovaries, bladder dysfunction, kidney failure and infertility – and this is not taking into consideration the impact on quality of life and even a women’s career due to the chronic pain that accompanies it,’ adds Dr. Raphael. ‘This is why it’s crucial that it be diagnosed and treated as quickly as possible by experienced doctors, in a dedicated division that focuses on the management of endometriosis. Treatment can be either medical or surgical depending on the woman’s age, fertility requirement, severity and location of the disease, but one certainty is that this treatment will make a hugely positive impact on the quality of life that each woman manages to lead going forward.”

Treatment options available to women with endometriosis are surgery, hormone treatment and pain relief, with the choice of treatment determined by several factors, including the individual circumstances of the woman, her age, the severity of her symptoms, the desire to have children and the severity of the disease. All of the treatments aim to reduce the severity of symptoms and improve the quality of life for a woman living with the condition. 

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Lucy Wildman

Lucy Wildman

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