What to do about endometriosis

“Endometriosis is difficult to diagnose. Misdiagnosis is very, very common,” says Dr Dipen Prajapati, consultant gynaecologist at Nordica Fertility Centre, Abuja.Endometriosis results when normal cells from the endometrium—the lining of the uterus—get into places they should not be. Problem arises because the cells behave in the same way they normally would—regardless of where they appear.They […]

“Endometriosis is difficult to diagnose. Misdiagnosis is very, very common,” says Dr Dipen Prajapati, consultant gynaecologist at Nordica Fertility Centre, Abuja.
Endometriosis results when normal cells from the endometrium—the lining of the uterus—get into places they should not be. Problem arises because the cells behave in the same way they normally would—regardless of where they appear.
They grow and thicken every month in response to hormones and get shed in the absence of a pregnancy—but unlike normal cells that line the uterine cavity, the blood that results have no way of escape, as if found in monthly periods.
Endometriosis is commonly deposited on ovaries and in fallopian tubes, reducing chances of conception.
“For those who have endometriosis, definitely there is a challenge to conceive,” Dr Prajapati admits in a talk with women to mark 10 years of awareness on endometriosis at Abuja-based Nordica.
Experts don’t know exactly what causes the condition but theories suggest a handful of theories: metaplasia, when normal cells change to endometrial cells; failure of immune system; even retrograde menstruation, when menses flows into the tube instead of out the vagina.
Up to 90 million women world over suffer the pain of endometriosis, and it isn’t just limited to the menses but lasts all month.
“The woman will suffer terrible pain all month, not only during periods. It is a serious pain,” says Dr Prajapati.
The exact number of Nigerian women with the condition is difficult to ascertain, since fertility treatments through clinics are yet to come under fully central regulation, experts worry.
What’s certain is that endometriosis affects all races, unlike fibroids, which is more common in blacks.
Up to 10% of women of reproductive age have the condition, and at least three in 10 women with endometriosis could be infertile.
“Bleeding causes inflammation, leading to scar tissue which may block the tubes,” explains Dr Prajapati. In addition, endometriosis interferes with ovulation and fertilisation, and the cysts that form also interfere with egg quality. Endometriosis also deposits toxins that harm eggs or embryos.
Treatment from endometriosis ranges from conservative management and medical treatment to surgical removal of cysts. But choice of treatment will depend on age, severity of symptoms and whether a woman still desires to have children.