Winifred Bosa.

If your menstrual pain is far worse than usual and you feel lack of energy, bleed excessively,  mood changes, anxiety and depression due to ongoing pain; if it reduced your quality of life by taking days off work, study or school because you can’t function normally ; if you feel lower back and abdominal pain , pain with intercourse , pain with bowel movements or urination , digestive problems ;  if you are finding it difficult to be pregnant ,fertility  expert say , you may be experiencing endometriosis and you need to see a doctor immediately.

For when not detected and left untreated, endometriosis can lead to chronic pelvic pain, infertility, and disability in affected persons , so early diagnosis and treatment is the  key to one being relieved of this condition.

Endometriosis is a gynaecological disorder that affects 176 million women and girls worldwide during what should be the most promising years of their lives. Experts estimate that the world loses at least $100bn annually to the effects of this disorder alone. Endometriosis does not only affect the woman or girl, it could also affect her relationship with her family, employers, colleagues, friends, teachers, and loved ones. And at present has no cure but can be treated with early diagnosis.

In lieu of this , the month of March has been designated as the endometriosis month globally; to raise awareness on the need for victims to get treated or help someone living with this condition get help and also for medical experts to  discuss way forward pertaining endometriosis .

In West Africa and particularly in Nigeria , The Medical Director (MD), Nordica Fertility Centre, Dr Abayomi Ajayi,  is unmasking this ailment through the Endometriosis Support Group Nigeria ESGN , a group aimed at fighting the scourge of endometriosis in Nigeria and West Africa.

Explaning endometriosis at events to mark EndoMarch 2017 , he said “endometriosis,  occurs when tissue similar to the linning of the womb is found elsewhere, most commonly on the ovaries,in the recto-vaginal septum, bladder or bowel. That tissue behaves like the lining of the womb, bleeding every month and can cause severe and chronic pain. This  endometrium or that inner lining of the uterus can be present in some other places apart from just the lining of the Uterus.

What happens is that every month that they bleed, those endometrial implants on other places also bleed. So let’s imagine that a woman has this lining on her abdomen, it means that every month she bleeds in her abdomen and because abdomen does not usually have blood inside, all the organs in the abdomen will start reacting to the unusual present of the blood in the abdomen.”

Though the severity of the pain is not necessarily a reliable indicator of the extent of the condition ,  Dr Ajayi who is also a consultant gynaecologist and fertility expert, explained that the symptoms are different from woman to woman.

“symptoms could be so misleading that a lot of people were misled to believe it was something else they were suffering from, depending on where these deposits are.

In fact some people have deposit in the chest and therefore can be bringing out blood from their throats and that could be mistakenly interpreted to be tuberculosis. There are also few women that the deposit is in their brains and so they bleed into their brains, which most often results in epilepsy “.

On failure of diagnosis and lack of awareness , Dr Ajayi clarified that the symptoms are so wide spread and that is why it is called masquerade of diseases and sometimes it is very difficult for doctors who are not specialised on Endometriosis to recognise them .” most of the times, the doctor may examine but would not find any reason why the pain is there and all the doctor could do at such situation was just give the sufferer  some pain relief tablets or worst still tell her that there is nothing wrong with her but it is in her head. This is the life that many patients with Endometriosis live with.”

He continued,  “I reviewed over 200 patients. I found that it was present in only three of them. So I concluded also that it was not a common thing but little did I know that we were missing a lot of things and that was in about 1993.

Then we started Nordica Fertility and then the husband of the person that her chest was cut at the Teaching Hospital, one way or the other found his way to Nordica. I didn’t know how because I was just one of the doctors that took care of the wife. So we started talking, and he told me that the wife had since left for the UK for treatment but he wanted her to come back home and he was looking for a doctor that would look after the wife. That was my first treatment of Endometriosis in Nigeria and this led us into doing laparoscopy surgery during which we started discovering a lot of women with endometriosis in Nigeria.”

He said that approximately 176 million women worldwide are affected with endometrosis,  while some women have many symptoms where severe pains occur,  others have no symptoms and as such , about 1/3 of women with endometriosis discover they have it because they have not been able to become pregnant, or because endometriosis is found during an operation for another reason.

In Africa, he lamented that the situation is worse, because very little is known about the condition and therefore, a lot of women are living with it without ever being diagnosed, as the condition was believed not to be common among blacks before now , but,  however, over the years, he said that it has been discovered that no race is left out of this excruciating ordeal.

“And because we were told that this disorder is not common in blacks, so until about 30 years ago, no doctor was focusing on endometriosis in this part of the world. Buy not up to two week after, another patient came over, this time; she was bleeding from the naval. And they have taken her to churches and other places for cure thinking it was a spiritual attack. For them, they were like, how can someone be bleeding from the naval? When she was brought we found out that it was endometriosis. That also raised my curiosity and I then knew there was endometriosis in this part of the world and it made me to go home and strive to do a study on it,” he observed.

Meanwhile in Nigeria, Ajayi disclosed that many cases are either misdiagnosed or not diagnosed at all ,adding  that even when detected, many women do not get proper treatment hence there is the need to raise awareness on the symptoms of the disorder among women, so that those who are affected can seek medical treatment, care and support to reduce the frustrations that come with the condition.

“It affects women in the prime life of their life. It is not a lifestyle disease neither is it is a disease you get later in life. It attacks teens, young women when they should be active, working, having children, or having sex. 50% of them are struggling with Sex because it is too painful. ”

He mentioned , treatments such as pain medications , In vitro fertiliaation IVF for patients trying to get pregnant  ,hormone therapy or surgery e.g Laparoscopy and laparotomy , they require going in through the abdominal region to remove the endometrial tissue but  however, if symptoms keep coming back after these surgical procedures, a hysterectomy, or total removal of the uterus, may be a last resort option .

So with each passing year , ESGN is intensifying effort to create awareness of this ailment and with this year’s theme Endometriosis in Adolescents ESGN is creating awareness amongst teenagers to enable them understand early in their lives what Endometriosis was all about and also to be able recognise early enough when they are suffering from it.

On this note , ESGN is  organising an essay competition on Endometriosis amongst secondary school students and the prizes for the winners will be presented at the Endometriosis Gala, which is slated for March 19 at the Civic Centre, Victoria Island Lagos.

However, there was an endo march recently in Abuja and in Lagos to end the silence of endometriosis . And also there would be a physician roundtable tomorrow  where experts from all over the world would discuss the eulogies, diagnosis and treatment options of adolescent endometriosis .