Are you one in every 10 women living with endometriosis?

Endometriosis Awareness Month is observed each year in March to raise awareness of this often debilitating disease that affects as many as 10% of women, because it is often diagnosed late, misdiagnosed and/or incorrectly treated.

In this article, our Cape Fertility team helps to raise awareness of the immense impact of endometriosis on a woman’s life; the treatments available to restore quality of life; and how we use a patient-centred approach to treat endometriosis with great success.

In a recent in-depth Health-e News feature entitled Endometriosis: One in ten women experience this debilitating and isolating condition several women spoke openly about how the condition severely affects almost every aspects of their lives.

For example, one young woman, now 25, who started suffering from endometriosis at the age of 12, recalls crouching in a foetal position on the classroom floor. “I remember one time I was in so much pain and the principal wouldn’t let me leave. My mom came in and declared, ‘I’m taking my daughter home, she’s really not feeling well.’ The principal told her, ‘Your daughter is fine,’ but my mother replied, ‘She is in pain, I’m not letting her sit here!'”

“It feels like my uterus is wrapped in barbed wire and a thousand ninjas are inside it and each one is stabbing,” tells another woman who, at age 37, has endured endometriosis for more than two-thirds of her life.

“Doctors also undermine your experiences with endometriosis,” says one long-time endometriosis sufferer. “When I am in such pain, I will tell them that I need a morphine drip as that is the only thing which helps. I often get told that they have been treating endometriosis for five to ten years – but I am the one who has been living with it for twenty-plus years!”

Speaking about endometriosis #speakupaboutendo is crucial to raising awareness, because its symptoms are generally not openly discussed.

Many women with endometriosis experience intense pain and isolation for many years, believing that it is normal! They often keep quiet about their symptoms, which means their endometriosis may not be diagnosed or treated. Young girls and even women are often embarrassed to talk about the symptoms or find it hard to describe the symptoms, especially those experienced during periods. Some of the other reasons why so many women suffer in silence include skeptical family and medical personnel disbelieving or disregarding their health complaints; living on anti-inflammatories and pain medication; being afraid of what might be wrong with them; and struggling to explain their inability to cope with school, work and home responsibilities.

However, a brief overview of the symptoms of will clearly show that these are not normal.

Do you have these symptoms of endometriosis?

#endometriosis is a non-cancerous condition in which the endometrium (the lining of the uterus) grows outside of the uterus. It can be minimal or mild, with only superficial implants and mild adhesions, or moderate to severe with chocolate cysts and more serious adhesions.

The symptoms can also range from no symptoms at all to severe symptoms. The most common symptoms of endometriosis are #pelvicpain or pain in the pelvic area, including painful periods and difficult or painful intercourse.

In the majority of the cases, chronic pelvic pain is due to endometriosis. Endometrium tissue or lesions can cause extreme pain and can also attach to other organs causing further pain and health complications. The pain can also be experienced at other times, such as during sexual intercourse, or when passing urine or stool, especially during a period. The pain can be so severe that it substantially negatively impacts the quality of a woman’s life.

Other associated symptoms of endometriosis include abnormally heavy bleeding with periods, fatigue, depression, eating problems and gastrointestinal (GI) problems. As Dr Rizwana Roomaney, a research psychologist at Stellenbosch University who specialises in endometriosis, says in the Health-e News endometriosis article: “In a study of 202 South African women with the condition, we found that 43% reported moderate to severe symptoms of depression. Physical day-to-day limitations such as walking, feelings about the medical professionals, and sexual relationships were significant predictors of symptoms of depression.”

Another very common symptom of endometriosis is infertility.

Symptoms can begin prior to a girl’s first period, and for most women symptoms persist throughout their menstrual life but can continue after menopause.

Treatments available for endometriosis

Unfortunately, there is no cure for endometriosis – it persists for the long-term.

However, endometriosis can be treated very effectively. The treatment options include medicines, surgery and assisted reproductive therapies (ART) such as IVF (In Vitro Fertilisation).

This means that the treatment of endometriosis is different for different women, depending on their specific symptoms and the outcome required. For example, when addressing pain, a different treatment is used than when treating infertility. As such, surgery is not always the first approach for pelvic pain management, but rather medical treatment. However, when a woman is trying to conceive, surgery is often necessary. Which treatment is required is also dictated by the patient’s quality of life. Chronic pain and severe pain for an extended time is not normal and has a very negative effect on a person’s quality of life.

It is also important to consider the side effects, the efficacy, the availability and the costs of each treatment option. In addition, the patient’s personal preferences must also be taken into account, when deciding on the treatment of endometriosis. As a result, each patient’s treatment plan for endometriosis will differ.

This makes it crucial that you choose the right clinic where you can receive the correct treatment for you.

Where to get the right treatment for endometriosis

Only choose a treatment clinic that is registered with SASREG, the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy. These clinics follow the recommended treatment protocols for South African patients based on international guidelines from the European Society of Human Reproduction and Endocrinology (ESHRE).

It is also important to ensure that the clinic you choose will provide the right treatment for your unique condition. The only way to know for certain which endometriosis treatment is right for you is to undergo the necessary tests at an accredited and recognised clinic, where a specialist with state-of-the-art equipment and years of experience will be able to make a professional determination and provide you with the best advice for the right treatment.

At Cape Fertility, we use a patient-centred approach to treat endometriosis with great success. That is because we believe that the treatment of endometriosis should be based on the symptoms of the patient, which are unique in each woman’s case. Treatment should therefore entail a combination of medical treatment, surgical treatment and ART based on the patient’s unique situation.

Without a patient-centred approach, mistakes in the diagnosis and treatment of endometriosis are common. Very often there is already a delayed diagnosis. Often, too, endometriosis is not properly diagnosed, and symptoms like anxiety and depression remains untreated.

If you suspect that you have endometriosis, especially if you are trying to conceive, we would like to invite you to come and meet one of our specialists by clicking here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality treatment, and higher success rates at our purpose-built premises, situated in the Claremont Medical Village in the beautiful city of Cape Town.