Endometriosis is not just a bad period

One in 10 women suffers from endometriosis or ‘endo’, a painful gynaecological condition that can affect fertility and quality of life.

September 10, is International Gynaecological Health Day, a time for women to become more aware of conditions that affect them. To this end, the Northcliff Melville Times explores endometriosis.

Greymont-based specialist obstetrician gynaecologist Dr Mongezi Siqana describes the condition as having no definitive management plan for treatment or cure.

“It is an inflammatory disease where the cells from the inside of the womb are found elsewhere in the body. Most commonly around the uterus, liver, skin, bowel and even the lungs in some cases.”

Infertility or difficulty in falling pregnant happens when the ovaries and fallopian tubes are affected by conditions like an endometrioma or ‘chocolate cyst’ forms, or tubes are blocked.

When a woman begins her menstrual cycle, normal period pain eases as the days progress. With endometriosis, the opposite happens, pain increases each day during her cycle.

“Some discomfort is expected and is cyclical to correspond to a woman’s period cycle but if it becomes problematic, it is time to go to the gynae to see what is happening – especially for endometriosis as it is a progressive disease that gets worse with time if not treated.”

Possible symptoms of endometriosis:

• Pain worsens during a period rather than easing
• Sex is painful
• Painkillers are always needed during menstruation
• Difficulty falling pregnant
• Ovarian cysts.

It is classified by stages with stage 1 being mild up to stage 4 where the most severe cases are dealt with.

Treatment is done in two ways – medically and/ or surgically:

Medical

• Treatment is offered with progesterone-based medications, or a
• Hormonal device is inserted into the uterus
• Causing a temporary menopausal state to halt disease progression
• Making use of scans to look for disease progression or to identify problems.

Surgical

• The stage of disease will determine if or what kind of surgery is needed
• Is usually performed when medical treatments have been unsuccessful
• Deep infiltrating disease may involve working on the bowel and other serious interventions
• Removal of chocolate cysts
• Shaving off or burning off endo from surrounding organs
• To look at ovaries and egg supply for fertility reasons
• Is usually a simple and safe laparoscopic or keyhole surgery procedure.

“It is crucial to only use doctors who are experienced in the fertility field as unnecessary surgeries are performed,” says Siqana.

He also encourages women to find a doctor who is sympathetic and knowledgeable about how endo can present itself. “If all the symptoms are there but no visible endo is found, it does not automatically mean it is not there. The patient should be treated as if it were regardless because it can hide.”

Linden resident Bridget Gunner was only diagnosed in her 40s after years of painful and debilitating periods.

“My gynaecologist was blasé about my symptoms saying things like ‘let’s only worry when you want to fall pregnant’ or ‘many women have bad periods’.”

She was unable to have her own children – which she really wanted – but did adopt.

“I suffered excruciating and debilitating pain which was always made worse by stress.

“It was only after I did my own research that I thought I might have endo. I spent so much time researching and consuming everything I could to try and understand what was wrong with me. When I found my current gynae my situation drastically improved with proper treatment for my stage 2 endo.

“Everything could have been so different if I had been listened to and diagnosed earlier. I encourage all women who are fobbed off by their doctor, saying it is in their minds or all women suffer. Find someone who will care for you with compassion and expertise.”

Jeana Kent lives in Fairland and has recently undergone surgery for her endometriosis. “I am feeling good physically, but it is as much a mental journey which is sometimes harder.”

She plans on having children in a few years with her boyfriend but worries about her fertility with her stage 3 diagnosis. “I am so grateful to have a partner who is compassionate and understanding; many women don’t have that, and it must be so much harder to endure.

“My diagnosis was a shock – I had never heard of it before.”

She laments how pain during menstruation is, ‘so normalised that women suffer in pain and aren’t given treatment that really considers what the cause is.’

Jenna Schubach is currently studying education and psychology after being diagnosed at 14 with endometriosis.

“My period started when I was 12, and it was always more painful and heavier than that of my peers.

‘Being younger I think really helped me get better treatment. There was not this obsession with me falling pregnant, so my symptoms and quality of life were taken seriously, something I don’t think happens enough for women diagnosed at an older age.”

Despite receiving good medical care, she describes the mental tax the disease has on her as ‘overwhelming’.

“I feel like a grandmother sometimes with pain or chronic fatigue. I need to constantly keep my stress levels in check, and over the years I have found my own tips and tricks, which help me manage this condition.”

Siqana says when a woman enters menopause the endometriosis generally goes away.

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