Managing Endometriosis Beyond Menstrual Pain


Many women, right from when they have their first menstrual cycle, experience varying forms of pains and discomfort which is easily pegged down as a painful period, also known as Dysmenorrhea.
Those who have painful periods experience the symptoms before their flow starts, others during the period but all, experience a respite when it stops.
There are some other women who experience a higher degree of pain, accompanied with bleeding, which is not limited to the vagina alone but other parts of the body.
The pain isn’t only experienced during their monthly menstrual cycle but can occur at any time of the month and lasts through several days. It is called endometriosis.
Endometriosis is a condition where the tissues similar to those that line the uterus grow outside it on other organs in the pelvis, such as the fallopian tubes and the ovaries.
It is said that one in 10 women live with endometriosis, while about 176 million women worldwide suffer from the condition.
Researchers believe that an increase in the level of estrogen in a woman could trigger some of the symptoms.
Estrogen is the hormone that causes the uterine lining to thicken each month.
According to John Hopkins Medicine based in Baltimore, Maryland, U.S., during a woman’s regular menstrual cycle, this tissue builds up and is shed if she doesn’t become pregnant.
They explained that patients with endometriosis have endometrial-type tissue outside of the uterus.
“Women with endometriosis develop tissue that looks and acts like endometrial tissue outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity.
“Each month, this misplaced tissue responds to the hormonal changes to the menstrual cycle by building up and breaking down just as the endometrium does, resulting in small bleeding inside of the uterus.’’
Mrs Kemi Adekomi, a woman who has lived with endometriosis for about 12 years, says she never experienced pain during her periods until the condition started, when she was almost 30.
“It was very funny that morning when I woke up and started experiencing severe pains.
“It’s my period but I don’t usually experience pain but this is not normal. Beginning from that day, I started having menstrual pains, and I was almost 30 years old.
“And that began my journey with endometriosis,’’ she said.
Dr Abayomi Ajayi, a gynaecologist and founder of Endometriosis Support Group, Nigeria (ESGN), says that pains can occur anytime of the month, from any region around the abdomen, depending on the placement of the endometrium.
Ajayi, who is also the CEO, Nordica Fertility Centre, Lagos, says: It can happen, even under the navel, so the woman may be bleeding under the navel.
“It could happen that it’s in the chest wall, in which case the person may be coughing out blood.
“Pain could be there all the time; the main symptom is pain. This pain could be at any time,’’ he said.
Confirming this, Adekomi said the pains weren’t limited to her monthly periods but could be experienced at any time of the month.
“At some point, it transcended to pains at any time of the month. We need to take note that it’s not only at your period that you could have endometrial pains,’’ she said.
Narrating her experience with treatment for endometriosis, Adekomi said she had to undergo surgery before she could get pregnant.
“My wedding came and there came the real problem of endometriosis. I was not able to take in immediately and then I started to fret.
“I was waiting to get pregnant after my wedding for almost two years.
“I went back to my gynaecologists and they said, to be sure and ascertain what your problem is, you need to go and get a laparoscopy.
“Then I went in for the surgery, they took some biopsies and it was confirmed that what I had was endometriosis.
“The surgery was successful and they had to put me on drugs and injection once a month.
“Miraculously, the third month after my surgery I took in,’’ she said.
Mayo Clinic Symptoms Checker says the signs and symptoms of endometriosis may include; painful periods, pain with intercourse, pain with bowel movement or urination.
Others are excessive bleeding, infertility, fatigue, diarrhoea, constipation, bloating and nausea.
Mayo Clinic further explained that the condition is sometimes mistaken for other conditions such as pelvic inflammatory disease (PID) or ovarian cysts that can cause pelvic pain.
“It may be confused with Irritable Bowel Syndrome (IBS), a condition that causes bouts of diarrhoea, constipation and abdominal cramping.
“IBS can accompany endometriosis, which can complicate the diagnosis,’’ the doctors added.
While having endometriosis is not a “death sentence’’, complications could lead to death.
WebMD, an American corporation known primarily as an online publisher of news and information pertaining to human health and well-being, says medications could ease the pains and make the person feel better but won’t cure the condition.
Treatment of endometriosis could include therapies such as hormonal contraceptives – birth control pills, patches and vagina rings – to help control the hormones responsible for the buildup of endometrial tissue each month.
Surgeries such as laparoscopy and hysterectomy (removal of the womb) can also be used for treatment of the condition.
However, laparoscopic surgery is the most common procedure used to diagnose and treat the condition.
British Columbia HealthLinkBC, says a laparoscopy is done to examine the pelvic organs and remove implants and scar tissue.
Some celebrities, who suffer the condition, have tried to break the silence about endometriosis, by speaking about it.
Dolly Parton, an international celebrity, who was taken to the hospital to have a partial hysterectomy during a tour in 1982, said she suffered from depression after learning she would not be able to have children.
“Every day I thought, I wish I had the nerve to kill myself,’’ she said.
Another international celebrity, Whoopi Goldberg, at the Endo Foundation’s 2009 Blossom Ball, was surprised to learn that many women weren’t aware of the condition.
Goldberg, who suffers the condition, said she had known she had it for a long time.
Nigeria’s ex-Beauty Queen, Nike Oshinowo, disclosed in interviews that she had over 17 surgeries because of endometriosis.
She told Vanguard that the pains were so intense that at one point, she passed out.
“Until I turned 40, Nigerians didn’t know I suffered from endometriosis.
“At last, it was understood why if I come to your party, at 8 p.m. I had to go home to bed and to take my painkillers.
“When you live with endometriosis, you live with pain.
“I have a library in my home. It is a library about pain. I have so many books on pain cure.
“Anyone experiencing painful period should see a doctor,’’ she advised women.
Corporate individuals and NGOs also try to put up programmes to create awareness during Endometriosis Awareness Month, which is marked annually in the month of March.
While giving her testimonial at “The 2019 Endo Carnival and March’’ in Lagos, Adekomi urged women to go for checkups to ensure they know what the problem is.
“When you know what a problem is, it’s easier to attack it.
“When I knew what the problem was, I went to the people who were fit to handle it,’’ she said.
Chioma Echendu, a student of Canon James Pearse Anglican College, Lagos, and winner of the 2019 ESGN Essay Contest, said she learned a lot about endometriosis from the organisation’s visits to her school.
“This is not the first time they are coming to our school. We read a lot about it, we researched on it.
“I wrote about what endometriosis is and what it’s not. It’s impact on females; socially, physically, emotionally and mentally.
“There’s no cure for endometriosis but you can manage it. Having it is not the end of one’s life,’’ she said.
Her English Language Teacher, Ms Yomi Opeodu, said students from her school had been winning the essay contest in the last three years because they’re well informed about the condition.
“When the gynaecologist started questioning the Junior Secondary School ((JSS) students, she was amazed; they’ve been reading about it,’’ she added.
Experts say managing endometriosis could mean making lifestyle adjustments that may help reduce pains and discomfort for people living with the condition.
Jean Hailes, a wellbeing blog for women, says though there is no direct evidence that lifestyle reduces the severity of endometriosis; physical activity, exercise, sleep, stress management and relaxation help improve health.
Doyin Popoola, nutritionist and Face of ESGN 2019, says there are some foods that people with the condition should eat more while some other foods should be avoided.
Popoola, who also works at “Oh So Nutrition’’, said those suffering from the condition should increase their intake of foods that contain Omega 3 fat, such as Salmon, Sardine, Mackerel and Canola oil.
“Also, they should avoid red meat because they increase the level of estrogen.
“They should avoid caffeine, avoid alcohol, trans-fat and processed fats.
“They should also increase their intake of fruits and vegetables,’’ she said.
Odafe writes for the News Agency of Nigeria.


Joan Odafe