ENDO WHAT?

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ENDO WHAT?

Yes, that is what most people say!
Endometriosis: Pronounce it like this, Endo-me-tree-O-sis. Endometriosis is a nightmare condition that happens only to women. It can sure make life hard, painful, irritating and downright messy. Yes, it happens down there! Okay, let’s start this way. The womb is called the uterus. It is lined by a tissue called the endometrium, which prepares it for a pregnancy. If there is no pregnancy, the tissue dies and sloughs off the wall of the uterus. This happens monthly in the menstrual period.

Endometriosis is a disorder in which this tissue – the endometrium – that normally lines the inside of the uterus – grows outside the uterus.It now grows on the inside and outside of the uterus; on the ovaries, fallopian tubes, the tissue lining your pelvis and other organs in the abdomen. So, you know women have monthly menstruation in which this lining is shed as bleeding. Imagine all the tissues in all these places also bleeding; just like that. Like multiple menstrual periods in different locations. This then causes abdominal pains, cramps and serious horribleness. It makes the sufferers cranky, irritable and completely miserable. Worse, it can cause anemia in some people and even lead to adhesions and infertility is others. For women who have endometriosis, it is often described as hell. It drives some close to insanity for a few days each month. Some are made miserable every day! In fact, some women have come close to suicide because of the distress caused by severe cramps and severe pains from the contractions and bleeding. It’s no joke for sufferers, families and partners.

Causes
Doctors don’t know exactly what causes endometriosis. Some experts think that menstrual blood with endometrial tissues travels back through the fallopian tubes and passes out into the pelvic cavity where the cells stick to the organs. This is known as retrograde menstruation. This may explain why the commonest place to find endometriosis is on the ovaries.
Genetics may also play a role in whether you get endometriosis. If your mom or sister have it, you’re more likely to get it. And research shows that when there is a hereditary link like this, the disease seems to be worse in the next generation. Ugh!

Difficult to diagnose
Sadly, the condition is difficult to diagnose. Mostly, because it presents in so many different ways in different women. Also, many assume it’s simply menstrual pain and a ‘normal’ thing in women. This leads to delays in treatment and a lot of suffering for many women.The diagnosis is based on a good history and a low threshold for suspecting endometriosis. It is often confirmed for definite by a laparoscopy. This is a technique where cameras are introduced into the abdomen to look at the uterus, the ovaries and see if one can spot the problem.

Treatment
The first treatment of course is the use of pain killers. Tablets and patches are available to help manage the pain each month. Sometimes it is best to start a day before the anticipated beginning of the period. That may help to prevent it catching the sufferer unawares. Analgesics and anti-inflammatory drugs such as simple Paracetamol and Ibuprofen are useful.

Hormone therapy
Hormone therapy and birth control pills are a good choice if the pain medicines aren’t helping. Hormones can be used to reduce the amount of estrogen the body creates. They can also prevent menstrual period and cause the lesions to bleed less, decreasing inflammation, scarring, and many other problems.

Have surgery
Surgery often involves removing the uterus; an operation called a hysterectomy. This can be partial or total. It can be done in a way to leave the ovaries in young women or the ovaries can be removed along with the uterus in much older people. Removing the uterus can be a cure for endometriosis especially if the woman has completed her family.
But, it is sometimes not that easy.

Get pregnant
Having a baby is good in the sense that you are off your periods for a few months. It is also sometimes advisable for people to have their families because many of the definitive treatments involve stopping the menstrual periods. For example, the use of contraceptive pills can interfere with periods by stopping or delaying it.But, it is not that easy for some women as endometriosis can cause difficulty with conceiving and therefore render women infertile. In this regards, some women may need special assistance to get pregnant. It can be that bad for some! Some women of course, may choose not to have children.

Meet the expert
You can discuss this condition with Dr Abayomi Ajayi, the MD of Nordica Fertility Centre in Abuja. The facility is a specialist centre for assisted reproduction and supports the Endometriosis Foundation. There are many ways in which women with endometriosis can be managed and helping them to complete their families before or even after surgery.Talk to him for expert opinion and advice.

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