What you need to know about endometriosis

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, according to the World Health Organisation (WHO).

It can cause severe pelvic pain and make it difficult to get pregnant.

Endometriosis tissue acts like the lining of the uterus when it thickens, breaks down and bleeds with each menstrual cycle. But it grows in places where it doesn't belong and doesn't leave the body.

WHO estimates that it affects about 10% (190 million) of women and girls of reproductive age worldwide, and the American Society for Reproductive Medicine found that 24% to 50% of women with infertility have endometriosis.

Endometriosis can cause pain, especially during menstruation, and also lead to fertility problems, but there is currently no known cause of endometriosis.

According to WHO, there is no known way to prevent endometriosis. There is no cure, but the symptoms can be treated with medication or, in some cases, surgery.

Some of the risk factors that increase the risk of one having endometriosis may be starting your period at an early age, going through menopause at an older age and also, short menstrual cycles for example less than 27 days or heavy menstrual periods that last longer than seven days and finally having higher levels of estrogen in your body may be the risk factors that lead to endometriosis.

According to Valine Anyango, a clinical officer at Yoshua Hospital in Mombasa County, the main complication of endometriosis is infertility in women.

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She goes on to say that up to half of people with endometriosis find it difficult to conceive.

"For pregnancy to happen, an egg has to be released from an ovary and travel through the fallopian tube to be fertilised by a sperm." Ms Anyango says.

She explains that the now-fertilised egg needs to attach itself to the wall of the uterus to start developing.

"Endometriosis can block the fallopian tube and prevent the egg and sperm from combining. But the condition also seems to affect fertility in less direct ways. For example, it can damage the sperm or egg." She explains.

However, she says that women with mild or moderate endometriosis can still conceive and carry a pregnancy to term.

"Painful and heavy menstruation, prolonged bleeding, painful sex, back pain, painful bowel movements, especially during menstruation, are important signs associated with this condition," says Ms Anyango.

She adds that not all women with endometriosis have the symptoms. "It is important to note that only about 1/3 of women with endometriosis may not have any symptoms. "

She says: "People with this condition should see a gynaecologist to assess and determine the extent of the disease, as they may be under the misconception that menstrual pain is normal.

It is very important to note that not all menstrual pain is normal and people should seek help in such cases," concludes Valine Anyango, a clinical officer at Yoshua Hospital.

According to the World Health Organization, access to early diagnosis and effective treatment of endometriosis is important but limited in many settings, including low- and middle-income countries.

It also says that patients who could benefit from medical symptom management are not always offered treatment because of limited awareness of endometriosis among primary healthcare providers.

Delays in diagnosis often prevent timely access to available treatments, including non-steroidal analgesics (painkillers), oral contraceptives and progestin-based contraceptives. Due to the limited capacity of health systems in many countries, access to specialised surgery is sub-optimal for those who need it.