These were the words of a 35-year-old woman diagnosed with endometriosis who recently underwent surgery for her condition. She, however, is just one of hundreds of thousands of women worldwide who go through pain month after month, often in extremes.
According to Specialist Obstetrician and Gynaecologist, Dr. Reiaz Mohammed (whose office is located at Gulf View Medical Centre, La Romain) it is quite common for women to ignore signs such as pain. "Many women accept pain as part of their lives, believing that it is a natural part of their menstrual cycle. Women need to be aware that endometriosis may be responsible for their symptoms and that there are treatments available to help them."
So, what exactly is endometriosis?
The doctor, who studied at the University of the West Indies (Mt. Hope Campus) and the Royal College of Obstetricians and Gynaecologists (UK), explained: "Endometriosis is a condition that affects women during their reproductive years. When a woman has a period she bleeds from the lining of the womb known as the endometrium.
Endometriosis occurs when there are deposits of the endometrium outside the womb. These deposits can be found on the ovaries, fallopian tubes, the tissue which lines the pelvis (peritoneum), bowel, bladder and even in the lungs. This misplaced endometrium responds to hormones in the same way as the lining of the womb, so that when a woman has her period she not only bleeds from the lining of the womb but she also has bleeding from these other deposits as well. Because this blood cannot escape from the body it causes irritation and inflammation. This can result in nearby organs becoming stuck to each other. This is known as adhesion."
"During the menstrual period, most of the blood and the lining of the womb is shed through the vagina and out of the body. However, some of this tissue, instead of coming out of the body may pass through the Fallopian tubes to enter the pelvic cavity. This is referred to as retrograde menstruation. Some women will be able to get rid of this tissue without any problems. If their body is unable to get rid of it, deposits are formed on nearby organs and structures resulting in endometriosis."
The exact number of women who develop endometriosis is not known because many women have endometriosis without symptoms, or with mild symptoms, and are never diagnosed, often remaining undiscovered until they attempt to conceive. Investigations to diagnose endometriosis are only done if symptoms become troublesome and are not eased by initial treatments. Estimates vary from about one in 10 to as many as five in 10 of all women develop some degree of endometriosis.
While many speak of the pain of endometriosis, as the doctor previously hinted "many women with the condition may not have any symptoms and it is only detected either when operations are done for other causes, or attempt to get pregnant and cannot. The most common symptom that women with endometriosis have is lower abdominal or pelvic pain. The pain can be constant but occurs a few days before and during the period. Patients may also experience pain during intercourse. This pain is felt deep inside and may last for a few hours after sex. Patients with endometriosis may also have difficulty in becoming pregnant. Other uncommon symptoms may include bleeding in between periods, pain on having bowel movements and very rarely, blood in the urine or faeces."
Unfortunately, this is a condition that is not easily diagnosed, because there is no simple test. "Your doctor may suspect that you have endometriosis based on your symptoms," Dr. Mohammed said. "The only way to definitely diagnose endometriosis is by laparoscopy." (Laparoscopy is a small operation that is done under general anaesthetic. A small incision is made close to the belly button which allows a camera to be inserted to see the organs in the pelvis such as the womb and ovaries. Endometriotic deposits can be seen and a sample can be taken and sent to the lab to be tested to confirm the diagnosis of endometriosis.)
Now that you know you have the disease, what can be done?
"Some patients with endometriosis may have very mild symptoms and opt not to receive any treatment. Painkillers can be used to help alleviate pain," Dr. Mohammed advised. "Hormonal treatments are available when pain interferes with the patient's quality of life. These work by decreasing the amount of oestrogen, which is produced by the ovaries and is needed for endometriotic deposits to grow and survive. By decreasing the amount of oestrogen, the endometriotic deposits gradually shrink and may clear away. Many different types of hormonal treatments are available which are equally effective. The choice of treatment is based on side effects and cost. Surgery is also an option when medical treatment is unsuccessful or when medical conditions prevent the use of hormone treatments."
So is there anything a woman can do to reduce her chances of getting endometriosis and if diagnosed with the condition, is it safe to have sex? Posed with these questions, the doctor responded by saying: "Use of the oral contraceptive pill may help decrease the chances of getting endometriosis. This effect may last up to one year after stopping the pill. As for having sex upon diagnosis of the condition, it is safe to have sex. However, patients with endometriosis may experience pain during or following sex. Changing positions can help decrease pain caused by deep penetration."
While many women interviewed claimed they found ways to deal with and essentially live with endometriosis, all is not quite lost. Dr. Mohammed insists that there are treatments out there to help. "If you are experiencing pain, don't just ignore it and accept it as a part of your life; visit your doctor and get treated right away!"