Endometriosis - the silent epidemic that affects 10% of women globally

Women reporting severe chronic abuse of multiple types had 79 % increased risk of laparoscopically-confirmed endometriosis Picture: File

Women reporting severe chronic abuse of multiple types had 79 % increased risk of laparoscopically-confirmed endometriosis Picture: File

Published Mar 27, 2024


Dubbed a "modern epidemic," endometriosis is at the forefront of causes for chronic pelvic pain. It plays a significant role in infertility, impacting up to 50% of women seeking treatment.

As the world observes Endometriosis Month in March, according to the World Health Organisation, endometriosis affects approximately 10% of women of reproductive age globally.

In South Africa the prevalence of endometriosis has been largely understated, due to high diagnostic costs, lack of information and underdeveloped healthcare infrastructure.

Among the effects experienced by those suffering from endometriosis, fertility issues stand out as one of the most distressing symptoms.

Endometriosis is a condition where the cells that form the lining of the uterus grow outside the uterus. Symptoms of endometriosis vary but commonly results in painful periods, chronic pelvic pain and pain during intercourse.

In many cases, the impact of the disease on reproductive health is often the most pronounced and can be emotionally and mentally devastating.

Endometriosis can cause infertility if it results in adhesions (scar tissue) that cause the ovaries and fallopian tubes to get stuck together or the ovaries to get stuck to the pelvic sidewall. This prevents fertilisation from taking place. In instances where the endometriosis occurs inside an ovary, it can prevent or decrease the chances of ovulation or the production of eggs, which in turn, makes it more difficult to conceive.

Furthermore, if endometriosis grows inside the uterus and penetrates the uterine wall, this results in a condition called adenomyosis, which adversely impacts the implantation of the embryo in the uterus. If endometriosis forms inside the pelvis, it creates what’s known as a hostile environment that reduces the quality of the egg that gets formed. This in turn, impacts the function of the fallopian tube to pick up the egg, affecting fertilisation, the development of the embryo and implantation.

However, equipped with accurate information on how to manage symptoms as well as the treatment options available, women can reduce the impact that the disease has on their lives and their dreams of starting a family.

Dr Abri de Bruin is the Senior Medical Director of Genesis Reproductive Center, and heads up Mediclinic Kloof’s dedicated multidisciplinary endometriosis unit, which currently has the most modern theatre in the southern hemisphere.

In his opinion, awareness campaigns that highlight the prevalence of endometriosis and the importance of reproductive health are vital in curbing the effects of this “21st century disease.”

He elaborates: “Endometriosis is definitely more prevalent today than it was 20 years ago and is becoming increasingly prevalent in younger women. Experts attribute this rise to factors such as increasing stress levels as well as the kinds of hormones contained in the foods we eat.

While the medical community has not yet pinpointed the exact reason why endometriosis grows in certain individuals, we are now infinitely more knowledgeable on how it presents in different women and how to treat it in the least invasive way.”

Dr. Kamlanathan Subrayen, a leading endometriosis specialist at Lenmed Ethekwini Hospital and Heart Centre in Durban highlighted the need for increased awareness among patients, families, and primary healthcare providers to combat the lengthy delay in diagnosis, particularly in adolescents.

"No one is too young to have endometriosis," he remarked, highlighting the importance of early diagnosis and management.

Dispelling myths surrounding endometriosis, Dr Subrayen emphasises key facts: the condition can begin as early as the first menstrual period, a hysterectomy does not cure endometriosis, and the significance of medical treatment to minimise the necessity for repeated surgeries.

IOL Lifestyle