ONE thing Jamaicans can all agree on is that we hate a thief. They rob us of our hard-earned money and possessions and, even worse, they rob us of our freedom, often leaving us with post-traumatic stress symptoms for life. Endometriosis (endo) is just that, a thief.
It robs affected women of money with its expensive treatment plans and time lost from work. It robs them of their freedom to enjoy life when it decides to flare, and often carries with it intense anxiety/depression from the lifelong nature of the disease. This disease occurs when tissue similar to ones that line the inside of your womb is present outside of the womb, leading to long-standing pain and a variety of complications.
Effects of endometriosis
This lifelong disease affects one out of every 10 women worldwide. That means if you know 10 women, you know someone with endo. Chronic pelvic pain, painful periods, painful sex, and difficulty getting pregnant are some of the main features of the disease. Not to be left out are symptoms of chronic fatigue, anxiety, depression, as well as painful passage of urine and stool. Relationships with friends and significant others are often strained, and jobs are difficult to keep. So, literally, endo robs women of some of the best years of their lives.
How to know if you have it?
Many women can be diagnosed based on symptoms and imaging alone, however, definitive diagnosis requires surgery. Minimally invasive laparoscopic surgery is the gold standard for diagnosis, and is used as part of the treatment plan. This technique involves the use of advanced high-definition cameras to look inside the belly via very small incisions (some around the size of a fingernail). Not only can we use it to identify lesions that are a few millimetres in size, but we can remove them at the same time. Recovery time is less than half that of traditional open surgery, and most often you can go home the same day.
How to get rid of the thief?
So let's say you are away from home, a thief breaks in and your silent alarm calls the police. If the police tries to get the thief by going through the front door, then the thief will just escape out the back. If the police go in through the right side, the thief will escape through the left, and so on. So, to catch the thief, the police surrounds the house so the chance of escape is minimised. That's the model we employ when trying to tackle endometriosis. Owing to its chronic nature and somewhat uncertain origin, we incorporate a variety of treatment options to maximise the chance of success.
Front door - As mentioned above, laparoscopic surgery is used to both diagnose and remove endometriosis lesions. This helps in reducing the disease burden and allows other modalities to work better.
Back door - Medications are usually used to help suppress these deposits and control pain.
Right side - Dietary modification is aimed at creating an anti-inflammatory environment, reducing foods that promote inflammation and increasing those that fight it.
Left side - Physical therapy is used, especially in women with painful sex, but can also help with pain from internal scarring. Regular exercise is well known to reduce painful period from whatever cause.
Roof access - Psychotherapy is important in developing coping mechanisms for managing a chronic disease, as well as tackling the often-accompanying depression and anxiety.
There is no cure for endometriosis, so the best thing we can do for it is catch it early. Don't ignore your body's cry for help. If the pain you experience with your periods interrupts your life, then have it checked out. If sex is painful to the point of you having to stop, or if it lingers for hours to days after, have it checked out. Don't allow “the thief” to kick back and wreak havoc in your pelvis.
Dr Ryan Halsall is a consultant obstetrician gynaecologist who operates at ILAP Medical, 22 Windsor Avenue, Suite 2, Kingston 5. He can be contacted at firstname.lastname@example.org or 876-946-0353. Follow him on Instagram: @drhalsall
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