Endometriosis

Endometriosis is a reproductive problem that affects millions of women and girls around the world.^1,2 It causes painful, life-impacting symptoms and may affect work and school attendance.^1,2

Endometriosis occurs when endometrial tissue, the tissue that normally lines the inside of the uterus, grows outside the uterus.^1,3 When it grows in places it should not normally be, most commonly on the ovaries and the pelvic peritoneum¹ (the membrane that lines the inside of the abdomen and pelvis),⁴ inflammation and scar tissue develop in the pelvic area.²

Endometriosis is illustrated below:

While the cause of endometriosis is unknown,⁵ suggestions include:

• Genetics (passed down by family members with the same condition).⁵
• Immune system problems.⁵
• Lymph system abnormalities that may cause the development and spread of endometrium cells.⁵

However, none of these fully explain why endometriosis occurs.⁵

Common symptoms of endometriosis include:¹

• Painful periods.
• An irregular menstrual cycle (not having a period regularly each month).
• Pelvic pain.
• Pain during sex.
• Infertility.
• Nodules (lumps) on the ligaments of the uterus, which can be felt during a physical examination.
• Masses or cysts on the ovaries, which can be felt during a physical examination.
• A uterus that is ‘tipped backwards’ (retroverted).

Women with endometriosis are also likely to have depression and anxiety.¹

Did You Know? There is not enough data on how many people in a community of African women suffer from endometriosis. More locally focussed research into this difficult condition is needed.⁶

A patient with endometriosis symptoms may undergo a series of diagnostic tests:⁵

• A physical (pelvic and vaginal) examination by a general practitioner (GP).
• An ultrasound scan or MRI done by a healthcare professional or other specialist.
• A laparoscopy done by a surgeon – keyhole surgery where a tiny camera is used to look for patches of endometriosis tissue.

Endometriosis affects approximately 10% of women and girls of reproductive age globally (190 million people).² It can severely affect a patient’s quality of life, causing stress and fatigue.⁷ Painful periods can also make it difficult or even impossible to attend work or school.²

• Non-steroidal anti-inflammatory drugs (NSAIDs) or oral contraceptive pills can be used to manage pelvic pain and regulate periods.¹
• Hormonal therapies, like progestogens and antiprogestins, or gonadotropin-releasing hormone (GnRH) analogues may also be used.¹
• Severe cases may require surgery, either to cut away the endometriosis tissue or to remove the uterus (a hysterectomy).¹