Breaking the silence on painful periods

Tracy is a 22-year old graduate and a banking executive in one of the Nigerian banks. Like her colleagues, Tracy is determined to make a successful career in her chosen profession but unlike most of them, she is slowed down by the pains she has to endure at the onset of her monthly periods. She is hardly able to get out of bed on the first day of her cycle and always manages to go to work on the second day. Like most women, Tracy would wish she kept her menstrual periods private but no matter how hard she tries, her colleagues would always tell when she is in her period. Her boss cynically looks at her and she often hears uncomplimentary remarks from some of her colleagues attributing her reaction to ‘normal’ menses to sheer laziness.

When Tracy could not cope with the burden of painful period, a snag she had borne for close to five years, thinking it a normal phase that will eventually go away, and pushed by the hostile work environment, she sought medical attention and it was discovered that she is suffering from endometriosis, an abnormal health condition resulting from the presence of endometrial tissue, which normally grows inside the uterus, outside the uterus and causing pelvic pain, especially during menstruation.

The tissue which grows outside the uterus, like its counterparts in the womb, is linked to the woman’s hormonal cycle. However, unlike a period, the tissue remains within the body and bleeds forming adhesions (scar tissue), lesions and blood-filled cysts. Some of the symptoms of endometriosis include bleeding, pain, infertility, fatigue, suppressed immune system, etc. Treatment for endometriosis is determined on a case by case basis, and may include drug therapy and use of painkillers, hormonal treatments, and surgical intervention, including hysterectomy.

The cause of endometriosis is unknown but some risk factors have been attributed to it and they include nulliparity (those who have never given birth), family history of the disease, menstrual cycles shorter than 27 days with bleeding lasting longer than eight days, any medical condition that prevents the normal passage of menstrual flow and leading to retrograde or backflow of menstrum into the peritoneal cavity, and a history of pelvic infection.

Tracy is only one of the one in eight women and girls who have this health condition and who are afraid to talk about it and mostly have to carry this burden privately and in self-pity. It is worthy to note that this incurable and the unpreventable health condition that affects close to 200 million women and girls in their childbearing ages globally is mostly not talked about, leaving the sufferers to silently endure the severe physical and psychological pains and other burdens of the disease alone.

Due to the nature and character of endometriosis and the ignorance around the disease, people have come to create a plethora of misconceptions around it, linking the health condition to many implausible outcomes. Some claim that the extent of the disease determines the level of pain it presents; that pregnancy cures the disease; endometriosis always leads to infertility; personal diet contributes to the severity of the disease etc.

It is for these reasons that the first week of March of every year is earmarked globally to create awareness for endometriosis. The week, which commences from March 3 – 9, also aims at promoting a greater understanding of endometriosis as a real, debilitating and disabling disease; highlighting the consequences of living with this condition; seeking the best practice and consistent care and treatment for everyone; and providing an opportunity for those whose lives have been affected by endometriosis to play an active part in helping to make a difference.

The Week is celebrated with activities including awareness march around many cities, conferences, symposia and talk shows to draw attention to this silent but widespread debilitating disease. It encourages women, especially those who suffer from endometriosis to come out and discuss their experience, those physical and psychological pains, the discrimination they have come to bear; their efforts towards assessing treatment and cost; and how they cope with the condition.

World Endometriosis Week affords health practitioners the opportunity to educate the teeming ignorant population on the prevalence of endometriosis and treatment options available for it and encourage sufferers to go and seek early medical attention as infertility caused by endometriosis, for example, can be managed through in-vitro fertilization (IVF) intervention. It also provides the experts a platform to correct the misconceptions about the disease so as the assist policy makers in appreciating the health condition and have more empathy for the likes of Tracy in their circles – be it home or office.

One of the biggest misconceptions that border around endometriosis is that which claims that painful periods are normal. There is nothing normal about painful periods. It could be a sign of endometriosis or some other serious health issue that needs to be urgently treated. So as the world celebrates the 2016 World Endometriosis Week, we should use it as an opportunity to learn more about endometriosis, and also encourage one another to seek proper medical attention for issues that may relate to the disease. It is also a season to grow and nurture empathy for those living with disease.

Abiara and Akinajo are consultant gynecologists with a fertility clinic in Lagos.