ENDOMETRIOSIS & INDIAN WOMEN

Hi, hello and welcome to my blog!

I've decided to write about Endometriosis (Endo) for four reasons:

1) Next month is Endo Month, so I thought I'd start up with some awareness tips.


2) The lack of its awareness in Asian countries.

3) Endo affects almost "89 million young women in the reproductive age group worldwide" (Baria, Z 2010), of which 25 million are Indian women (TNN, 2011). 

• that's almost 1/4th of all diagnosed Endo sufferers
• 5 times those suffering from Endo in the US
• and almost 13 times those suffering Endo in the UK!

This pie chart should put it into perspective.

This is clearly an alarming number of Indian women suffering from this reproductive disorder.

3) Answering your questions.

My Experience with Endometriosis

I was diagnosed with Stage IV Endo, in early 2010, post my laparoscopy. I've been under various treatments for just over a year now and thankfully have found something that works for me, thus placing it under control. However, like many of you I too have suffered from the pains my entire life and continue to live with the frustrations it brings.

In the simplest of terms, Endo (pronounced EN-DOH-MEE-TREE-O-SIS) occurs when the endometrial cells lining the inside of our uterus are found OUTSIDE of the uterus. They begin to stick/attach to other organs in the pelvic region such as ovaries, fallopian tubes, bladder, colon and in some rare cases, as far up as the lungs and the brain.

 

Endo can severely affect a woman's lifestyle, or worse result in infertility. 

The causes of Endo are unknown, but the symptoms highly common.

• Pain before and/or during periods 
• Pain with intercourse
• Depression with PMDD
• General, chronic pelvic pain throughout the month
• Low back pain
• Heavy and/or irregular periods
• Painful bowel movements, especially during menstruation
• Painful urination during menstruation
• Fatigue
• Migraines 
• Infertility
• Diarrhoea or constipation
  
  
  *Taken from Endo Resolved http://www.endo-resolved.com/symptoms.html*

Many women have reported to dealing with agonising pain, whilst others do not even know they are suffering from it!!

Why focus on Indian women?

Indian women will shy away from any treatment associated with Endo, as it tends to be in the form of birth control pills/injections. 

The best way to identify any cysts is to have a transvaginal scan (TVS) as an ultra sound may not always detect abnormalities. However, no un-married woman in India will have an internal scan. 

Even doctors advise against it. 

If a woman asks for an internal scan/pills and she is unmarried, she will be perceived as having a sexually active life. 

Having sex before marriage is considered to be dishonouring the family. So if a woman is seen taking birth control pills/injections relating to the treatment of endo, family members may raise concerns regarding her chastity. 

Infertility is also extremely frowned upon. Women are expected to give birth within 1-2 years of being married as this is seen as a sign of a family's growth and happiness. However, as women tend to remain virgins till they are married (average marriage age between 23-28), they may only be diagnosed until they try for a child.


Misdiagnosis can occur when women don't speak up against their doctor. For example, some Endo sufferers may experience painful sex given their internal adhesions. However, they may not address this issue as they are taught to believe that sex is painful. It is also a common trait amongst some Indian women not to ask the doctor the details regarding their examination. Additionally, doctors will also not provide patients with information as they feel that patients will not understand anyway.  

Fact: the average age for diagnosing Endo is 27. 

Although larger cities like Delhi and Mumbai have centres dedicated to woman health and early diagnosis, there are still smaller regions where girls as young as 11 suffering from Endo. Women in India are taught to deal with menstrual pains, regardless of its intensity and associated symptoms. 

Finally, hospitals in India provide both private and government health care services. Government health care is slow and tedious,with an average gateway of 6-9 years for providing a diagnosis. In contrast, private health care is extremely costly, and hospitals do not hesitate on handing over hefty bills to their patients should their problem require further treatments. 

For this reason, families hesitate to send their daughters for check ups. This nature of avoiding visits becomes embedded in the women who will continue to avoid trips to their gynaecologists and only ever visit when their situation becomes intolerable.

Conclusion

Endo is not highly prioritised in the medical field and there is still a considerable amount of research to be conducted. However, experience proves that this is the most debilitating reproductive disorder that can cripple a woman and change her entire life. 

If you think you suffer from endo, or you share its symptoms, go and consult your doctor/GP. Push for a scan as it is not always detected in blood tests.  

If you know someone suffering with Endometriosis, support and love them. They are at their most vulnerable stage stage in life.

I am NOT a doctor, nor am I a gynaecologist. However, I am on a bumpy path to recovery through successful treatment options. Therefore, I am happy to answer any questions that you may have.

Till next time!




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References

1. TNN (2011) Don't depend on pain killers for Menstrual pain, Times of India online, http://articles.timesofindia.indiatimes.com/2011-04-21/bangalore/29458530_1_endometriosis-painkillers-indian-women
2. Baria, Z (2010) Dealing with Endometriosis 
   http://articles.timesofindia.indiatimes.com/2010-05-18/health/28298624_1_endometriosis-laparoscopic-surgery-ovaries
3. Manchester Evening news (2010) Asian women less likely to seek treatment for endometriosis
   http://www.rscbayarea.com/asian-women-less-likely-to-seek-treatment-for-endometriosis
4. Endo Resolved (2012) Endometriosis Symptoms
   http://www.endo-resolved.com/symptoms.html