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Why Endometriosis Matters
By Dr Sharifah Halimah Jaafar
Despite being a common illness , endometriosis has historically been underrecognised by both the medical fraternity and the public , leading to subsequent underdiagnosis .
Endometriosis is a disorder that affects a large percentage of women of reproductive age , yet it is rarely discussed in mainstream media and often goes unrecognised . A chronic and debilitating condition , it develops when the tissue that normally lines the uterus grows outside of it , in areas such as the ovaries , fallopian tubes , and bladder . It can cause severe pain , infertility , and other related issues such as headaches . Some research indicates the condition is more common than breast cancer , prostate cancer , and diabetes .
Despite being a common illness , endometriosis has historically been under-recognised by both the medical fraternity and the public , leading to subsequent underdiagnosis . The average delay between the onset of the disease to diagnosis is between seven and twelve years , leaving young women affected by the disease in pain and confusion without a legitimate diagnosis of their symptoms . One of the most common early symptoms is dysmenorrhoea or menstrual-related pain , which is often not taken seriously and is either dismissed or frequently perceived to be normal as part and parcel of being a woman , which she is expected to live with it . As a consequence , this common narration hampers early detection of the disease and delays timely intervention before endometriosis progresses further into a severe form of the disease with complications .
According to a recent understanding of the pathophysiology of endometriosis , the onset of the disease could be as early as adolescence . As soon as women attain menarche ( first menstrual period ), they are exposed to a series of oxidative stress brought on by the backflow of menstrual flow and changes in microbiomes and flora in the vaginal and peritoneal fluids that trigger the development of the endometriosis of different clones or variants in susceptible individuals . This new understanding gives hope for the possible prevention of severe disease if those modifiable factors that lead to the sustenance of the growth of endometriosis could be managed effectively and in a timely manner .
Endometriosis can manifest in many forms and spectra , from superficial and cystic lesions to deep infiltrating lesions at any stage of life . It is a highly individualised disease with varying symptoms , and its impact varies significantly from person to person . Some people have very little pain , while others have recurring debilitating symptoms that impact them on a daily basis . Unfortunately , to date , there is still no reliable screening method to detect endometriosis in its early stage .
Furthermore , diagnosing endometriosis in adolescence can be equally challenging as neither ultrasound nor advanced imaging can detect early lesions which are common in this age group . Diagnostic laparoscopy and biopsy are the gold standards for diagnosing endometriosis . An invasive
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