Not ‘women’s troubles’, it’s endometriosis

HYDERABAD:  How many ‘she is just cranky because of her periods’ jokes have you come across this month? If you thought these jokes were just annoying, here is a horrifying truth: dismissal attitudes about the debilitating pain and other symptoms during periods made their way into medical approaches to problems faced by menstruating women.

Apoorva Tripathi, an MA student from Mehdipatnam, was rushed to a hospital when her period cramps became unbearable. “I was throwing up and could not stand because of the pain. My parents took me to the emergency room and the doctor casually told me that it could be a ‘psychological pain’. Only when I insisted that my periods have become extremely painful, he referred me to a gynecologist,” she says.

According to the Endometriosis Society of India, about 25 million people suffer from endometriosis, among which the majority of them are not diagnosed until their 30s or 40s. One of the primary causes is the symptoms of endometriosis being dismissed as ‘women’s troubles’ or ‘psychological pain’.

Dr Gitanjali, OB-GYN in Secunderabad, notes, “During the menstrual cycle, the body sheds the lining of the uterus (endometrium). Sometimes, menstrual blood flows in reverse, back into the fallopian tubes and ovaries. This is called retrograde menstruation and results in a condition called endometriosis. In most people, cysts, called chocolate cysts, form in the ovaries due to endometriosis. In some cases, the tissue forms in the rectum, bladder or anywhere in the abdominal cavity.”

While the cause of this condition is not exactly known, Dr Vandana Hegde, clinical director and OB-GYN at Hegde Fertility, says patients with high estrogen levels or who have a genetic predisposition to this are the ones most affected.

Thirty-six-year-old Seema (name changed) suffers from endometriosis. She used to feel dizzy during her period but visited the doctor only she faced issues related to infertility. She was finally diagnosed when she was 27. Endometriosis, often neglected and assumed to be just a painful period, can interfere with the patient’s daily life. From extremely painful periods and chronic pelvic pain to infertility and cancer, the disorder can affect one’s physical and mental health and can disrupt their work and social life.

Dr Gitanjali says the condition cannot be cured completely, but only managed. “If it is in a mild stage, hormone therapy i.e., taking hormone supplements can help manage the condition. If it is severe, we perform laparoscopic surgery and remove the tissues. Since it is a recurring condition, regular medication and check-ups are necessary. In some complicated cases, we suggest that the patient undergoes hysterectomy (removal of the uterus and ovaries).”

Many menstruating women stop working because of the difficulty of coping with this condition. “While there are noticeable symptoms like pain during periods and sexual intercourse, some people are asymptomatic. The disease is a progressive one and it is crucial to diagnose it early to prevent damage to the pelvic anatomy. If the patient complains of severe pain during their periods, do not dismiss it. Visit a gynaecologist as early as possible,” says Dr Vandana.

Warning signs

• Painful periods accompanied by vomiting and dizziness
• Chronic pelvic pain
• Painful intercourse
• Discomfort/bleeding while defecating or urinating (rare symptom)

Who’s at high risk

• People whose menstrual cycle started early (before 12 years of age)
• Short cycle
• Heavy bleeding
• If the condition is hereditary