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Gynaecologist, Dr Maureen Owiti explains endometriosis

Gynaecologist Dr Maureen Owiti explains that endometriosis is a condition found only in women, and is characterised by tissue from the lining of the uterus (endometrium) growing outside the uterine cavity.

The most common symptoms of endometriosis include pain, which can be mild, such as discomfort during periods, to severe, where women or girls are unable to attend to their daily routines. It can even affect bowel movement, and the patient can also have pain during sexual intercourse.

Some women may have no symptoms at all. In atypical cases, symptoms include unusual vaginal bleeding, bleeding from odd areas such as the belly button, ears, eyes, nose and even into the pleural space (lining of the lung).

Radio presenter and TV host Njambi Koikai was diagnosed with endometriosis five lung collapses and surgeries later. After living with painful menses for almost two decades, she sought medical attention in 2016 after suffering the first lung collapse.

Initially, she was misdiagnosed, then a different doctor later diagnosed her with severe pelvic endometriosis, which had spread to her chest.

Her story attracted media attention last year, following her medical appeal. In some women, endometriosis can lead to infertility or inability to conceive.

The disorder’s exact cause is unknown, but it is only found in women in their reproductive years, and therefore it is postulated to be due to the high estrogen levels at this time, which is why symptoms start in the teens and wane after mid-40s, and completely cease after menopause.

It is currently estimated that the prevalence of endometriosis is about two per cent in women aged 15-30 years. However, this could be an underestimation based on how difficult it is to obtain a definitive diagnosis, especially because laparoscopies are mainly available in private institutions and can be expensive. Misdiagnosis, like what happened to Njambi, is also common.

Ciru too was once misdiagnosed with an STI. Treatment ranges from over the counter (OTC) medications such as paracetamol or NSAIDs such as ibuprofen, to birth control pills and hormone therapy such as progesterone or gonadotropin-releasing hormone agonists.

There is also surgery, ideally laparoscopic surgery, with last resort being a hysterectomy or removal of the uterus. There’s no cure for endometriosis and treatment aims to relieve symptoms such as easing pain, slowing the growth of endometriosis tissue, improving fertility and also stopping the condition from returning.

OTC drugs and birth control pills may be affordable to some patients, but hormone therapy and laparoscopy can be costly. Patients with NHIF can access services fully paid by the fund in government institutions that have laparoscopy towers.

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