Endometriosis

Endometriosis is one of the factors causing infertility. The more severe the condition, the more likely it will impact the chances of pregnancy.

Endometriosis occurs when the endometrium grows outside of the uterus. During menstruation, these endometrial tissues will bleed outside the uterus. These endometrial tissues will adhere to or even invade other locations like ovaries, fallopian tubes. The displaced endometrial tissues will be thickened as usual. During menstruation, they will break down, bleed and cause pain.

Chocolate cysts are commonly found in patients. This is a large endometrial mass. The blood in the cyst is brown and looks like a chocolate thick mass, hence the name “chocolate cyst.

In general, patients will suffer from pain. The main factor is that the blood backflow causes obstruction, and the organs are pressed due to the movement of the cyst, resulting in constant pain. Not all women suffer from pain, but the absence of dysmenorrhoea (menstrual cramp) is not necessarily a good thing, as it leads to patients being diagnosed later.

A typical woman will feel pain and discomfort on the first day of menstrual cycle. There will be no major problems afterwards. However, endometriosis patients experience pain before menstruation, during menstruation, and even after menstruation.

Patients suffering from endometriosis have difficulty in enjoying sex. When they have sex, patients will feel abnormal pains deep inside of their vaginas. Once the uterus is covered with chocolate cysts, and the posterior large intestine are full of blood-filled endometrial tissues, during sexual intercourse, patients’ cysts and endometrial tissues are pulled, resulting in abnormal vaginal pain, thus no way to enjoy sex.

When patients go through vaginal examinations, it is not difficult to find that endometrial tissue growing on the back of the uterus or on the vagina. The moment the endometrial tissues at these areas are touched, the patients will feel extremely painful. The haemorrhage of the endometrial tissues is concentrated at the back of the uterus, so patients may also experience pain or even bleed during bowel movements.

Some patients’ chocolate cysts grow faster, others are slower, but patients can slow down the progress of disease through treatment and fight for time to get pregnant. Endometriosis has a serious impact on the quality of life of patients, which makes them unable to carry out their daily lives normally, including going to work and attending classes. According to some general practitioners, patients will suffer pains and take medical leaves rather often, in average 3 days per month.

Estimated 350,000 Malaysian women are affected

Endometriosis affects 5 to 10% of U.S. women, some doctors estimate that about 350,000 women in Malaysia are affected by the disease.

According to the survey, about 5.5 million U.S. women and 16 million European women have suffered endometriosis. Currently, no similar study is done in Malaysia yet. Above estimation is solely simulated based on U.S. patient data.

Endometriosis patients facing frequent relapsed until their menopause

There are about 7 million women between the ages of 20 and 49 in Malaysia, and 5% of them are 350,000. Many women opine that endometriosis is worse than cancer.

If cancer is diagnosed and treated early, the patient can still return to normal life; however, endometriosis keeps on recurring until patients stop menstruating. Meanwhile, patients may face infertility problems as well as social and family pressures, which end up affecting them, both physically and emotionally in long run.

Adenomyosis

Adenomyosis is closely linked to endometriosis. The symptom is uterine muscle wall will be covered with thick endometrial tissues, so the entire uterus looks hypertrophy.

Every time menstruation comes, the uterus will be congested and bleeding, causing severe pains to patients, especially during defecation. This kind of severe pain can even make patients unable to stand upright. They can only lie and rest.

Treatments

Endometriosis is a chronic disease. Patients need continuous treatment to relieve pain and reduce its negative impacts to the bodies through drugs and injections. Patients should only opt for surgery as last resort. Of course, when patients have chocolate cysts as large as 8 cm, normally they have no choice but to remove the chocolate cysts surgically; or when the endometrial tissues are found in the lungs, patients must also remove them via surgery.

Treatments include painkillers and hormone therapy. Patients will only have their uterus and ovaries surgically removed only if no other option is available.