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March is endometriosis awareness month. Endometriosis is a disease that affects women in the reproductive age; from when they start menstruating up to when they are over 40 years.  However, it can also affect those in menopause.

Dr. Spire Kiggundu, a gynecologist, fertility specialist and endometriosis surgeon at Henrob hospital in Zzana says endometriosis attacks the uterus, ovaries, and fallopian tubes. It makes it difficult for women to have children.

He explains that every month, the inner lining of the uterus called the endometrium builds up and waits for pregnancy. If it does not happen, it shades off or menstruates.

Dr. Spire Kiggundu. (Credit: Ritah Mukasa)

However, in some cases, instead of coming out, the lining migrates to different areas such as the tubes, ovaries, lower part of the intestines (rectum) and bladder.

It can also invade the lungs, brain, eyes and ears.

There, it becomes aggressive hence causing scaring (endometriosis). It moves through the blood system and can cause great damage.

“Endometriosis is caused after that layer goes to other body parts. It attacks the cells and surrounding organs and becomes a disease,” he stresses.

The pain can be sharp or shooting paired with cramps. Some bellies bloat and the victim bleeds heavily with large blood clots.

The red flags

Rogers Kwizera, endometriosis sonographer says, girls who cramp early and those who get cramps in the early days of their cycle are likely to have severe disease in future.

Some cramps are severe to the extent of being admitted in the sickbay or hospital. They are put on strong painkillers and usually, they miss school and fail to sleep for hours.

Kwizera says, that is not normal and it should be cause to worry.

He warns that the pain will progress to endometriosis after six to seven years, if the adolescent does not get help.

He is quick to add that endometriosis is a serious disease. It eats away the tubes, ovaries, rectum and uterus hence leading to infertility.

Other patients present with bowel complications that can be corrected by surgery.

Dr. Kiggundu adds that some patients experience excruciating pain while having sex because the disease eats away the upper part of the vagina, cervix and rectum.

On the flipside however, Kiggundu says, some patients do not have obvious symptoms other than failing to conceive. It is until they are scanned that the disease is detected.

Others have perennial pelvic pain even when they are not menstruating.

Another symptom is experiencing pain while passing stool or urine, frequent bathroom visits, back pain and diarrhea or vomiting during menstruation. That indicates that the disease has gone to the bladder and rectum.

“If a patient cannot conceive then the uterus, tubes and ovaries are likely affected.  A severe headache shows that the disease has gone to the brain,” he says.

The manifestation depends on where the disease is. Some women cough and defecate blood while others bleed in the eyes, ears and umbilical cord.