Endo- Wuh?! (derived from Endowhat ®)- An Introduction: Part I

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As an educator by profession, I sometimes like to have a little Q&A session in class.

So let’s try having one right now. Here are the questions:

  • Did you know that there is a chronic condition affecting approximately 176 million women worldwide with an associated 22 billion USD in treatment costs? Symptoms of this condition include painful periods and ovulation, infertility, internal bleeding and scarring and is also associated with ovarian and other types of cancers.
  • Did you know that there is no known cure for this chronic and debilitating condition?
  • Finally, did you know that this condition is not a widely discussed, or recognized ailment within the Caribbean?

Surely a condition that has such a significant impact on women and society would be widely known, as its effects are not only felt by the women who have it, but by their family, friends and society as a whole.

This condition is known as endometriosis.

Endo-wuh?!?

This is generally the response I receive when I tell people that I was diagnosed with endometriosis.  My own mother (who, God bless her– has been around for quite some time) only heard of the condition upon my diagnosis.

Endometriosis is a gynecological condition that occurs when there is displaced endometrial tissue in several places; i.e. the pelvic cavity bladder, large intestines, rectum, etc. Endometriosis also has a significant impact on the woman’s ovaries and fallopian tubes.

Endo MArch

Jamaican women participate in the global Endo March, which includes some 60 countries. (Photo courtesy of Base Jamaica)

Why is this an issue?  Well, the endometrium (uterine lining) responds to hormone levels in the body and build up and breaks down during the female menstrual cycle. During menstruation this lining sheds and exits the body…

Or so we thought.

The displaced cells caused by endometriosis, also respond to hormones and attempt to exit the body. However, where these cells are located there is nowhere for them to go. So they remain in the area resulting in several outcomes; an inflammatory response, scarring, adhesions and or disruption of nearby organs.

Remarkably even with all the medical and technological advances to date, no one has found a definitive cause of endometriosis. There are several theories: from retrograde menstruation (reverse menstruation- blood flows back into the fallopian tubes and into the pelvic cavity rather than exiting through the vagina), migration of endometrial cells via the blood stream to other locations and metaplastic cells in regions other than the uterus which have changed to endometrial cells. Unfortunately all of these are still theories.

Currently there is no cure for this condition.

Suggested treatments include excision surgeries to remove the endometrial cells and adhesions, hormonal treatment-i.e. either birth control pills or GnRH antagonists, becoming pregnant or having a hysterectomy.

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A young participant in Jamaica’s Endo March. (Photo courtesy of Base Jamaica)

As a woman currently residing in the Caribbean and living with this condition, the question I’ve often asked myself is why am I only NOW learning of this condition? If so many women are estimated to have it, why does it seem like there a huge gap in knowledge, particularly in the Caribbean? Growing up I was taught that pain associated with menstruation is “normal” and that it’s just my lot in life. This caused me to suffer in silence for many years.

We as Caribbean people feel a sense of pride in how far we’ve come and how much we’ve accomplished. To be honest, with our resources, we have certainly made tremendous strides that should never be discounted, however it still seems taboo to discuss female reproductive health.

We need to seriously consider the negative impact endometriosis and other conditions have had, and will have on women’s health if they are not strongly advocated for.

*Next time: Endo- wuh: Exploring this condition within the Caribbean context (Part II)

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