save your woman from Endometriosis.

Many women who suffer from endometriosis do not like to talk about it. A fertility expert, Dr Abayomi Ajayi, says such women have nothing to be ashamed of, reports OYEYEMI GBENGA-MUSTAPHA.

It is a condition suffered by women, yet much is not known about endometriosis.

Endometriosis is a painful disorder in which the tissue lining a woman's uterus (the endometrium) grows outside it (endometrial) implants. It involves the ovaries, bowel or the tissues lining the pelvics. Endometriosis has no cure, for now, and it can lead to infertility in women. This is why Medical Director of the Nordica Fertility Centre, Lagos, Dr Abayomi Ajayi, is seeking editors' help on educating the society about endometriosis.

At a one-day forum with the Guild of Editors at the Eko Hotel and Suites on Victoria Island, Lagos, Ajayi said though endometriosis has no cure yet, early diagnosis and management are essential. The media can help create awareness on the condition such that all will understand it like other non-communicable diseases, such as malaria.

He said: "Editors can help spread the message on endometriosis, as one of the most common gynaecological problems. Its diagnosis can be delayed or missed, leaving the problem unrecognised, misdiagnosed. As of today, the prevalence of endometriosis in general population is unknown, and it is mainly found in women of reproductive age and it shrinks at menopause. It is estimated that five to 15 percent of women have some degree of the disease.

"That girl or woman who constantly cries or rolls while menstruating or about to menstruate, given some form of treatment, but with no respite could actually be suffering from endometriosis. We have attended to quite some women with the condition, here in Nigeria. None was going to be 'the Face of Endometriosis', until Chief Nike Osinowo was treated of the condition. Her submission to share her story, the adequate publicity given to the human interest story has really helped to lay bare that the condition exists in the country. It was you, gentlemen of the Press, that took the story to the populace, and now, more women have been attended to, and they are getting on better with their lives."

Ajayi said the condition could lead to infertility and deny women of children; "for about eight percent of women in assisted reproductive art (ART) programmes have the primary diagnosis of endometriosis and it constitutes the third commonest findings, 15.7 percent at laparascopy. The data is from Review of laparoscopic procedures at Nordica Fertility Centre done by Strathy et all (1982)."

According to him, the predisposing factors are age (25 to 35 years); hereditary, or genetic predisposition (if there is a mother or sister with endometriosis in the family); starting menses early, i.e., less than 12 years; frequent periods less than 28 days or longer, lasting menstrual flows of more than seven days; never had children; slim women and a closed hymen.

But, what is the cause of the deisease? Ajayi said: "The exact cause of endometriosis is unknown. But other possible causes are retrograde menstruation; metaplasia, i.e., cells of the abdomen change to endometrial cells; surgical transplantation can lead to endometriosis; e.g., surgical scar endometriosis, such as cesarean section, episiotomy or even surgeon's gloves. Blood streal or lymphatics- brain, lungs or immune failure.''

When asked how the symptoms of the disease could be identified, Dr Ajayi said: "Endometriosis is largely asymptomatic; the classic triad pain is the commonest complaint, i.e. painful period, lower abdominal pains outside the periods or pain during sexual intercourse (dyspareunia); pain during defecation (dyschezia) infertility and postmenstrual spotting in about 20 percent."

He continued: "The simplest way to understand the mechanism of the condition is that bleeding causes inflammation, leading to scar tissues which may block Fallopian tubes; this can interfere with ovulation and fertilisation. Endometriomas (ovarian cysts) also interfere with ovulation and quality of egg; toxins/chemicals are also released by the endometriotic deposits which are toxic to the eggs and embryos, the toxins also affect the lining of the womb and disturb implantation."

He added: "The good news is that diagnosis and treatment are available. Diagnosis is done through taking of history above; pelvic examination and pelvic ultrasound (transvaginal ultrasound). Laparascopy is the gold standard of diagnosis. It can be used to detect, take biopsy sample and treat.

"Treatment considerations are related to age; severity of symptoms; stage of disease and infertility or fertility desire. No cure yet for the condition but it can be managed; symptoms can be relieved; best chance of cure is removing uterus, tubes and ovaries, a recurrence after this is but possible. Complications are infertility; chronic pelvic pain that interferes with work and social life; endometriomas/largecysts can rupture and intestinal obstruction from adhesions can take place.

"Our engaging you today on this condition is to ignite hope in women with the condition. That they can get pregnant, some after laparascopic; treatment with intrauterine insemination (IUI) that improves fertility in minimal to mild endometriosis; IVF appropariate especially when tubal function is compromised, if there is male factor infertility and/or other treatments have failed among other treatments available.

He urged the editors to shed more light on the condition so that women suffering from it could be understood and treatment sought, ''just as you did with other diseases, such as HIV/AIDS and Ebola. ''We have a support group called Endometriosis Support Group, a Nordica Fertility Clinic initiative. Sufferers must know they are not alone, they can encourage other another and share ideas on how to cope," said Dr Ajayi.

Mr Bolaji Tunji, director, Sun Newspapers, who represented the President of Guild of Editors, Mr Femi Adesina, said journalists have always been vibrant in reporting issues, especially that: "which are germane to health and livelihood of citizens. We will continue in that light".

The Publisher, City People, Mr Seye Kehinde said he, through the "medium at my disposal have carved a niche to reach the high and mighty, low and lonely and we will continue to ensure the condition-Endometriosis remains in the front burner".