Endometriosis is a medical condition where cells that normally line the womb start to grow in other places causing debilitating pain when they are shed.
‘It has been a month since I had severe pain necessitating a painkilling injection. I am scared of this month since I do not know what to expect in the next few days.”
This is the voice of Winnie Watenga — a 28-year-old suffering from extreme period pains, scientifically known as dysmenorrhea.
Since her teenagehood, Ms Watenga has dreaded the beginning of her monthly cycle — it comes with excruciating pain that sometimes causes her to lose consciousness.
“It is really painful...I get so sweaty, weak and at times fall unconscious until a pain injection is administered to me,” she said in an interview.
“I have never really got to know what the major problem is from the doctors but reading stories from others, I hate to think it maybe endometriosis.”
A Nairobi-based consultant obstetrician and gynaecologist, Dr Isaack Wasike, said Ms Watenga’s excruciating pains could be an underlying condition for endometriosis.
Endometriosis is a medical condition where cells that normally line the womb start to grow in other places, especially outside the uterine wall or in the fallopian tubes and ovaries; these cells can cause intense pain when they shed and fall away.
An online provider of health information called Right Diagnosis estimates that Kenya had 1.65 million people with endometriosis out of a population of about 17 million females. This corresponds with data from the Endometriosis Foundation of Africa show that one in every 10 women suffer from endometriosis.
“In Kenya 60 per cent of women who present dysmenorrhea on laparoscopy have endometriosis but that depends on the sample size. There is a current research being done locally by Kenyan doctors...perhaps it will give us more insight on the numbers,” said Dr Wasike.
He said there were two types of dysmenorrhea, namely, primary dysmenorrhea and can advance to become endometriosis.
Primary endometriosis usually occurs in girls starting their periods and women who are yet to give birth. It is the psychological function of the uterus and hormonal imbalances affecting the uterus thus causing uterine spasm.
“This is because the uterus is still very tight as women in this bracket are yet to deliver,” said Dr Wasike.
“Secondary dysmenorrhea is common in women who have already given birth usually because of procedures done on the uterus or infections.” According to the UK’s National Health Service (NHS), intense period pain can be caused by an underlying medical condition although it tends to affect older women aged between 30 and 45 years.
The conditions that can cause period pain include endometriosis, fibroids, pelvic inflammatory disease and adenomyosis.
The primary symptom of endometriosis is pelvic pain, often associated with the menstrual period. But such pains associated with women may highly be disregarded as an exaggeration of the female gender, while worsening an underlying medical condition.
A study has shown that women’s pain including period discomfort is taken much less seriously by doctors as compared to men’s complaints about pain.
Dubbed, “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain”, women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients’”.
Published in the Journal of Law, Medicine and Ethics the study found that men wait an average of 49 minutes before being treated for abdominal pain, while women wait 65 minutes for the same symptoms.
“It’s thought that this is because women are seen as exaggerating pain and being “dramatic” due to sexist stereotypes, while men are listened to and believed when they express the same pain and symptoms,” said one of the study authors, Diane E. Hoffmann of the University of Maryland Francis King Carey School of Law.
Although history depicted menstruation as a taboo and with some cultures even secluding menstruating women and girls for days until “they were clean”, it is no longer offensive to talk about it.
But still, the subject is not considered decent enough to merit serious scientific consideration thus women will continue suffering every month because of this, said another study author, Anita J. Tarzian.
According to Ms Watenga, her pain keeps reoccurring even after treatment.
“I was treated some time back in college and the pain does not always come monthly it may take some time for me to experience it. Last month, for instance, it happened after a year and some months.”
Ms Watenga who has since relocated to the US says she is set to seek a second doctor’s opinion, hoping to put the endless pains to rest.
New NHS guidelines now highly recommend that women suffering from dysmenorrhea should be checked for endometriosis.
Dr Wasike said: “A medical investigation must be done. A diagnostic laparoscopy test will show endometriosis. While an Ultra Sound or MRI can also be done, they may not pick the condition.”
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