Dr Madhuri Laha Cover Story Pune Unit
Your uterus isn’t trying to kill you, it’s endometriosis.
A gynaecologist explains the signs and symptoms you should look out for
It took 12 years for Taanvi Vora* to get a diagnosis for the terrible cramps she’s been enduring since her first period at age 13. The pain only grew with each cycle. “I’d be given a hot water bottle and told that it’s just part of the cycle. They said it would ease up as I got older but it only got worse,” she says. She’d never had heard of what endometriosis was until she was 25.
Endometriosis affects 25 million Indian women, yet information on this debilitating condition is largely limited.
“I never thought period pain could be this bad. Nobody believed it, not even the doctors I first went to,” says Sharvi. “Imagine your body revolting so badly that you want to punch your uterus into submission.”
She was relieved to finally know what was going on inside her own body at age 32.
“It was all by chance. I was struggling to get pregnant. That’s when I started talking about my monthly misery and the OBGYN started exploring endometriosis as a possibility.”
What is endometriosis?
According to Dr Madhuri BurandeLaha, Motherhood Hospital, Kharadi, the causes of endometriosis are still unknown. Simply put, it’s a condition where the tissue similar to what lines the uterus grows on other parts of the body. This can include your ovaries, fallopian tubes, bowel and pelvis.
The hormonal changes we experience during the menstrual cycle cause the area to become inflamed and painful.
“The tissue will grow, thicken, and break down. Over time, the broken-down tissue has nowhere to go and gets trapped in the pelvis,” she adds.
Endometriosis is categorised into 4 stages (I-minimal, II-mild, III-moderate, and IV-severe), depending on “the exact location, extent and depth of the endometriosis implants (endometrial tissue in irregular locations) as well as the presence and severity of the scar tissue and also the presence and size of endometrial implants in the ovaries. ”
However, this doesn’t mean that the pain and discomfort a woman experiences with stage 1 endometriosis is any less or ‘minimal’ compared to a higher stage.
The first signs of endometriosis
“For me, it was just increasing intensity of pain and a very heavy flow. People at work thought I was just being lazy when I’d call in sick every month during my period. I couldn’t get out of bed. It’s only after I came in one month and was violently vomiting in the office bathroom that my female colleagues took it seriously,” adds Vora.
The symptoms are different for every woman. The most common ones being pelvic pain, pain during and before periods in your lower abdomen, discomfort during sex and bowel movements, and cramps 1-2 weeks before your cycle start.
The intensity and degree vary from person to person.
“My easiest period was when I got through it with pain pills for four days. The worst was when my mother had to call an ambulance after I fainted because of how much pain I was in,” says Sharvi.
When there’s no cure, how do you treat it?
There are different treatments for women with endometriosis. Laha explains there’s pain medication, hormone therapy, laparoscopy and minimally invasive surgery.
The last resort for extreme cases is a complete hysterectomy.
Vora got relief after her doctor suggested she get an intrauterine device (IUD) – a T-shaped birth control device that’s inserted into the uterus. “No more periods, no more pain. If and when I want to have children, I can have it reversed. For the time being, I finally have some peace.”
Sharvi was diagnosed after laparoscopy and is scheduled to get laparoscopic surgery in the coming months.
“I think I was more relieved that people finally believed me. I wasn’t weak for not being able to bear this pain that isn’t normal. It wasn’t all in my head.”
“Cliches have surrounded menstruation since the dawn of time. [A woman tells the doctor] ‘I have this horrible life-altering pain, and these symptoms’, then the doctor will kind of pat her on the head and say take this pill. Then you’ve got this vicious cycle, and ultimately she stops telling people,” says Heather C Guidone, the Center for Endometriosis Care, Atlanta, Georgia.
Vora says, “Sadly, you’re going to have to be stubborn. If you feel any of these symptoms go to a doctor. If they dismiss it, go to another one. We’re lucky we have this kind of access, make the most of it. This kind of pain isn’t normal. I wish I’d known that sooner.”