Healthcare | Sunday 26 March, 2017 6:00 am |

25 March 2017, Abu Dhabi – UAE: Physicians revealed that Endometriosis effects 10% of women and causes severe pain and dangerous complications including problems in fertility in cases of late diagnosis and treatment. They have emphasized the need for medical and/or surgical intervention to limit the complications.

Physicians also confirmed that cost of endometriosis treatment is three times the cost of breast cancer treatment in terms of women being absent from work on a monthly basis, the cost of treatment, and the effects on the daily life of patients.

In line with the Endometriosis Awareness Campaign organized by Danat Al Emarat Hospital in collaboration with the Emirates Endometriosis League (EMEL), which falls in March every year, physicians affirmed the need for continuous awareness on endometriosis as it has become crucial to raise awareness on the disease amongst the public and medical professionals. Awareness will lead to earlier diagnosis and treatment, limiting the cases to suffer from extreme pain and complications, especially that this disease is considered chronic and recurrent.

Dr. Islam Sidky, Consultant Obstetrics, Gynecology and Minimally Access Surgery at Danat Al Emarat Hospital for Women & Children in Abu Dhabi and the Vice President of the Emirates Endometriosis League (EMEL), said “there has been an increase in number of cases we see suffering from severe pain because of Endometriosis in patients aged between 12 – 20 years old. Severe pain negatively affects the patient’s daily lives due to missing days of school or work to visit the doctor to help with controlling the pain with prescribed painkillers.

He added that both the public and medical communities still need a lot of awareness regarding this medical condition which can strike anywhere between 7 – 10% of all women between the ages of 13 – 45 years old according to scientific studies. These studies have also shown that 50% of women that suffer from infertility and difficulty conceiving suffer from endometriosis.

Dr. Sidky also mentioned that a large number of cases get diagnosed in late stages, where it becomes difficult to respond to treatments and more complications arise which could be dangerous if adhesions were formed around the uterus, as well as the appearance of cysts around various internal organs that may then require surgical intervention.

He further added that, “Danat Al Emarat Hospital, which is part of United Eastern Medical Services Group, has organized an awareness campaign in collaboration with EMEL which included a talk last Thursday in Arabic and was attended by over 35 women, most of whom suffered from Endometriosis or symptoms of the disease. Doctors from Danat Al Emarat also spoke about the disease in The Women’s Show earlier this month, which was attended by over 500 women and physicians. Another talk in English is also planned on 30 March 2017.”

He clarified that endometriosis is a chronic disease that strikes some women for unknown reasons during their menstrual cycle, and can be accompanied by severe pain. Cells in the uterine lining grow inward towards the ovaries and fallopian tubes rather than outward, occasionally it may also reach the bladder and the intestine. In cases where right diagnosis was delayed for years, the disease might become malignant and can lead to complications.

“Diagnosis depends on the history of the symptoms, linking them to the menstrual cycle, then performing blood tests and ultrasound imaging. In some cases, the disease may require cross-section imaging, and ultimately laparoscopic surgery and treatment at the same time to confirm the diagnosis,” Dr. Sidky added.

He added that the uterine cells that are affected can form into cysts and nodules accompanied by severe pain. He also indicated that the main symptom of the disease is severe pain, which can be difficult to diagnose in the early stages, considering that pain is a symptom of other diseases.

From his side, Dr. Amin Hassan Abdelmagied, Consultant Obstetrics, Gynecology & Advanced Minimally Access Surgery at Danat Al Emarat Hospital confirmed that "endometriosis is a complicated, chronic and stubborn disease that is surrounded by lack of awareness, myths and taboos among all societies around the globe. Hence, raising awareness among the public and doctors is extremely important. Despite a huge amount of research, there is so much that is still unknown about this challenging condition.”

 

He stated, “amongst the many challenges of the disease is the fact that its response to treatment varies amongst different patients. Therefore, each patient needs an individually tailored treatment that is suitable for her own needs and circumstances. Another challenge is the fact that it takes an average of 7-10 years and seeing many doctors before the diagnosis is established. We must all join efforts to shorten this time because early diagnosis can reduce women's suffering and improves the chances of better disease control with fewer long term complications. It is highly advised that women with such symptoms visit the right specialized physician at early stages to avoid any delays in diagnosis.”

 

He further added that delays in diagnosis and proper management can negatively impact prime years of women lives (late teens to fifties) as the disease progresses and its symptoms can magnify. Some cases will need surgical intervention, the complexity of which can increase with delayed diagnosis and disease progression.  We are fortunate to have the expertise to perform such surgery in our hospital and manage endometriosis cases. He explained that the disease is strongly linked to infertility which puts a premium on early diagnosis and specialized management by trained and experienced endometriosis specialists.

 

Dr. Amin Hassan further stressed on the importance of raising awareness amongst parents, schools, family doctors and all community members. “It all hinges on seeing the right Doctor at the right time,” he said.

 

From EMEL side, Dr. Ghassan Lotfi, President of the Emirates Endometritis League (EMEL) stated, “it is internationally acknowledged that one out of every 10 women suffers from endometriosis." He also indicated that there is no direct or clear method for early detection of the disease, and a delay in diagnosis increases the suffering of the patient from complications and problems in fertility. This disease is a chronic disease, and there is no permanent cure, as the disease will continue to occur with every monthly menstrual cycle. Early diagnosis helps control the disease and prevents the occurrence of complications as well as limiting the associated pain.”

He stated, “a preliminary study was run on 277 adolescents from schoolsin Abu Dhabi, Dubai, Sharjah, and Ajman, and has showed that 30 – 33% of female students miss school because of severe pains associated with the menstrual cycle, a sign of increased likelihood for an endometriosis diagnosis.”

Dr. Lotfi also said that severe pain associated with menstrual cycle and intaking painkillers, and not showing up to school or work are some of the major symptoms of the disease. Studies also showed that the cost of endometriosis and its complications treatment is three times more than the cost of breast cancer treatment, as with endometriosis the woman life is affected negatively, and suffering occurs every month.

He said there was a lot of evidence from scientific studies that show a relationship between ovarian tumors and endometriosis in 1.5 – 2% of cases, particularly in those cases where treatment is delayed. He indicated that in the case of early treatment, the patient can experience a relatively normal lifestyle as well as enhanced fertility. It was also founded that between 50 – 60% of those who experience chronic pelvic pain suffer from endometriosis.

“Physicians are required not to take these cases lightly, and that physicians at family medicine clinics and also pediatricians need to be made aware of endometriosis, and must consider such a diagnosis when presented with a menstrual cycle accompanied by severe pain, chronic pelvic pain, and a delay in conception. They must consider at the same time treating these cases by specialized physicians that have the needed experience and skills to manage endometritis cases resulting in better outcomes,” Dr. Lotfi concluded.