March is endometriosis awareness month. The disease affects Black women in disproportionate numbers.
Idries J. Abdur-Rahman, MD Blackdoctor.org / March 25, 2020
Endometriosis awareness takes place across the globe during the month of March, and beyond, with a mission to raise awareness of a disease which affects an estimated 200 million women worldwide. Tia Mowry is a television actress whose life was devastated by endometriosis, a common disease. The famous twin, to sister Tamera, offered the disease a familiar face when she share her own her life with endometriosis in 2017. In her mid-twenties, Mowry was diagnosed and like many Black women her age, her symptoms were dismissed as being “normal.” She shared the following in an interview with
:“Each one would brush me off. ‘Those are just really bad cramps, some women get them more severely,’ one told me. ‘Just put heat on it,’ one suggested. Another doctor simply said: ‘Get on the treadmill—working out helps.’ Deep down, though, I always knew what I was feeling was more severe than just cramps. No one should ever have cramps so bad that they’re ready to call an ambulance. I once found myself crying in the back of my car, and my sister Tamera had to drive me home because I was in too much pain to drive.”
BLACK WOMEN & ENDOMETRIOSISEndometriosis uniquely affects African-American women. Traditional thinking was that endometriosis was a condition of white women but that conventional thinking is rapidly changing.Unfortunately, when Black women have chronic pelvic pain it is presumed to be due to other conditions pelvic inflammatory disease, a pelvic infection (PID) or uterine fibroid tumors which are very common in Black women. However, endometriosis is real and common in many African-American women.What exactly is endometriosis? Endometriosis is a condition that occurs when the tissue that normally grows inside of the uterus, called endometrium, grows outside of the uterus in the pelvis. Once in the pelvis, the endometrial tissue causes inflammation and scarring as it attaches to pelvic organs, fallopian tubes, ovaries, bowel and bladder. This scarring and inflammation is what causes the painful symptoms many with endometriosis experience.
Endometriosis is a common disease. Approximately 10% , or five million, American women are affected. Endometriosis is sited as the single most common causes of chronic pelvic pain in women and pelvic pain that has lasted for six months or longer.
The exact cause of endometriosis is unknown but possibilities include menstrual bleeding that goes through the fallopian tubes into the pelvis, genetic factors as it is more common in families and having had a prior Cesarean section (C-section) delivery.
While we don’t know the exact cause, we do know the symptoms of endometriosis. These symptoms which are frequently wide ranging and debilitating include:
• Irregular vaginal bleeding including heavy periods,
• long periods or spotting/bleeding between periods.
• Pelvic pain. Crampy pain that can occur anywhere in the pelvis.
• Women patients with endometriosis have cramping that goes beyond normal period pain. Endometriosis related menstrual cramps are debilitating resulting in missed work/school and an inability to get through one’s daily activities.
• Painful intercourse that is usually most pronounced during deep penetration.
• Dyschezia, which is painful bowel movements.
• Infertility. Inability to conceive despite 12 months of trying.
Patients with endometriosis usually will end up having surgery and frequently they will have multiple surgical procedures.
Diagnosing endometriosis requires a minor surgical procedure known as laparoscopy. For women who want to avoid surgery, a presumptive diagnosis can be made using hormonal medications.
• Laparoscopy the same camera surgery that is used to make the diagnosis, can also be used to remove areas of endometriosis. Unfortunately, with time, the endometriosis often returns but the procedure can be repeated.
• Hysterectomy is the definitive treatment for endometriosis. It provides the best symptom relief but it is only an option for women who want no further children.
Idries J. Abdur-Rahman, MD, FACOG is a board certified Obstetrician/Gynecologist.