Endometriosis, a painful and often misunderstood condition affecting 1 in 10 women globally, is a silent struggle for many, with alarmingly low awareness in India. Despite impacting over 42 million women in the country, endometriosis continues to be dismissed, leading to delayed diagnoses and prolonged suffering. Medical experts emphasize the importance of early recognition of symptoms to prevent severe complications, including infertility and kidney failure.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, affecting organs like the ovaries, rectum, ureters, bowels, bladder, and, in severe cases, even the lungs and diaphragm. Dr. Vimee Bindra, an endometriosis specialist, highlights that nearly 40% of patients show no symptoms, and many are diagnosed only through routine imaging. Among the most common symptoms are painful periods, chronic pelvic pain, infertility, painful bowel movements, painful urination, recurrent urinary tract infections (UTIs), nausea, vomiting, and severe fatigue. However, menstrual pain is often brushed off as normal, with some women advised that marriage or childbirth will resolve their discomfort. “If period pain interferes with daily life and doesn’t subside with over-the-counter medication, it’s not normal and requires medical attention,” Dr. Bindra stresses.
Early diagnosis is crucial to prevent long-term organ damage, yet many women struggle for years to receive the right care. Diagnosis begins with symptom evaluation, a pelvic examination, and imaging techniques like transvaginal ultrasound or MRI. However, imaging alone may not always detect endometriosis, especially if the results are interpreted by non-specialists. Dr. Bindra warns, “Many women are declared healthy due to normal ultrasound or MRI reports, even when they have endometriosis. Proper training for doctors is essential.”
The treatment approach for endometriosis varies depending on the severity of the condition. While some patients can manage with medication, others may require surgery. Laparoscopic or robotic surgery is preferred, as it offers better visibility and precision compared to open surgery. For cases where endometriosis deeply infiltrates organs like the bladder or rectum, a multidisciplinary team, including gynaecologists, colorectal surgeons, and urologists, is crucial. However, incomplete or poorly executed surgeries may leave residual disease, which can be mistaken for recurrence.
Beyond physical suffering, endometriosis also impacts women’s personal and professional lives. Painful intercourse often leads to marital issues, while the chronic pain and fatigue contribute to anxiety and depression. Dr. Bindra notes, “Endometriosis is not just a reproductive disease; it affects every aspect of a woman’s life.”
The financial burden of treatment is another significant challenge. Complex surgeries can be expensive, especially when multiple specialists are involved. Many insurance companies do not cover endometriosis-related surgeries, classifying them as infertility treatments instead. The founder of the Endometriosis Foundation of India is advocating for insurance companies to recognize endometriosis as a serious condition requiring coverage.
Stronger government initiatives are needed to bridge the knowledge gap and improve patient care. Dr. Bindra suggests that one intervention could be teaching both boys and girls in schools about painful periods and abnormal symptoms to promote early awareness. Additionally, ensuring that endometriosis surgeries are covered under health insurance policies without long waiting periods is vital to making treatment accessible. Updating medical college curricula to emphasize the latest diagnostic and treatment approaches for endometriosis is also critical. Dr. Bindra even proposes making endometriosis a separate super specialty in post-graduate medical education.
To further raise awareness, the Endometriosis Foundation of India is organizing the Yellow Ribbon Run on March 2, in Hyderabad. The yellow ribbon, which symbolizes endometriosis awareness, serves as a reminder that it’s time to start talking about menstrual health and stop dismissing women’s pain. “We need to start talking about menstrual health and stop dismissing women’s pain,” Dr. Bindra said.
Endometriosis may be a silent disease, but it’s time to break the silence.
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