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28 March 2024

Endometriosis can cause infertility in women

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By Majorie van Leijen

In the UAE, 7 to 10 per cent of women suffer from endometriosis and it is the third most common cause of hospitalisation among female patients in the age group of 15 - 50 years ,” said Nadia Al Sawalhi, Head of Obstetrics and Gynecology at Latifa Hospital.

Moreover, the disease is known to cause infertility in 30 to 40 per cent of the women with the disease. These are shocking numbers, yet the disease remains largely unknown and often undiagnosed.

Endometriosis was the topic of the interactive Twitter Clinic recently held by the Dubai Health Authority (DHA) on a weekly basis.

Nadia Al Sawalhi, Head of Obstetrics and Gynecology and Ghassan Lotfi, Consultant in gynecological and laparoscopic surgery from Latifa hospital were the doctors ..

Endometriosis is a chronic disease where the cells from the lining of the uterus flourish outside the uterine cavity. This subsequently causes chronic pain, adhesions and possibly infertility, explains Ghassan.

Symptoms of endometriosis include different types of pain in the lower back and abdomen during the menstrual cycle, and could include nausea, migraines, or chronic fatigue.

Concerning is the probability of infertility, which occurs in 30-40 per cent of the cases worldwide. Having endometriosis does not automatically mean that you will never have children. However, it does mean that you may have more problems in getting pregnant, and it has been seen that that with the severity of the disease the  difficulty of getting pregnant rises.
 

A dedicated walk-in facility in the UAE


The only dedicated endometriosis centre in the region is housed by Latifa Hospital, offering medical and surgical services. The center receives an average of six patients (including follow-up patients) per week, with referrals from public as well as private hospitals.

Because of the high number of referrals coming from the private sector, it has recently launched a once-a-week walk-in clinic dedicated to the referred patients.

Patients who are diagnosed with endometriosis at one of the public hospitals are automatically referred to the Centre.

Therefore the hospital decided to set-up a specialised clinic for patients with private sector referrals, explained Nadia.

Every Tuesday the clinic now accepts patients that have a referral from the private sector or a medical record showing that they have endometriosis, she added.

In addition, the hospital will begin to accept several private health insurance cards. “Presently, patients who have private insurance policies are reimbursed by their insurance companies as per their policy status. However before the end of this year, they will have the facility of direct billing, if their policy includes that,” said Nadia.
 

Suspecting endometriosis? Here is what to do

Endometriosis is often diagnosed when seeking fertility solutions, but this is not the only suitable moment to find out if you are dealing with this disease.

Some women have no pain, even though their disease affects large areas, while other women with endometriosis have severe pain even though they have only a few small growths. However, is it likely that the severity of the disease increases over time.

Endometrioses is easily mistaken for other health problems that cause pelvic pain, and is not easily diagnosed making misdiagnosis an occurring possibility.

When suspecting endomtriosis, the obstetrician/gynecologist may carry out a pelvic exam to feel for large cysts or scars. However, smaller areas of endometriosis are hard to feel.

Another option would be to perform an ultrasound, an imaging test to see if there are ovarian cysts from endometriosis. Magnetic resonance imaging (MRI) is another common imaging test that can produce a picture of the inside of your body.

The only way to accurately pinpoint endometriosis, however, is laparoscopy, a surgical procedure that gives insight in the abdomen.

The same surgical procedure can provide the opportunity to remove endometrial tissue.

This surgery may be a preferred solution when there is a wish to become pregnant, as it is likely to improve the fertility possibility.

When there is no wish to become pregnant the patients may opt for pain medication or hormone treatment, both of which can reduce symptoms but not reverse the disease.

[Image via Shutterstock]