Experts Explain Endometriosis and Encourage Women with This Condition to Reach Out for Help

WORDS LIM TECK CHOON

5 FACTS ABOUT ENDOMETRIOSIS

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  1. It is a condition that sees tissue similar to that of the uterine lining growing outside the uterus, such as at the ovaries, fallopian tubes, and the tissue lining the pelvis.
  2. It can also be found in other areas of the body, but this is very rare.
  3. Endometriosis can cause debilitating pain, severe bloating, and fatigue, especially during one’s period.
  4. It can affect one’s ability to have children, as 30% to 50% of women with infertility also have endometriosis.
  5. Approximately 350,000 women in Malaysia may be silently suffering from this condition.
WOMEN SHOULD REACH OUT FOR MEDICAL ATTENTION IF THEY BELIEVE THAT THEY HAVE ENDOMETRIOSIS
FEATURED EXPERT
SURITA MORGAN
Founder and President
Endometriosis Association of Malaysia (MYEndosis)
Website

Surita Morgan tells us: “Malaysians are generally not aware of what endometriosis really is and why some women have this condition. One of the biggest reasons is because it is often considered as a taboo subject. People are simply uncomfortable speaking about menstrual health openly. But it doesn’t have to—rather, it shouldn’t—be that way.”

She adds: “We need to change the narrative around menstrual health and endometriosis. We need better research, better resources, and better recognition of this condition. By doing so, we can begin to pave the way for a future where endometriosis is not a burden anymore carried in silence, but a challenge met with understanding and solidarity.”

UNDERSTANDING ENDOMETRIOSIS
FEATURED EXPERT
DR LIZA LING PING
Consultant Obstetrician, Gynaecologist, and Fertility Specialist
TMC Fertility

Dr Liza Ling Ping shares that endometriosis reveals itself in stages.

The First Stage or Minimal Endometriosis

At this stage, there are scattered patches of endometriosis tissue, often without symptoms or with mild pelvic discomfort.

The Second Stage or Mild Endometriosis

The number of tissue patches increases, potentially affecting fertility and causing discomfort during menstruation and intercourse.

The Third Stage or Moderate Endometriosis

There is further spread of endometriosis tissue, along with scar tissue and adhesions that can lead to chronic pelvic pain and digestive issues.

The Fourth Stage or Severe Endometriosis

This stage is characterized by extensive endometriosis tissue patches, large cysts, and significant scarring. There is intense pain as well as potentially impacting bowel and urinary functions.

CAN ENDOMETRIOSIS BE TREATED?

Dr Liza reveals that there is a range of treatments available such as laparoscopic surgery to specialized fertility treatments, all aimed at managing symptoms and preventing escalation.

Early diagnosis and intervention can open the door to effective treatment options that not only alleviate symptoms, but also improve quality of life, and even protect fertility.

Hence, she advises women that are affected by this condition to seek formal help and professional medical attention.

A Quick Primer for Understanding Ovarian Cysts & Uterine Fibroids

WORDS LIM TECK CHOON

FEATURED EXPERTS
DR WONG YEN SHI
Consultant Obstetrician & Gynaecologist
Sunway Medical Centre Velocity
DR FARAH LEONG RAHMAN
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity
DR WONG YEN SHI ON UTERINE FIBROIDS
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AT A GLANCE
  • They are non-cancerous growths that form in the muscular layers of the uterus.
  • One can have a single fibroid or multiple fibroids.
  • Often found in women in their reproductive years—that is, the period of time when they are capable of conceiving.
  • We still don’t know what causes fibroids to develop in a woman. Dr Wong states that hormones and growth factors could be possible causes.
YOU MAY HAVE UTERINE FIBROID(S) IF YOU HAVE…
  • Irregular or painful period
  • Heavy bleeding during your period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight gain
  • Painful sexual intercourse

TREATMENT

  • Fibroids can be removed via surgery. Depending on the location and size of the fibroid(s) present in the uterus, this can be open surgery or laparoscopic surgery, the latter involving the use of a laparoscope to make fewer and smaller cuts in the body. Women that no longer want to have children can also opt to have their womb surgically removed.
  • Newer treatments such as uterine artery embolization (blocking the blood vessels that nourish the fibroid, thus causing it to shrink) and high intensity focused ultrasound (HIFU) surgery can be considered, but note that not every medical facility in Malaysia offer these treatments.
  • Medicines to relieve symptoms such as heavy menstrual bleeding and painful period
DR WONG YEN SHI & DR FARAH LEONG RAHMAN ON OVARIAN CYSTS
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AT A GLANCE
  • These are sacs that contain mostly fluid, sometimes with tissues or blood, which form within the ovaries or on its surface.
  • They are mostly benign, but can be cancerous on rare occasions–especially among women between 60 and 65.
  • Ultrasound and CA125 tumour marker test are used to tell whether an ovarian cyst is benign or cancerous.
  • Conditions such as pregnancy, pelvic infections, and endometriosis can increase the likelihood of developing ovarian cysts. A woman with a history of ovarian cysts is more likely to develop ovarian cysts in the future.
  • Yes, it’s possible to have both fibroids and ovarian cysts at the same time.
YOU MAY HAVE OVARIAN CYST(S) IF YOU HAVE…
  • Irregular or painful period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight change
  • Unexplained loss of appetite
  • Quick sense of fullness while eating
  • Painful sexual intercourse

TREATMENT

  • Smaller cysts usually don’t require treatment. Instead, the doctor will monitor the cyst for signs of growth and other changes. 
  • Larger cysts can be removed via open or laparoscopic surgery.
CAN UTERINE FIBROIDS & OVARIAN CYSTS AFFECT ONE’S CHANCES OF HAVING A BABY? DR FARAH EXPLAINS 
  • Most women with fibroids and cysts have no problems getting pregnant.
  • However, depending on the size and location, uterine fibroids may affect one’s fertility. For example, fibroids that form in the womb lining may block the fallopian tubes, keeping the egg from being fertilized by a sperm cell, or make the womb environment less conducive for a fertilized egg to attach to the womb for further development.
  • Fibroid developing during pregnancy may increase the risk of early delivery. “In some cases, it can cause severe pain when fibroids outgrow their blood supply. If the fibroid is large, it can cause the baby to be positioned wrongly, such as the baby’s head not turning down even at term,” explains Dr Farah.
  • Ovarian cysts forming during pregnancy is usually not a cause of concern, except when the cyst grows so big that it ruptures open.

DR FARAH’S ADVICE

  • Go for regular gynaecology check-up to detect the growths of uterine fibroids and ovarian cysts as well as to ensure that the rest of the reproductive system is in good condition and working order.
  • When you’re about to embark on your pregnancy journey, seek advice from your doctor if you have a history of uterine fibroids and/or ovarian cysts.
  • We still don’t have any evidence-based method to prevent the formation of uterine cysts or ovarian fibroids. However, practicing good health and maintaining a well-balanced diet will be good for your overall well-being and improve your chances of a safe and successful pregnancy.