One in seven women worldwide suffers from endometriosis, a painful condition more common than diabetes that robs years from women’s working lives, though much of the damage is avoidable, a medical expert said.
Prolonged disease can lead to infertility, as it damages the ovaries and fallopian tubes, while the resulting inflammatory environment hampers implantation, endometriosis surgeon and Indian Centre for Endometriosis (ICE) director Dr Abhishek Mangeshikar told PTI.
Endometriosis is now recognised as more than a gynaecological condition, which can affect almost any part of the body and occurs when tissue similar to the lining of the uterus grows outside the uterus, sometimes in unexpected locations and organs, he said.
Some of the more complex and frequently misdiagnosed cases involve lesions affecting the intestines, ureters, bladder, chest, diaphragm, nerves and even the abdominal wall, often requiring specialist care and a multidisciplinary team for accurate diagnosis and appropriate treatment.
For millions of women in India, endometriosis is more than a health condition, with chronic pain and symptoms taking a toll on their work lives and career progression, he said.
According to data from the Endometriosis Society in India, nearly 2.7 crore women suffer from this condition, Dr Mangeshikar said.
As per global statistics, one out of seven women have endometriosis, which is much more common than even diabetes, but it’s a disease that is very rarely heard of, he added.
The condition steals years from women’s working lives, and a large part of that damage is avoidable, Dr Mangeshikar said.
“Advanced endometriosis is not a disease for a general gynaecologist. It can involve the bowel, bladder, ureters and pelvic nerves, and surgically it can be more complex than many cancers. Yet while any gynaecologist would immediately refer a suspected cancer to an oncosurgeon, there is an alarming reluctance to refer advanced endometriosis to specialist centres,” he said.
The result is repeated incomplete surgeries, organ damage, recurrence and years of pain, Dr Mangeshikar said.
“Every failed operation means more hospital stays, more missed work, lost promotions, and for many women, leaving their careers altogether. This has to change. Endometriosis needs the same referral culture we have,” he added.
When the condition is misdiagnosed or inadequately treated, women can become trapped in a vicious cycle of being advised to get pregnant as a form of treatment, an approach he described as a persistent myth and misconception surrounding the disease.
“But when specialists treat endometriosis, the recurrence rates fall into single digits of about 2-4%,” he added.
Endometriosis is not a lifestyle disease, and one does not get this condition due to an unhealthy diet, the medical expert said.
“We don’t know the epigenetic factors responsible for the condition, whether it grows, how aggressively it grows, or which organs it affects – that is still under a lot of research. But we do know that it is inflammatory, so it does respond worse to, say, an inflammatory diet, but there is no cause indicating that it is a lifestyle disease,” he stated.
Prolonged disease can lead to infertility issues because it damages the ovaries, the tubes, and the inflammatory environment hampers implantation, he said.
“In long-standing cases, the cysts can turn cancerous, especially in the older age groups; there is a slightly higher risk, but that being said, the risk is not overtly worrying in terms of statistics, and it doesn’t guide, like removal of the ovary or anything, but it is something to keep as a differential diagnosis when you see the disease in older women,” he added.
