Endometriosis: Recognising the symptoms and signs

In Malaysia, this adds up to around 300,000 women, although doctors believe the figure to be higher due to under-diagnosis.

"To put it simply, in a class of 50 students who are all girls, five of them would eventually be diagnosed with some form or degree of endometriosis at one point in their lives," said Dr Tang Boon Nee from Subang Jaya Medical Centre.

The consultant obstetrician and gynaecologist noted that prevalence was also higher in Asian countries, going up to 15 per cent.

“We are not sure why, but we think that genetic factors play a role.” she explained.

Awareness of endometriosis in Malaysia has increased over the years through social media, support groups and dedicated websites about the condition, in which tissue similar to the lining of the uterus grows outside the uterus, causing severe pain in the pelvis.

While people may have some knowledge of the condition, many do not associate the symptoms with their experience, according to Tang.

Many of her patients diagnosed with endometriosis often recall having terrible menstrual cramps when they were younger.

“A lot of them had to skip school on the first couple of days of their period because the pain was so debilitating,” she said.

To some extent, Tang added, menstrual cramps have also been normalised in Asian households.

“But they shouldn’t have cramps until it affects their day to day life. Other symptoms include general bloating, especially around the time of their period, or severe, heavy periods.”

Access to early diagnosis and treatment is crucial, but for many women, the journey of being diagnosed with endometriosis is far from smooth.

According to Tang, some patients get used to their symptoms, while others remain in denial of their pain.

“Another important thing to consider is the fear of diagnosis of endometriosis because it has many implications,” she said, citing infertility, lack of insurance coverage or further hospital expenses.

“The fear of consequences, potential treatment, the cost of it and what other people will say leads a lot of people to just accept the symptoms.”

To address this, Tang said it was important to have more open discussions about women’s health.

She stressed that treatment can be tailored to a patient’s age, needs and wants, from hormone therapy to surgery.

“It can be treated especially if you catch it early. They (women) can have normal fertility, normal menses and be pain free.

“If we give that hope to women, I think more will seek help.”