New WHO fact sheet on Endometriosis

2 April, 2021

WHO has produced a new fact sheet on Endometriosis. As is the case with so many conditions, the priorities are to raise awareness and knowledge among patients and health workers.

https://www.who.int/news-room/fact-sheets/detail/endometriosis

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Endometriosis

31 March 2021

Key facts

- Endometriosis is a disease where tissue similar to the lining of the uterus grows outside the uterus, causing pain and/or infertility

- Endometriosis affects roughly 10% (190 million) of reproductive age women and girls globally

- It is a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.

- The variable and broad symptoms of endometriosis mean that healthcare workers do not easily diagnose it and many individuals suffering from it have limited awareness of the condition. This can cause a lengthy delay between onset of symptoms and diagnosis

- At present, there is no known cure for endometriosis, and treatment is usually aimed at controlling symptoms

Access to early diagnosis and effective treatment of endometriosis is important, but is limited in many settings, including in low- and middle-income countries.

- There is a need for more research and awareness raising around the world to ensure effective prevention, early diagnosis, and improved management of the disease

- Introduction and definition

- Endometriosis is a disease characterized by the presence of tissue resembling endometrium (the lining of the uterus) outside the uterus (1). It causes a chronic inflammatory reaction that may result in the formation of scar tissue (adhesions, fibrosis) within the pelvis and other parts of the body. Several lesion types have been described...

Prevention

At present, there is no known way to prevent endometriosis. Enhanced awareness, followed by early diagnosis and management may slow or halt the natural progression of the disease and reduce the long-term burden of its symptoms, including possibly the risk of central nervous system pain sensitisation, but currently there is no cure.

Diagnosis

A careful history of menstrual symptoms and chronic pelvic pain provides the basis for suspecting endometriosis...

Treatment

Treatment can be with medications and/or surgery depending on symptoms, lesions, desired outcome, and patient choice...

Addressing current challenges and priorities

In many countries, the general public and most front-line healthcare providers are not aware that distressing and life-altering pelvic pain is not normal, leading to a normalisation and stigmatisation of symptoms and significant diagnostic delay. Patients who could benefit from medical symptomatic management are not always provided with treatments due to limited awareness of endometriosis among primary healthcare providers...

Subsequently, some of the current priorities related to endometriosis include:

- Raising awareness about endometriosis among health care providers, women, men, adolescents, teachers and wider communities. Local, national and international information campaigns to educate the public and healthcare providers about normal and abnormal menstrual health and symptoms are needed.

- Training all healthcare providers to improve their competency and skills to screen, diagnose, manage, or refer patients with endometriosis. This can range from basic training of primary healthcare providers to recognize endometriosis, to the advanced training of specialist surgeons and multidisciplinary teams...

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org