How pharmacists can raise awareness of endometriosis

While around 176 million women worldwide suffer from endometriosis, awareness of the condition amongst both the public and healthcare practitioners remains low. Pharmacists can make a valuable impact by raising awareness of the symptoms of endometriosis and providing support to sufferers.

Endometriosis occurs when the uterine lining grows outside of the uterus. This usually occurs in the pelvic or abdominal cavities. The condition mostly affects women aged 25–35 years.  

While the etiology is unknown, Centre for Chronic Disease Management Director Dr Hanan Khalil previously suggested that risk factors include: family history, starting menstruation before the age of 12, experiencing periods lasting more than seven days, immune system disorders and abdominal surgery that can disrupt the endometrium.

Pharmacist and lecturer at Griffith University, Denise Hope told Australian Pharmacist that there are a number of symptoms that might suggest a woman is suffering from endometriosis. These include period pain that is described by the patient as ‘congested’ or ‘bloated’, heavy bleeding, recurring or chronic pelvic pain, deep dyspareunia and recurring bladder or bowel symptoms.

Ms Hope said delays in diagnosis are often linked to a lack of knowledge amongst the public about the condition, which many patients initially believe to be intense menstrual cramps requiring over-the-counter medicine.

The most definitive diagnosis is via laparoscopic surgery and biopsy. However, this procedure is often delayed until there has been a significant impact on the woman’s quality of life. It is therefore important that pharmacists are aware of the symptoms of endometriosis, and can ask patients targeted questions.

‘If we are able to delay disease progression, we can improve the quality of life and minimise the impact of advanced disease including infertility,’ Ms Hope said.

This week a series of events will take place around the world, as part of EndoMarch, aimed at increasing the awareness of endometriosis. These events are sorely needed. Endometriosis Australia estimates that, on average, it takes between 7–10 years for a woman to be diagnosed. This delay can result in years of pain and a diminished quality of life.

Delay in diagnosis not only impacts the quality of women’s lives, but it can also lead to diminished treatment outcomes.

‘Women accept painful menstruation as normal and are often reluctant to complain. Therefore, they can go many years without appropriate diagnosis. Pharmacists can help to break down these barriers through increasing patient awareness of endometriosis and its symptoms, and through targeted questioning to aid differential diagnosis of women’s reproductive health conditions.’

Pharmacists are a key source of information on endometriosis, with their role in providing education, assisting women manage the symptoms and referring them for diagnosis and treatment. For more information on the condition, refer to the National Action Plan for Endometriosis.

References

1. Manderson, L., Warren, N., Markovic, M. (2008). Circuit Breaking: Pathways of Treatment Seeking for Women With Endometriosis in Australia. Qualitative Health Research, 18(4), 522–534. At: https://journals.sagepub.com/doi/abs/10.1177/1049732308315432