About one in every ten women who are able to have children have endometriosis, according to the World Health Organization.

This is a condition in which the tissue that usually lines your uterus grows in other parts of your body.
Every month, when you have your period, the tissue inside your uterus breaks apart, and it leaves your body through the vagina. That is what causes menstrual bleeding.

But when this tissue grows in other parts of your body, it still bleeds, but has no way of leaving your body. This can cause inflammation, swelling or pain – or all three. It can also cause scar tissue and lesions, which is what happens when there has been damage or an injury in a part of your body. This condition can be very painful, and can affect your life, and stop you from doing things you enjoy or must do, such as going to school or work.

“When I started having my periods, I would be bedridden, faint or vomit from the pain and bleed excessively,” says Rinchen van Rijswijk, (27). “Living without a diagnosis was really hard, as living with chronic pain really affected my quality of life. It was difficult to know that something was wrong, but I was not being heard by my doctors, who said that periods were meant to be painful.”

When listening to Richen’s account, it is not difficult to see why this condition can also lead to anxiety and depression.

Four in every ten women who struggle to fall pregnant have endometriosis. The endometrial tissue can stop your body from releasing eggs, block the journey of the sperm, or stop a fertilised egg from reaching your uterus where it can grow.

There are four types of endometriosis, each describing the area of your pelvis or your stomach/abdomen affected by the growths. These can include the lining of your abdomen or pelvis (called the peritoneum), your ovaries, the abdominal wall itself. The fourth one, which is rare (only between one and five per cent of women with endometriosis) invades the organs inside or outside the pelvis.

Symptoms of endometriosis

While most women have period pains every now and then (this does not mean you have endometriosis), this condition can cause severe menstrual pain. Other symptoms include the following:
· Back pain while you are having your period
· Pain (or blood) when you use the toilet
· Constantly feeling tired
· Pain during sex
· A runny tummy or struggling to poo

Doctors are not quite sure what causes endometriosis, but the condition does seem to run in families. If your sister or mother has the condition, your chances of having it seem to be higher. Some doctors think that it might be caused by menstrual blood that goes back into the pelvis instead of out through the vagina.

Diagnosis and treatment of endometriosis

There is no specific test to find out if you have endometriosis, but a doctor will take a careful look at the history of your menstrual symptoms and the pelvic pain you experience. Sometimes the symptoms of endometriosis can look like those of other conditions, so it can sometimes be difficult to diagnose this condition.
This can be a problem for women who do not have easy access to healthcare, and often many people simply assume that this pelvic pain is normal.

“I would advise young women that they know their body better than anyone else and if they think there is something wrong to advocate for themselves and continue asking questions until they are taken seriously. I know how it feels to be ignored and to be made to feel crazy,” says Rinchen.

There is no cure for endometriosis, but there are a number of things that can help to control the symptoms. These include painkillers and various hormonal medicines used for birth control, such as pills or injections which prevent ovulation (but obviously not if you are trying to fall pregnant). These are often available free of charge at government clinics.

Rinchen had surgery and tried various contraceptive pills, both of which have made a difference.

Sometimes, an operation is recommended to remove the lesions if other treatments are not successful, but this treatment is not always available.

“I believe that if medical professionals had taken me more seriously earlier on, I would have had an earlier diagnosis and would not have had to suffer unnecessarily. I hope that endometriosis will start to get more attention from medical researchers as there are way too many people out there suffering because of a lack of knowledge around what is seen as a ‘women’s disease’,” said Rinchen.

Tell us: why is it important that people are aware of this condition?