Dr. Abayomi Ajayi, a consultant gynaecologist and fertility expert, urges women who experience excruciating pain during sex and menstruation to seek medical evaluation for endometriosis. He explained that many women living with untreated endometriosis find it difficult to enjoy sexual activity because of the unbearable pain during and after intercourse. In addition to painful sex, women with endometriosis often face fertility challenges, chronic pelvic pain, and heavy menstrual bleeding.
Ajayi made these remarks at an awareness programme organised by the Endometriosis Support Group Nigeria (ESGN) to mark the 2023 Endometriosis Awareness Month. The annual event, held each March, aims to raise awareness of a disease that affects roughly 190 million women and girls of reproductive age worldwide. According to the World Health Organization, endometriosis impacts about 10 percent of women in their reproductive years and is associated with severe, life‑impacting pain during periods, sexual intercourse, bowel movements and urination, as well as chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.
Endometriosis is a condition in which tissue that normally lines the uterus grows elsewhere in the body. Pain during or after sexual intercourse is a common symptom. Some women experience intense pain with any form of intercourse, while others feel it only with deep penetration. The timing of pain also varies: some women suffer only around their periods, while others experience discomfort throughout the month. Severe abdominal pain and cramping can force women to alter their daily lives. Ajayi emphasized the importance of communicating with partners about the physical and emotional impact of the pain, expressing needs for love and intimacy, and addressing fears of rejection or guilt associated with reduced sexual activity.
Prompt diagnosis and treatment are crucial to reducing the negative health impacts of endometriosis. The condition is a significant factor in female infertility, yet it is often misunderstood, misdiagnosed, and delayed for years. The most reliable diagnostic method is laparoscopy, a surgical procedure performed under general anaesthesia in which a small telescope is inserted through the abdomen. Treatment goals may include pain relief and fertility enhancement.
Healthcare workers must be aware of endometriosis to consider it in their differential diagnoses. The disease can mimic other conditions; for example, a patient might present with symptoms resembling epilepsy or tuberculosis, leading clinicians to overlook the underlying endometriosis unless they probe beyond the surface presentation. Simple lifestyle or dietary changes are usually insufficient, making early intervention essential.
The WHO notes that endometriosis has significant social, public health, and economic implications, reducing quality of life through severe pain, fatigue, depression, anxiety, and infertility. Painful sex can lead to avoidance of intercourse, affecting the sexual health of both partners. Addressing the condition supports the human right to the highest standard of sexual and reproductive health, quality of life, and overall well‑being.
A 2022 qualitative study published in *BioMed Central Women’s Health* highlighted that lack of information exacerbates the challenges faced by women with endometriosis. The researchers concluded that increased awareness and communication between patients and healthcare providers are essential to improve quality of life. They called for cooperation among healthcare professionals, psychologists, and support organisations, emphasizing the need for better communication and recognition of psychosocial issues to ensure empathetic care for women living with endometriosis.
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