Valerie Wangithi, 23, a make-up artist based in Nairobi is seated outside a restaurant lost in thought. She does not hesitate to let out what she has been contemplating.
“I have had enough, I really want my uterus removed once and for all because this is too much, I just can’t take it anymore,” she starts off.
“I was diagnosed with endometriosis (a disorder in which tissue that normally lines the uterus grows outside the uterus) in 2019. But before I get to that, I started getting my menses at the age of 11 ... they showed up with a lot of cramps,” Ms Wangithi says.
She says she is tired of her extremely heavy and irregular periods, which are accompanied by unbearable cramps, bloating, constipation and vomiting. Sometimes, she says, she goes for months without periods.
Dr Mutakha Godfrey, a consultant obstetrician/gynaecologist based in Eldoret, explains that endometriosis is a common condition that can cause pelvic pain and difficulty getting pregnant.
“The cause of endometriosis is not known but a common theory is that some menstrual blood along the endometrium flows backward from the uterus through the fallopian tubes and into the pelvis during the monthly menstrual period,” the doctor explains.
“There are several other theories as well but research is still ongoing.”
The doctor says the condition comes with immense pain. It also makes it more difficult to become pregnant by causing scar tissue that can damage the ovaries or fallopian tubes. If they get pregnant, the “symptoms of endometriosis often improve afterwards”, the doctor observes.
Ms Wangithi discloses that she has never received any form of treatment. “The available gynaecologists are so expensive and booking consultations is double the time.”
She believes that losing her mother at a young age, which saw her passed around from relative to relative and at times abused, denied her the opportunity to have someone who would help her navigate her current predicament.
“Opening up to friends is not easy as most will think you messed up with your body or link it to some hormonal imbalance.”
According to Dr Mutakha, once your health care provider suspects that you have endometriosis, the only way to know for sure is through a biopsy. Endometriosis cannot be definitively diagnosed by ultrasound, X-ray, or other non-invasive methods, he adds. The diseases is usually categorised as mild, moderate or severe depending on what is found.
“However, the category does not always correlate with symptom severity; people with mild disease can have severe symptoms,” Dr Mutakha says.
For Ms Wangithi endometriosis affects her daily life.
“When having these extremely painful periods, I often do not have the money for regular painkiller injections and now my condition has started to affect my performance at work,” she says.
Dr Mutakha notes there are a number of treatment options, including nonsteroidal anti-inflammatory drugs like brufen and hormonal birth control pills, patches and vaginal rings, which are effective in managing pain. Surgery can also be done through laparoscopy to remove affected tissue.
For Ms Wangithi, all she wants is for her uterus to be removed, but Dr Mutakha this should only be considered when other treatments fail or when you want a permanent treatment.
“Periods already come with emotional imbalance. The pain and anxiety makes you fear for the next time they decide to show up and I am tired and sick of it,” she says.
She is one of the roughly 10 per cent women of reproductive age globally affected by the disease according to the World Health Organization.