Endometriosis and retrograde menstruation.
Endometriosis is one of the major causes of INFERTILITY among women , others are polycystic ovary syndrome (PCOS) and tubal blockage.
The prevalent symptom of endometriosis is pain especially period pain (dysmenorrhoea), painful sexual intercourse (dysparaunea) or backache.
The other sequele of endometriosis are infertility and spontaneous abortion which may be recurrent.
Interestingly no definite etiology of endometriosis could be considered, and it remains mysterious. Sometimes it is called as a disease of theories. Of many theories postulated, I favoured most the theory of retrograde menstruation. This phenomena happens in many girls right from onset of menstruation especially those with retroverted uterus or very tight cervical os , but cause no harm.
Those with strong immunity would be able to mop up the menstrual blood which has spilled behind the uterus.
When the girl's immunity drops as results of inadequate intake of fruits and vegetables, multivitamins due to imbalance diet , emotional and physical stress, the body loses ability to mop up the menstrual blood. In long term the endometrium contained in the menstrual blood will implant and grow at the pouch of Douglas and surrounding areas. This will progress to the growth of endometriosis.



Fertility and reproductive problems are progressively increasing among malaysians, mainly due to changing life style , culture and habits. From a simple agricultural life we have been transformed into industrial and technological mindsets and practices. The western cultures have controlled out lives, we are caught in rat race resulting in extreme mental stress and thus leading us to 1001 diseases. Fertility rates have declined sharply mainly due to improved level of education and socioeconomic status, urbanization, delayed age of marriage, change from extended to nuclear family system, change of diet as a result of western fast food campaign, increase in enviromental pollution and so on. The list never ends. Our fertility and reproductive center in Kompleks YJN. Bukit Jalil is inundated with daily calls seekiing appointments for fertility therapy. I have to perform laparoscopic surgeries on these patients and we have a long waiting list. This is happening in spite doing 6 laparoscpic surgeries on every monday and thursday, total of 12 a week. I am recruiting more fertility gynecologists to assist us clear the backlog. Those who are keen can get in touch with me.