BUTLER, Pennsylvania — The prevalence of endometriosis in South Africa is not entirely known. A 2022 academic journal article published in Reproduction and Fertility explored the status of endometriosis in Africa. It revealed that it is largely misunderstood and suggests that the actual prevalence in the continent may be higher than currently reported. On a global scale, the World Health Organization (WHO) estimates the prevalence of endometriosis to be around 10% among women and girls aged 15 years old or older. Addressing endometriosis is crucial in supporting women facing poverty. Luckily, there is progress in addressing and treating endometriosis in South Africa.
Endometriosis and Poverty
Endometriosis has several detrimental effects on sufferers’ lifestyles, which in turn affects how likely it is for those who have it to live in poverty. In a 2014 study about how endometriosis impacts sufferers’ lives published in BMC Women’s Health, two-thirds of participants reported that they had to take significant time off of school. Other participants reported that they had to “take time off work, choose part-time work” and that some even “had to give up their favorite job or lost the chance of promotion.” In having to do so, these participants reported a decrease in income, which negatively affected their financial standing.
In addition to the challenges that endometriosis poses, two prominent symptoms of the condition are heavy and painful periods. Consequently, individuals with endometriosis often experience period poverty, as the condition often “requires the purchase and use of much more menstrual products.” This issue aligns with findings from the previously mentioned 2014 study, where some participants highlighted the negative financial impact of paying for extra sanitary pads. Notably, 30% of South African women and girls deal with period poverty, making this a particularly significant concern.
The basic definition of endometriosis is it is “a disease in which tissue similar to the lining of the uterus grows outside the uterus.” Areas where endometriosis may grow but are not covered under gynecology include the bladder, ureters, bowel, rectum, intestines and peritoneum. As a result, endometriosis patients may present with symptoms and problems related to these other organs and membranes. This is exactly where Mediclinic Kloof’s approach to treating endometriosis comes in.
Located in Pretoria, South Africa, Mediclinic Kloof’s innovative and creative approach to treating endometriosis in South Africa involves recognizing that endometriosis is a complex, often multi-organ disorder and treating it as such. The clinic boasts a team of gynecologists, including the expertise of Dr. Abri de Bruin, who specializes in deep endometriosis. However, it is predominantly an interdisciplinary team, acknowledging the comprehensive needs of patients, particularly those dealing with deep endometriosis.
In addition to gynecologists, the team comprises urologists and gastroenterologists, specifically those with knowledge of endoscopies. Recognizing the multifaceted nature of patient care, the team also includes dieticians, physical therapists and biokineticists, available for patients as needed. Notably, Mediclinic Kloof specializes in conservative surgery as a treatment option for endometriosis, offering a common yet necessary treatment option.
Located in Sandton, South Africa, a suburb of Johannesburg, Mediclinic Sandton opened Hope Fertility Clinic in 2023. This specialized clinic focuses on the treatment of endometriosis in the country. Led by Dr. Neelan Pillay, Dr. Wynand van Tonder and Dr. Gaontebale Matlhaga, the clinic provides surgical and medicinal treatments to patients. These medicinal treatments include anti-inflammatory medications, which is important as professionals have recognized inflammation as “one of the mechanisms that triggers endometriosis.”
Women Taking Charge
Those who know best about what living with endometriosis in South Africa looks like and the treatments needed are those living with the disorder themselves. Luckily, those women are taking charge when it comes to awareness. Zoé Kirsten, Dimakatso Nonyana, Sharló Eden van Zyl, Innocentia Fhulufhelo Rambau, Nikita Theresa Bunce, Lebogang Mthethwa and Itumeleng Morule are among around 3,000 members of a Facebook group titled “Endometriosis South Africa.” In the group, women with endometriosis can “vent, ask advice, give advice and support each other.”
Unrelated to the group, Lesego Motshwane is an activist from Diepkloof, South Africa, dedicated to improving women’s health. She calls attention to her experiences living with endometriosis, adenomyosis and polycystic ovarian syndrome, advocating for greater awareness and understanding of these health conditions. Motshwane does this by working with World Women Leading Change, serving as the president of World Youth Leading Change Africa and through her nonprofit, Seratabatho Foundation.
Unfortunately, there is currently no cure for endometriosis, with only treatment options available. However, significant progress has been achieved in the treatment of endometriosis in South Africa, thanks in part to clinics like Mediclinic Kloof and Mediclinic Sandton and also owing to the valuable contributions of women who share their experiences and stories, fostering awareness and understanding of the condition.
– Natalie Coyne