Updates

Endometriosis is increasingly gaining attention in Malaysia as more women, particularly at younger ages, are diagnosed with the condition.

It occurs when tissue similar to the uterine lining grows outside the womb, causing chronic pelvic pain, excessive menstrual bleeding and fertility issues. Despite its significant impact, awareness remains low, leading to delayed diagnosis and misconceptions.

In Malaysia and globally, an estimated 6-10% of young women of reproductive age suffer from this condition.[1] Yet, despite its aggressive and invasive nature, endometriosis remains misunderstood and under-recognised,[2] often dismissed as merely “bad period pain.” In reality, it can cause debilitating pain, fertility challenges and significant disruptions to overall well-being.

One of the biggest barriers to timely treatment is misdiagnosis. Symptoms often mimic other conditions such as irritable bowel syndrome (IBS) or urinary tract infections (UTIs), leading to unnecessary treatments that do not address the underlying cause. Many women experience chronic pelvic pain, painful intercourse, heavy menstrual bleeding and unexplained infertility without realising these are warning signs of a serious condition.

Dr Tan Ee Ping, Consultant Gynaecologist and Advanced Minimally Invasive & Robotic Surgeon from Hospital Picaso, stresses that early detection and education are key to improving outcomes.

“Many Malaysian women still believe that severe period pain is normal, which delays diagnosis and treatment,” she explains. “Regular gynaecological screening, including transvaginal ultrasounds and pelvic examinations, are crucial in detecting abnormalities before they escalate. Early detection can significantly improve long-term outcomes and prevent unnecessary suffering.”

For many women, fertility is a major concern, with nearly 50% of those with endometriosis experiencing infertility.[3] The condition can cause inflammation, ovarian cysts (endometriomas) and scar tissue, making conception difficult. Often, women only discover they have endometriosis when struggling to conceive, by which time the disease may have already caused irreversible damage. Dr Tan highlights that early intervention—whether through hormonal management, minimally-invasive surgery or fertility preservation options such as egg freezing—can make a significant difference.

Surgical advancements have played a crucial role in improving treatment outcomes for complex endometriosis cases. Dr Sharifah Halimah Jaafar, Endometriosis-Focused Specialist and Advanced Minimally Invasive & Robotic Surgeon from Hospital Picaso, specialises in managing severe cases through cutting-edge surgical techniques. Traditional surgery can be invasive and challenging, particularly when endometriosis affects the bowel, bladder or delicate ovarian tissue.

“Robotic surgery has transformed the field, providing exceptional precision, minimised trauma and faster recovery times,” she explains. “With 3D visualisation, enhanced dexterity and EndoWrist technology, robotic-assisted procedures allow surgeons to navigate intricate areas with unparalleled accuracy, reducing complications, preserving fertility and lowering recurrence rates.”

However, Dr Sharifah emphasises that surgery alone is not a cure. “A holistic and comprehensive treatment plan is crucial to prevent recurrence and maintain quality of life. This includes long-term hormonal therapy to suppress disease activity, lifestyle modifications such as diet and stress management and regular follow-ups,” she says.

One key challenge within Malaysia’s healthcare system is fragmented care.[4] Many women see multiple doctors without a coordinated treatment plan, leading to delays, misdiagnoses and repeated surgeries that could have been avoided with a more structured approach.

Dr. Sharifah believes that a dedicated Centre of Excellence for Endometriosis is urgently needed to provide women with comprehensive, multidisciplinary care to ensure patients receive coordinated treatment.

Such a centre would offer access to advanced diagnostic tools and cutting-edge surgical options, including robotic surgery and high-intensity focused ultrasound (HIFU). More importantly, it would focus on tailored treatment plans that address both medical and emotional well-being.

Endometriosis is a public health concern that requires greater awareness, better training for healthcare providers and stronger policy support for specialised care. Dr Tan urges women to take control of their health and recognise that severe period pain is not normal. Seeking medical help early can prevent complications

To increase awareness on endometriosis, Dr Sharifah is debuting her book, Fighting the ‘Devil’ Within: A Chronicle of Untold Stories & Challenges of Endometriosis which sheds light on the struggles of women battling this silent condition while providing expert insights into effective treatment strategies and support systems. Through personal narratives and medical expertise, Dr Sharifah aims to empower women, caregivers and healthcare professionals in navigating endometriosis with greater understanding and compassion. The book will soon be available at MPH bookstores.

With greater awareness, improved medical expertise and access to specialised care, Malaysia can take meaningful steps toward ensuring that no woman with endometriosis is left to struggle alone. The conversation must continue, and the commitment to better care must become a national priority

This byline article is contributed by Dr. Tan Ee Ping, Consultant Gynaecologist and Advanced Minimally-Invasive & Robotic Surgeon & Dr. Sharifah Halimah Jaafar, Endometriosis-Focused Specialist and Advanced Minimally-Invasive & Robotic Surgeon, Hospital Picaso.

For more information on Hospital Picaso, please visit www.hospitalpicaso.com or https://www.facebook.com/hospitalpicaso/

References

[1] Chih-Feng Yen, Mukhri Hamdan, Pataya Hengrasmee, Zhongwei Huang et al. Improving the diagnosis of endometriosis in Asia-Pacific: Consensus from the Asia-Pacific Endometriosis Expert Panel for Endometriosis. Int J Gynecol Obstet. 2023;163:720–732.

[2] Henggeler C. Irritable bowel syndrome and endometriosis: diagnosis, similarities and nutritional management. Br J Nurs. 2023 Nov 23;32(21): S14-S20.

[3] Moradi Y, Shams-Beyranvand M, Khateri S et al. A systematic review on the prevalence of endometriosis in women. Indian J Med Res. 2021 Mar;154(3):446-454.

[4] Susan Thomas, LooSee Beh, Rusli Bin Nordin, 2021, Health care delivery in Malaysia: changes, challenges and champions. https://pmc.ncbi.nlm.nih.gov/articles/PMC5345496/

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