Case history: Endometriosis

It shows up as pain - pain in the lower abdomen before and during menstruation, pain during or following sexual intercourse, pain when moving your bowels, and pelvic or lower back pain during your menstrual cycle. The discomfort may be mild or intense, and it is one of the main symptoms of this condition affecting about 176 million women globally. But a woman can also suffer from this debilitating disorder and not know.

Renee Wong (whose name has been changed for reasons of patient confidentiality), 39, only discovered she had endometriosis when she had trouble conceiving. Tests revealed that her fallopian tubes were damaged from an overgrowth of endometrial tissue implants, to such an extent that they had to be removed.

"I was shocked to learn that I had endometriosis because I don't suffer from painful periods or pelvic or lower back pain," says Wong. "Without fallopian tubes, I cannot conceive naturally; so IVF is my only option if I want to start a family."

Endometriosis is a female medical disorder that occurs when cells from the womb lining grow in other areas of the body, says Dr Seng Shay Way, consultant obstetrician and gynaecologist at Raffles Women's Centre in Singapore.

Every month, a woman's ovaries produce hormones that tell the cells lining the womb to grow and thicken. The body removes these extra cells from the womb lining (endometrium) when a woman gets her period. However, if these cells - called endometrial cells - implant and grow outside her uterus, endometriosis results.

These growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants on their ovaries, bowel, rectum, bladder, and on the lining of the pelvic area. The growths can occur in other areas of the body, too.