He sat quietly, looked me in the eye and said ‘doc, I am menstruating and I have menstrual cramps’. I have heard that phrase a thousand times before but not like this one. He is a man, he has a wife and 2 children. He was also 25 years old.
I was rattled for a few seconds but when I finally came out of the shock, I asked other questions. It so happens that this man also had abdominal pain (what he described as period pains), he was quick to add that his wife also had the same although while his wife has been having regular menstrual cycles for years, this was just his second month.
He had diarrhea too and felt tired often.
After diagnostic tests, it just so happened that this man was not menstruating at all. He had a disease call Schistosomiasis. This disease is common in poor neighborhoods of Africa, Asia, and South America. People get schistosomiasis when they walk through or swim in waters infested with the larval forms of Schistosomes.
Schistosomiasis affects about 200 million people worldwide and is more common in tropical areas. The kids who love to play in pools of water are most at risk. Same can be said of those who drink from these non-portable waters.
Patients infected with Schistosomiasis may also have bloody stools and if not treated urgently, it leads to problems with learning and poor growth. Chronic infection may also cause failure of the liver and kidneys as well as cancer of the bladder.
So if you happen to live in such areas and you see those kids playing in ponds especially in endemic areas please discourage them. Boil and filter your water before you drink and if you show signs of Schistosomiasis, see a doctor. The World Health Organization recommends the use of anti-worm drug Praziquantel and this can be jointly administered with Albendazole and Ivermectin, separately for preventive chemotherapy in endemic areas.
Lastly, if you ever come across a man who says he his menstruating, don’t buy him a sanitary pad, please send him to a doctor he might have contacted Schistosomiasis!
