HEALTH | 13
HONI SOIT WEEK FOUR 2022
Do you have endometriosis? Signs, Symptoms and Emily Mackay explores diagnosis and treatment. Treatments for an incurable disease. What is endometriosis?
E
ndometriosis is an incurable, chronic condition which causes the inner lining of the uterus associated with menstruation to grow outside the uterus. The endometrial tissue can attach itself to surrounding pelvic tissues and organs causing painful adhesions and scar tissue to form. The disease has been listed as one of the 20 most painful conditions by the NHS, along with shingles, heart attacks and broken bones. So why is it still widely misdiagnosed and insufficiently researched? Since 2018, I have had two laparoscopic surgeries - both of which required hours of angrily pitching to my doctors that I desperately needed help. When I was 15, I had been suffering with endometrial pain constantly for eight months. Multiple hospitalisations, painkillers and hormonal medications left me completely zonked out and still in crippling pain. When I finally managed to see a renowned gynaecologist after four months of waiting, I was told that I was simply “overreacting” and “making up the pain”. The doctor attempted to refer me to see a pain psychologist and prescribed me antidepressants as a coping mechanism. I was devastated, frustrated, and confused. How could there be nothing wrong with me? Was this all a product of my imagination? A tonne of research and an insightful conversation with my Mum identified the most likely cause of my pain: endometriosis. A month later, I stormed into the specialist’s office with one thing on my mind: getting surgery as quickly as possible. The specialist hesitantly booked one for the day before my birthday - yay. I was satisfied and content. Little did I know that I would indeed be diagnosed with severe endometriosis. The endometrial tissue was so immense that
it exceeded my actual uterus in size, yet that’s not what pained me the most. When I was minutes away from anaesthesia, the specialist refused to be convinced, politely offering: “Would you like to stay in hospital overnight? I don’t think we’ll find anything.” Ouch.
When I finally managed to see a renowned gynaecologist after four months of waiting, I was told that I was simply “overreacting” and “making up the pain”. Misdiagnosis The real answer to this question is that most people simply don’t know what it is and how it’s different from “normal” period pain. People experiencing endometriosis are told constantly by specialists that the pain is all in their head. As a result, there is a dearth of menstruators openly expressing and identifying their symptoms out of fear of being dismissed by the so-called ‘experts’. Nevertheless, a consistent medical de-prioritisation of endometriosis has led to 15 out of every 1000 hospitalisations among women aged 15-44 to be endometriosis related (2016-2017). In addition, another 2017 study indicated that 29% of endometriotic women demonstrated moderate to severe anxiety and 14.5% presented signs of depression. Along with the social and mental impact, a failure to diagnose and treat endometriosis in the early stages has been
attributed to severe health complications, including infertility, irregular menstrual periods, amenorrhea, ovarian cancer, and food intolerances. In the face of such adversity, sufferers are forced to take it upon themselves to identify their symptoms early and selfdiagnose. Laparoscopic surgery is the only way to medically diagnose endometriosis, and requires an impressive level of selfdetermination, self-trust, and painkillers. Yet, surgery should only be used as a last resort. Is it endometriosis or “just period pain”? The first step in diagnosis is working out if the pain you are experiencing is indeed endometriosis or “just period pain”. Period Pain Premenstrual Syndrome (PMS) encompasses a large range of naturally induced symptoms that occur prior to and during menstruation, resulting from the hormones oestrogen and progesterone. Many people experience moderate pain during their period caused by contractions of the uterus that lasts for the first couple of days of menstruation when oestrogen levels are high. This often follows PMS symptoms such as mood swings, acne and breast tenderness. PMS symptoms are usually treatable through period pain medications or the contraceptive pill. During PMS, your ability to perform everyday tasks should not be significantly restricted. If it is, this would be the first sign of abnormality. Treatments for PMS If you suffer from pain during your period, there are some strategies you can take to lessen the pain, including: using a heat pack, doing gentle exercises (such as yoga), complementary therapy (such as
acupuncture), pain relief medications, the contraceptive pill or an IUD implant. Endometriosis In contrast, pain from endometriosis tends to shift every cycle and can be present in the lower back, upper abdominal, bowels, bladder, and ovaries. People with endometriosis tend to experience chronic pelvic pain that “comes in waves” relevant to each stage of the menstrual cycle; pain does not necessarily occur exclusively around menstruation. It is common for sufferers to experience periods of severe pain resulting in physical impairment and hospitalisation. Additionally, sufferers can develop chronic fatigue, intolerances to foods (such as gluten and dairy), pain during intercourse, nausea, as well as pain with bowel or urinal movements. Treatments for Endometriosis There is no singular way to cure endometriosis, however, there are some treatments available. Hormonal therapy, such as contraceptives, can be used to prevent ovulation and menstruation to restrict the growth of endometrial tissue. A laparoscopic surgery may also be undertaken to remove scarring and abnormal tissue growth. In extreme circumstances, patients may have their ovaries or entire uterus removed. Some common self-care strategies for endometriosis at home include regular exercise, yoga, meditation, pain medications, heat packs, maintaining a healthy and balanced diet, psychological support, mindfulness, regular sleep and therapeutic treatments such as acupuncture. If you believe you are experiencing endometriosis, above all it is imperative that you speak to a gynaecologist to explore possible treatments.
Re-personalising the self Toni Whitcombe takes a walk outside her body.
you from all the possible ways that you could be perceived by the strangers who flood the rest of the house. There is no ambiguity between these four walls. Alone, you are not reduced to the changeable and indiscernible way in which others grasp you; you are the clear and inescapable way that you identify yourself to be. But your uninterrupted voice is hostile tonight. It is undisputed and deafening inside this echo chamber you have sealed yourself within. Belatedly, you notice that your body has spat out your mind; that it’s slid under the bathroom door and snuck back into the depths of the party.
You’ve similarly examined the precise ways in which her body contorts in different settings: how her mouth disappears when anxious; how her ears become sponges when she engages in political discussions; and how, when she’s upset, her feet turn into lead inside her lemon yellow shoes… But right now her face escapes you. It feels as if you’re looking at her through someone else’s eyes. Someone has stolen yours and replaced them with their own.
She detaches herself from you and points into the darkness.
Disentangled from your imagination, hollowed of all memories and rinsed of all emotions, your physical form glides towards the glugging noise that pours out of the next room. Here, a short brownhaired woman is hunched over a mahogany benchtop upon which several ignored water glasses and near-empty bottles of wine are splayed.
“Yeah, I think it’s the first door on the right, just down the hall there.”
“Hey again stranger, do you want some red too?” she asks.
You don’t have the vocabulary to describe what you’re experiencing to her, and you’re afraid that any attempt to do so will freeze you in this state. So as the line between subjects and objects continues to smudge, you melt into a stool that rests next to her. All you can do is wait for your mind to return to you. You’ve forgotten where you left it. After all, remembering was not your job.
“Ok perfect, I’ll be right back. I love you.”
Without a thought, the words “No I’m okay” crawl out of your lips.
Y
ou twist your muddy boots into the bristles of the doormat, rest your umbrella against the wall, and add your tote bag to the mound of jackets that sit on the couch inside. In front of you, fifty-two pairs of shoes hammer the floorboards to Bowie’s “Let’s Dance” while hands dive in and out of chip bowls. Shortly after you’ve entered the front room, two lemon-yellow converse desert the group and make their way towards you. “Hey! You’re finally here” she says as she wraps you in her soft warm arms, in one of those long embraces that whispers “You’re here with me, you’re safe.” “Sorry I’m so late, the traffic was really bad,” you mumble into her ear. “Do you know where the bathroom is?”
“I love you too.” And now you’re in the bathroom. Mopping up your smudged mascara with a square of toilet paper helps distract
“Alright, nevermind.” She pushes aside her wine and substitutes it for a glass of water, proceeding to silently peer through it and study how the light makes it distort your figure.
I unlock the bathroom door from the outside, twist the handle, and let your mind reunite with your body in the external world. Through writing this piece to you, I have been able to gain some sense of control over and familiarity with an experience which has repeatedly alienated me from my own
subjectivity. Over the past ten or so years, depersonalisation has made me a stranger to myself – and by extension, those I love – to varying degrees and lengths of time. I’ve read that some people may only ever experience depersonalisation as a one-time occurrence, while others with the disorder can spend their whole lives suspended in this feeling of unreality and detachment from their own mental processes or body. This prospect alone makes it difficult to remember that depersonalisation is actually a natural way in which our bodies can react to stress or trauma. Unfortunately, there’s no salve that you can apply to your mind when it peels away everything you know and feel from your body. Just like a painful sunburn, all you can do is be patient with yourself – it takes time to heal.
