“It’s Not Just A Bad Period, Sis”: Endometriosis
Hey sister, sister! Have you ever had those “days of the month” where it's actually more like a week and also it feels like you’re gonna die a little bit from the pain? Do people tell you “Maybe you just have bad periods”? Many menstruating people and women, including the beautiful Tia Mowry, can certainly relate.
These “painful periods” can actually be a sign of something called endometriosis. Endo, for short, is not a disorder that is talked about much, so I understand if you have not heard about it. Endometriosis happens when tissue that is similar to the lining of your uterus (called endometrium) migrates outside of the uterus to the exterior of your fallopian tubes, ovaries, or even other organs in the pelvis or abdomen. This can cause many symptoms such as chronic pelvic pain, very painful periods, pain during sex that gets even worse during your period, heavy periods or abnormal bleeding in between periods. It can also cause you to have nausea, vomiting, fatigue, problems with going to the bathroom, lower back pain right before and during periods, and even infertility. Problems getting pregnant happen due to scarring and adhesions in the fallopian tubes and uterus from these inflamed tissues.
Now that we know what Endo is, let’s talk about how hard it is to get a doctor to give you the diagnosis. Some doctors tend to ignore these symptoms women experience during periods, and this is why patients take an average of 8-12 years to receive the diagnosis after their symptoms start. Black and Hispanic women can take even longer and are actually much less likely to be diagnosed with endometriosis at all. This type of pain in Black women tends to be misdiagnosed as something else (such as fibroids, which are common in Black women and can present with similar symptoms), or disregarded altogether. One of the good things of having a doctor that looks like you, as you can have in Culture Care- you know they’ve made sure that they are aware of these things and they’re going to listen to you.
It’s a fight to get this diagnosis, and therefore management, but it’s a fight that is worth it. Tia Mowry knows this fight well; she struggled with pain and problems becoming pregnant for years before going to a Black doctor who finally gave her the diagnosis. The lesson here is that your pain is real and you are the one that knows your body best.
If you think endometriosis may be what’s causing your symptoms, ask your gynecologist for a transvaginal ultrasound, which can rule out other structural issues with your reproductive organs or find an endometrioma (a cyst with endometriosis fluid). The only way to definitively diagnose though is laparoscopy, where a camera is inserted into your abdomen and these tissues are directly visualized. This may be a later step, though, and an ultrasound + symptoms is probably a better way to start off.
Hopefully, you can get the diagnosis from your physician, and once you do, start with management options. These include medical suppressive therapy- including oral contraceptives, oral or injection progestins, or a medication called a GnRH agonist which calms down the hormones that induce inflammation in these tissues. However, symptoms usually recur right after stopping these medications. There’s also the option of surgery, where they excise the endometrial tissues in your pelvis and abdomen and may remove any adhesions in your uterus and tubes. Surgery can improve symptoms and increase pregnancy rates in those suffering from infertility and wishing to conceive.
I’ll also let you in on other secrets that may help. Many doctors may not offer other holistic options, especially to Black patients. Some holistic options include anti-inflammatory diets (fresh fruit and veggies), yoga, meditation, among other things. You do not even need to talk to a doctor first, these tips are good just for self-care and wellness.
In summary, advocate for yourself. You know your body better than anyone and if you think it’s more than a bad period, it very well may be. Yes, cramps hurt. Yes, periods suck. But your pain is real. Don’t let it take a decade till you get a diagnosis. Get the care you deserve by any means necessary. We are always here to listen.