WOMEN’S HEALTH

Endometriosis

Painful and/or heavy periods, pain during or after sex, chronic pelvic pain in your lower tummy or back, pain when urinating during your period? If you have experienced some of these, you may have endometriosis. 

What is endometriosis?

Endometriosis is a condition where the tissue that lines the inside of the womb (uterus), known as endometrium, grows in other parts of the body, typically within the pelvis. The lining in the womb thickens during the menstrual cycle to prepare for pregnancy, and sheds off when pregnancy does not occur. Similar to the endometrium, the tissue outside of the womb builds up and sheds off according to the hormonal cues. However, unlike the lining in the womb, the bleeding from the shedding off of the external lining cannot be secreted from the body. 

Over time, the internal bleeding from endometriosis forms cysts in the ovaries or bumps/deposits around and on pelvic organs (e.g., uterus, ovaries, fallopian tubes, urinary bladder, intestines), or cause the organs to stick together. 

It is estimated to affect 20-30% of women in the reproductive age group (from puberty to menopause). The cause of it has yet to be identified, and there is currently no cure. 

Frustration with endometriosis 

We want acknowledgment of this condition!  

Despite its prevalence, many lack awareness of this condition, including medical professionals. This leads to long wait times for diagnosis and treatment or even a misdiagnosis. 

Endometriosis compromises women’s quality of life. The pain could result in fatigue, lower productivity, or withdrawal from social activities. When they feel that their loved ones cannot understand their condition, they feel uncomfortable in the relationship and isolate themselves from them. Nearly half of the affected women feel depressed and anxious. Beyond the life-impacting pain, some women go through the grief of not being able to conceive. 

How can I cope with endometriosis?

Ψ Radical acceptance 

First, allow yourself to feel the difficult emotions arising from diagnosis and condition. You may feel angry, resentful, depressed or anxious. Notice your physical sensations – where are you feeling those emotions in your body. Bring awareness to your thoughts – are they supportive or critical.

Radical acceptance is about accepting things as they are instead of denying the reality or getting stuck in thoughts like “why me?”, “everything bad just has to happen to me”, “ was it something that I did?”. It does not mean you resign yourself to fate or become helpless. It is also not approval. It is the complete acceptance that you cannot change the facts, even if they are not how you want them to be.  

Accepting the reality will not remove your pain. But when you choose to radically accept things that are not within your control, you avoid getting stuck in bitterness and despair. This frees up your energy to focus on what truly matters to you in life. 

Ψ Challenge your thoughts 

Countless thoughts go through our mind upon receiving a medical diagnosis. Often, they pass so quickly that we are left to sit with the emotions. If we pay attention to them, we may recognise these common unhelpful thoughts: 

• Catastrophising (“I’m going to die from this”, “I will not be able to do what I enjoy anymore”) 

• All or nothing (“I am useless with this medical condition”) 

• Personalisation (“I’m to blame for my condition”, “It is because of me”) 

To manage those negative and unhelpful thoughts, ask yourself the following questions. 

• What's the evidence that supports or contradicts these thoughts? 

• What's the best/worst thing that can happen if you make this decision one way or another? 

• What would I tell a friend that's going through the same situation 

Ψ Ask for support 

No man is an island. 

Being independent doesn’t mean you cannot ask for help. You are not a burden, you have a very real condition called endometriosis.

It can be difficult to bring yourself to ask for help. You may feel anxious or guilty before asking for help. To ease this, you could prepare yourself for the request. Give yourself a pep talk, e.g., "I can do this!", "It is brave of me to ask for help". Think about how you would want to offer support to your loved ones if they suffer from physical pain. 

In order for your loved ones to help, try to be clear and specific about what you need help in. This could look like "I want to mail this parcel by this weekend, would you be free to help?", "Could you accompany me to the medical appointment?".

Sometimes, it is challenging to ask for help when you are curled up in pain. It would be useful if you educate your loved ones on the tell-tale signs that you want their help beforehand. For instance, “if you see me curling up in the couch or bed, it would be great if you could prepare a hot drink for me”.

There will be times where you feel overwhelmed with emotions or by the pain. Be kind to yourself and allow yourself to reach out.

Nonetheless, remember to express your appreciation and gratitude towards those who offered to help! “Thank you”, “I’m thankful that you…”, and “You have been great help” go a long way.

My loved one has endometriosis — how can I help? 

Ψ Emotional help 

Be sure to express compassion and empathy. They cannot predict when their pain and discomfort will hit so try to be flexible in plans. Do not blame, criticise or guilt-trip them when they back out of plans due to their discomfort. 

Offer a listening ear if they want to share about their struggles. Acknowledge their feelings and validate their strengths. This could sound like "of course you are angry that this is happening to you. I would be too”, "you are frustrated because you want to be independent but the pain is stopping you".

When comforting them, be mindful that you are not minimising their pain and concerns. “You should be glad it is not cancer", “just put a heat pack on your stomach, I do that when I have menstrual cramps”, “you will feel better when you get out and be with your friends” are unlikely to make them feel better.

We understand how tempting it is to rush in and make things better when we witness pain. We love them so we want to help them. But, giving advice and rushing to problem-solve would most likely not make them feel better. Rather, it makes them not want to tell you about their pain. So, lean into their pain and acknowledge that things are as bad as it feels to them. 

Ψ Practical help 

Learn more about endometriosis to understand what they are going through. Show that you are keen to help, and ask how you could help. For instance, you could offer to accompany them to medical appointments or help grab their groceries.  

Lastly, take care of yourself as you care for someone else.