For women throughout history, diagnoses of medical conditions haven’t come easy. In the male-dominated field of medicine, women’s symptoms were often dismissed, and regarded as a waste of time. For some, the all-encompassing diagnosis of “hysteria” would do the trick, leaving many women without the urgent medical care they so needed.
These days, the dismissal of female patients due to the historical label of “hysteria” would be deemed as negligent treatment at hospital. That said, that doesn’t mean that the female body is completely understood, leaving many women without reliable diagnoses even still.
One classic case of this is endometriosis. Despite one in ten UK women suffering from this often debilitating condition, many women go years, or even decades, without a confirmed diagnosis. But why is this, and what can be done about it? Find out more, here…
What is Endometriosis?
Endometriosis occurs when tissue similar to that of the wombs lining grows in other places in the body. A lot of the time, this growth is restricted to the outside of the uterus, as well as the ovaries and fallopian tubes. For other women, however, this growth can reach many other areas of the body.
Much like the lining of the uterus, which swells and breaks down during ovulation, these growths do the same. However, as they have no place to leave the body, they become trapped.
This can cause cysts to form, especially on the ovaries, and surrounding bodily tissue becomes very irritated, which is often very painful. It can also cause scar tissue to build up in the pelvic organs, which produces bands of fibrous tissue. This then causes tissues and organs in this area to stick together, ultimately leading to a lot of pain.
Despite the common misconception that only women above a certain age can suffer from this problem, it can affect women of any age. As long as they’ve begun their reproductive cycle, any woman is then susceptible to it.
Unfortunately, this condition is life-long, and can have severe consequences, including infertility. Although the symptoms can be managed, and surgery is the closest thing to a cure, it’s something that will prevail for the rest of the sufferer’s life.
The Symptoms of Endometriosis
The symptoms of endometriosis can vary; some women can be badly affected, while others might not even notice until a lot later in life. The main symptoms of endometriosis include:
- Pelvic pain, in the lower tummy and back, which is worse during your period.
- Pain that affects your daily activities.
- Heavy periods, so much so that you might bleed through tampons, pads, and your clothes.
- Pain during or after sex.
- Pain during bowel movements, especially during your period.
- Trouble getting pregnant.
- Constipation or diarrhoea.
- Blood in your urine during your period.
These symptoms, although worse during a person’s period, may affect the sufferer dramatically every day. This can not only have a severe impact on the physical comfort of the person, but also their mental health. For many women who don’t get the diagnosis and treatment they so need, this can lead to depression.
Although severe pain is often deemed to be a clear factor of endometriosis, this doesn’t occur with everyone, and isn’t indicative of the condition’s progression. For example, where you might have a sufferer with immense pain, they may have a mild condition. However, you might have someone else whose condition is far worse, but they have little to pain whatsoever.
Why Are These Symptoms Not “Normal”?
Some of the normal physical symptoms of menstruation include bloating, bodily aches, abdominal cramps, lower back pain, tender breasts, and fatigue. As we’ve seen, endometriosis has some similar symptoms to a normal period, which can make things a little confusing.
However, the pain and heaviness of your period could be an indicator of endometriosis. If your symptoms start to affect your attendance at work or school, and you are unable to commit to daytime activities as you’d like, this is a warning sign. Your period should not get in the way of your daily life, so if it does, getting advice, and potentially a diagnosis, is key.
Why Endometriosis is Often Misdiagnosed or Diagnosed Late
According to a 2016 documentary called Endo What?, the average time endometriosis diagnoses are made is a whopping eight to ten years. During this time, women will see an average of eight doctors before they get a proper diagnosis.
There are a number of reasons why endometriosis is often a last resort when it comes to medical diagnoses. Ultimately, it’s thought that uninformed doctors, lack of awareness on the issue, and gender bias in hospitals are the three main cause factors for the delayed diagnosis of endometriosis. Some of these reasons, explained, and some of the other main reasons this occurs are as follows:
- Misunderstanding of the condition: many doctors have little understanding of this issue, meaning this won’t usually be their first port of call when they hear the symptoms. A lot of the time, an endometriosis diagnosis is a last resort, despite how many women are affected by it.
- Lack of knowledge on the subject: in most schools, endometriosis is barely mentioned in sex education, meaning most women will think their symptoms are normal.
- Misconceptions of age: as endometriosis is commonly associated with middle age, women of younger age groups are often dismissed of their symptoms.
- Confusion with periods: as the symptoms of endometriosis often mimic those of a period, including pain, many doctors will dismiss it as simply a bad period. But, it’s important to know that, if your period pain is stopping you from going about your daily business, this isn’t normal, and should be looked into.
- Confusion with other conditions: the symptoms of endometriosis are also quite similar to some other conditions, which can be diagnosed before the ultimate diagnosis. These include ovarian cysts, pelvic inflammatory disease, and irritable bowel syndrome. Some of these issues can accompany endometriosis, which makes diagnosis even more tricky.
- Women concealing their pain: the stigma surrounding menstrual pain is often embarrassing, and can mean women are taken less seriously in the workplace. So, a sufferer may conceal their pain so as not to have to deal with this.
- Gender bias: unfortunately, women are still undermined in hospitals, meaning their symptoms are sometimes not taken seriously. So, urgency in medical care is not always prioritised, leading to a late diagnosis.
The Link Between Women and Hysteria in Medicine
As we’ve seen, one of the reasons endometriosis often goes misdiagnosed, or undiagnosed completely, is due to gender bias still rife throughout the medical world. Unfortunately, this means that some women’s medical care may be different to that of a man’s for certain ailments. But, where exactly does this stem from?
Back in the 19th century, women might complain to the doctors of a variety of symptoms, including anxiety, insomnia, irritability, nervousness, fainting, and epilepsy. However, the majority of doctors were men, and medical science was often practiced on male bodies. So, the “normal” patient being a man, these symptoms were misunderstood, and often ignored.
Instead, the all-encompassing and offensive diagnosis of female hysteria was prescribed; the first mental disorder we can attribute to women, and women only.
Women have always had the reputation of being “hysterical”, since the Father of Medicine, Hippocrates, wrote The Diseases of Women. 4000 years later, the term was still used as a viable diagnosis, up until the 1950s. Still, this reputation has been tricky for female patients to shake off, hence the issues many women have faced with their endometriosis diagnosis.
Getting a Diagnosis for Endometriosis
Once you’ve approached your doctor about your symptoms, it can be tricky to get a diagnosis. This is because, after all the above issues, it’s also difficult to spot. Although a visual inspection through the vagina may be attempted, this often doesn’t show any indication.
The only accurate way for it to be spotted is through a laparoscopy, or keyhole surgery. This is not only expensive, but also invasive, and relies on the doctor to be able to recognise the signs on examination. If they don’t spot these signs, and a biopsy also isn’t taken, it may go amiss.
What to do if Your Doctor Isn’t Taking Your Diagnosis Seriously
For many women, getting this laparoscopy can be tricky to begin with. Oftentimes, their doctor will brush aside their symptoms as a natural part of the menstrual cycle, which happens all too often. In most cases, hormonal birth control pills or painkillers, like Ibuprofen, will be prescribed.
It may take all sorts of tests, diagnoses, and wrong medication before a confirmed diagnosis is met. Although it’s not ideal, the key is to be adamant, and push for certain tests, including an ultrasound, MRIs, and a laparoscopy. After all, it’s your health, your body, and your life, and they have a duty of care to appease you.
Naturally, this may not always work, so asking for a second opinion elsewhere is always sensible. Also, be sure to do your own research on the matter, as this can help you to confirm your own thoughts, and encourage you to assert yourself in the matter.
Get Your Endometriosis Diagnosis!
As we’ve seen, endometriosis diagnoses are hard to come by, and the symptoms are ignored all too often. It’s clear that education, on both the patient’s end and the doctor’s end, needs a huge overhaul. Unfortunately, it just goes to show the gender bias still rife in the medical world, thanks to the outdated word “hysteria”.
Have you had any problems getting your endometriosis diagnosis, or perhaps you think you may have it, but have been ignored? Leave your stories, tips, and thoughts in the comments down below. We women have got to stick together!