ENDOMETRIOSIS: UNKOWN AND UNDIAGNOSED

Kiaya Sechrest | Contributor

Imagine you are experiencing abdominal pain so searing, it drives you to visit the emergency room. Imagine you are forced to wait for hours in debilitating agony because your pain is ranked low by the nurse making triage assessments. Imagine that, after all that, a doctor dismissively diagnoses you with run-of-the-mill abdominal pain and subjects you to more useless waiting. Imagine, years later, finally receiving a diagnosis, only to learn that, because your employer opposes birth control, you cannot afford the medication necessary to make your disease bearable. That sought-after diagnosis is endometriosis, and this story is far from conjecture.

Endometriosis is an extremely painful and underdiagnosed disease that affects one in every 10 people with a uterus. It occurs when the tissue that lines the uterus, known as the “endometrium,” grows on or around other abdominal organs. Due to chronic pain, the disease can significantly affect one’s quality of life and prevent them from fulfilling daily tasks. On average, it takes 10 years for those suffering from the disease to receive a complete diagnosis. This prolonged diagnosis process is due in part because endometriosis can be difficult to test for, but it is largely rooted in the fact that doctors and the medical field tend to not take female pain as seriously.

Joe Fassler, writing for The Atlantic, discusses the sexism that arises against those with female reproductive organs in emergency situations, especially when the pain is abdominal. Reports of pain are viewed as unreliable and exaggerated, to the point that it affects their treatment. “Nationwide, men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain,” writes Fassler. “Women wait an average of 65 minutes for the same thing.” His wife is erroneously diagnosed as kidney stones without a physical exam, given pain medication and put aside in the corner, despite the fact that she is physically writhing in agony. A few hours later, a different doctor realizes that she actually has a severely grown ovarian cyst, so large that it is weighing down her fallopian tube and twisting it. Only now, once she has proved that her pain is worthy, is her situation treated as an emergency.

The belittling of female abdominal pain is the most common reason doctors fail to diagnose endometriosis in patients. On Endometriosis UK, a website featuring true stories by people who have been diagnosed with endometriosis, nearly every account reports that their symptoms were not taken seriously. When they would discuss their pelvic pain, frequent nausea, and long and heavy menstrual cycles, doctors wrote the symptoms off as standard menstrual symptoms. Patients are told by doctors that their pain is “a normal part of being a woman,” forcing them to visit multiple doctors and medical centers and go through extreme measures before they can “prove” that their experience is abnormal and worthy of serious attention.

Before and after diagnosis, people with uteruses who experience these symptoms are typically recommended to start taking oral contraceptives. There is currently no cure for the disease, but the pill can help lessen the severity of symptoms in most cases. Yet, this prescription is not a viable option for everyone. Endometriosis and its pain can start from the very first period, which means that 11 and 12 year olds can benefit from the contraceptive pill. But because of the negative stigmas attached to birth control — like the association with casual sex — some doctors are reluctant to prescribe it to young patients in spite of enormous potential benefits. Or the young patient’s parents may not allow them to take it. Still thers deny oral contraceptives because of their religion or because of the side effects that can come along with it.

Those with endometriosis who do decide to take birth control pills may be left uninsured for it under the Trump Administration’s new rollback on birth control mandates. Even though oral contraceptives are one of the only ways for patients to keep this disease under control — and for some patients, are deemed medically necessary — patients could be left paying out of pocket if their employers decide not to include it in their coverage. Previously, the Affordable Care Act practically guaranteed that these people could get birth control, but now, some will be forced to fight the potentially debilitating effects of endometriosis without it.

The unequal treatment presented in medicine is not only sexist but also hazardous for those affected. It can lead to improper treatment and leave critical issues unattended. This will continue to occur until hospitals and medical schools make a commitment to ending pain biases among providers and the American government defends all available treatment options. Until these efforts are made, patients across the country will face the most dire form of oppression — debilitating, lifelong pain.