Medicosnext
Beyond Bad Periods, From misdiagnosis to awareness.
Ms. Ritika Dangol is a medical student at Universal College of Medical Sciences (UCMS). An avid learner, she is actively engaged in various research projects. A graduate of St. Xavier’s College, Jawalakhel, Miss Ritika aims to advocate for better understanding and care in women’s healthcare. Through articles like this one on endometriosis, she aims to shed light on overlooked conditions and empower women to seek proper care.
Endometriosis: The Silent Struggle
For millions of women worldwide, menstrual pain is dismissed as something “normal.” Yet for many, this pain signals a serious and often overlooked condition: endometriosis.
Despite affecting up to 10% of women of reproductive age, endometriosis remains underdiagnosed and misunderstood, leaving countless women to suffer in silence for years. From chronic fatigue and pelvic pain to infertility and mental health struggles, its impact extends far beyond monthly cycles — making awareness, early diagnosis, and proper caremore critical than ever.
On average, women wait 5 to 10 years to be diagnosed with endometriosis, as even severe period pain is often considered “normal.”
Why Is It Underdiagnosed?
Severe menstrual pain, heavy bleeding, and pelvic discomfort are frequently dismissed as “normal periods,” allowing endometriosis to hide in plain sight.
- Social stigma around menstruation prevents many women from seeking help.
- Even when they do, health professionals often underdiagnose due to limited awareness and diagnostic challenges.
- The gold standard for diagnosis is laparoscopy with histopathological confirmation. However, low-resource clinical settings make access difficult.
More Than Pelvic Pain
The effects of endometriosis reach far beyond the pelvis. Many women experience:
- Chronic fatigue
- Bowel and bladder issues
- Painful intercourse
- Infertility
These challenges often affect mental health, causing anxiety and depression, particularly as women struggling with chronic pain are frequently invalidated by society.
The economic impact is equally significant, with countless hours of productivity lost due to pain-related absences from school or work.
Globally and Locally
Although global awareness is growing, in countries like Nepal, endometriosis remains shrouded in silence.
- Endometriosis is often called “the missed disease” because of inconsistent diagnosis and treatment.
- Cultural taboos around menstruation make open discussion difficult, leading to delayed diagnosis and treatment.
- Unlike in developed nations where advocacy groups are active, women in resource-limited settings often suffer in isolation.
In Nepal, when girls complain of excruciating period pain, it is often disregarded as “normal.” According to gynecologists, patients who later turn out to have endometriosis frequently delay seeking treatment because their pain has been normalized.
Case Example:
An 18-year-old girl was diagnosed with endometriosis after years of unexplained pain. Each month, during her period, she could barely walk. Yet the advice she received was simply to “live with it,” as painful periods were considered normal.
For many, the condition is only discovered later in life when they face infertility — which affects 30–50% of women with endometriosis.
Management and Challenges
- First-line treatment: NSAIDs for pain relief and hormonal therapy.
- Severe cases: Laparoscopic excision is often performed, but recurrence is common.
- Barriers: Surgery costs and long-term medication make treatment difficult for low-income households.
The Global Scenario
Internationally, high-profile voices are bringing attention to this issue. For example, Halsey, an American singer and songwriter, was diagnosed with endometriosis after experiencing a miscarriage.
Her story highlights how easily women’s pain can be dismissed before a diagnosis is made. By sharing her struggles, she has emphasized the urgent need for awareness, early diagnosis, and proper medical care.
Her experience underscores the truth: endometriosis is not just a “bad period” — it is a serious health condition that can impact every aspect of a woman’s life.
Harmful Myths: Pregnancy as a “Cure”
A recent case in the UK involving a 17-year-old girl with endometriosis is deeply troubling. She was advised to “get pregnant” as a solution for her condition — despite there being no clinical evidence to support pregnancy as a long-term treatment. Shockingly, she is not alone.
In a survey of 1,073 women in the UK with endometriosis:
- 79% reported being told pregnancy was a solution.
Another case involved a 52-year-old woman who was advised the same. She had her first child at 24, only to find her symptoms worsened significantly afterward. By age 30, she underwent a hysterectomy, which finally ended her suffering.
The belief that pregnancy “cures” endometriosis reflects ignorance and poor medical knowledge. While pregnancy may temporarily suppress symptoms due to hormonal changes, it is neither a treatment nor a cure.
Such advice not only minimizes women’s suffering but also places an unfair emotional burden on those who are not ready, or may not want, to become mothers. This highlights the urgent need for evidence-based, patient-centered care.
Conclusion
Endometriosis is not a rare disorder. It is a common, life-altering condition that has been overlooked for far too long. Much of this suffering can be reduced through:
- Earlier recognition of symptoms
- Better education among healthcare professionals and the public
- Improved access to care
Girls and women must be encouraged to speak openly about their pain, rather than accept it as “just bad periods.” Breaking the silence is the first step toward gaining control over the problem.
Slowly but steadily, awareness of endometriosis is growing, and the condition is beginning to step out of the shadows.
