Eva and Jon are a young couple who have been living together for five years. They decide that their biological clock has rung and it is the perfect time to become parents, so they visit the gynecologist because Eva was taking contraceptives.
To her surprise, the gynaecologist diagnoses her with a cyst on her left ovary that must be removed as soon as possible. A month later, Eva wakes up in the hospital to hear her doctor tell her that the ovary “has been saved” and, in the confusion, she hears, “tomorrow you can go home”. However, three days later, Eva and Jon are still there. She wonders why so much silence, why so much pain, why so many painkillers and thinks she reads a shadow of bitterness in Jon's eyes.
Three days later, the gynaecologist came back with the discharge from hospital and explained the process again while Eva continued to ask herself “why?” until she reached a point of no return: “what you have is, in fact, a disease called endometriosis and, although it does not always happen, it has left you sterile. I am sorry, I am truly sorry.” Eva could not take her eyes off him “feel it? I could not understand it in any way.” Six months later and faced with Eva’s increasingly pressing pain, the couple broke up for good.
What is endometriosis?
Endometriosis is a condition in which the tissue that normally lines the inside of the uterus (the endometrium) grows outside of the uterus. Endometrial tissue implants in other areas of the pelvis, such as the ovaries, fallopian tubes, bowel, or bladder. With each menstrual cycle, this tissue also undergoes cyclical changes, which can lead to pain, inflammation, and the formation of adhesions.
Causes
- Retrograde menstruationThis is one of the most widely supported theories by experts. It is suggested that during menstruation, some of the menstrual tissue flows back through the fallopian tubes and implants in the pelvic cavity instead of being expelled from the body. Over time, these endometrial cells implanted outside the uterus can grow and develop lesions, leading to endometriosis.
- Theory of metaplasiaThis theory proposes that certain tissues in the pelvis, such as the peritoneum (the membrane that holds together the abdominal organs), can transform into endometrium-like cells in response to hormonal or inflammatory stimuli. These transformed cells can then grow and form endometriotic lesions.
- Lymphatic or blood disseminationAnother theory suggests that endometrial cells may spread through the lymphatic or blood system from the uterus to other areas of the pelvis, where they can implant and grow.
- Genetic and hormonal factors. Women with a family history of endometriosis have been found to be at increased risk of developing the disease. This suggests that there may be a genetic component to its development. In addition, hormones, especially estrogen, play an important role in the growth and removal of endometrial tissue. Therefore, disturbances in the hormonal balance contribute to the development of endometriosis.
Symptoms
- Chronic pelvic pain. Constant feeling of pain in the pelvic area that may worsen during menstruation.
- Pain during sexual intercourseKnown as dyspareunia, it can be caused by inflammation and adhesions in the pelvic organs.
- Heavy or irregular menstrual bleedingSome women with endometriosis may experience heavier periods or bleeding between cycles.
- Pain when urinating or defecating. Especially during menstruation, women with endometriosis may experience discomfort when urinating or have painful bowel movements due to the pressure exerted by the endometrial tissue on nearby organs.
- Fatigue and tirednessMany women with endometriosis experience constant fatigue due to chronic pain and inflammation.
- InfertilityEndometriosis can also affect fertility, as adhesions and inflammation can interfere with the normal process of conception.
Broken dolls. Coping with the diagnosis.
Infertility: Endometriosis can also affect fertility, as adhesions and inflammation can interfere with the normal process of conception.
It is essential to have the right support during this process. Here are some strategies to cope with an endometriosis diagnosis:
- Educate yourself about the diseaseObtaining reliable, evidence-based information about endometriosis can help you better understand the condition and the treatment options available.
- Seek emotional supportTalking to friends, family, or a therapist can provide a safe space to express emotions and receive emotional support during this time.
- Connect with support groupsThere are online communities and local support groups for women with endometriosis. Joining these groups can provide an opportunity to share experiences, advice and strategies for coping with the condition.
- Communicate with your partnerWhile receiving a diagnosis of endometriosis can affect both the woman and her partner, open and honest communication is essential to maintaining a strong and understanding relationship.
Impact on the couple
Endometriosis not only affects the woman diagnosed with it, but can also have a significant impact on her partner. Chronic pain and physical limitations of endometriosis may affect the couple's sex life, increasing frustration and anxiety.
It is crucial that partners support each other during this process. Some strategies to manage the impact of endometriosis on the relationship include:
- Encourage communication. Talking openly about concerns and feelings can help strengthen emotional connection and find solutions together.
- Educate yourself about endometriosis. Partners can learn about the disease to better understand the challenges a woman faces and provide support more effectively.
- Treatment accompaniment. Attending medical appointments and procedures can provide a greater sense of support and mutual understanding.
- Seek couples therapy. Couples therapy can be a valuable tool to address the difficulties that may arise due to endometriosis and strengthen the relationship.
Assuming and facing endometriosis together
Accepting and coming to terms with endometriosis as a couple is a process that can take time and patience. It is essential to remember that both parties have an important role to play in this journey of coping and supporting each other. Here are some guidelines for coming to terms with endometriosis together as a couple:
- Communication and empathy. It is essential to maintain open and empathetic communication. Both partners must feel comfortable expressing their emotions and needs. Listening without judging is key to strengthening the relationship.
- Joint research. Learning about endometriosis together can help couples understand the complexity of the disease and how it affects a woman’s daily life. This also facilitates the process of making informed decisions about treatment and symptom management.
- Support for self-care. A woman with endometriosis may require periods of rest and self-care to manage pain and fatigue. A partner can provide support by taking an active role in caregiving and offering help with daily tasks.
- Respect physical and emotional boundaries. It is important to recognize that endometriosis can affect a couple's physical and emotional intimacy. Respecting boundaries and finding other ways to maintain emotional connection is essential during this process.
- Couples therapy. Considering couples therapy can be highly enhanced to improve communication, understanding, and resilience in the relationship. A trained therapist can help address challenges and provide strategies to cope with endometriosis together.
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Deal with any diagnosis, such as endometriosis, with the help of a professional. Going to a specialized psychologist with your partner will help you to understand the situation and find the solutions, which there are, to be able to have a baby.
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Psychological effect of some medical messages on women
“You cause pain psychologically to get attention” This is one of the most repeated medical messages in women with endometriosis. This produces important physical and psychological consequences since the necessary tests are not carried out and the woman is left without the possibility of good treatment in the initial stages of the disease.
Furthermore, in this situation, the woman will come to doubt what she feels, her pain, herself, and will feel guilty for complaining and almost convince herself that she is “making it up.” However, it is very painful and confusing for a woman to go to a professional with acute and persistent physical pain – accompanied by other symptoms – and to be told, more or less, that she is “hysterical” or “a hypochondriac.” In her eagerness to get ahead – and self-convinced that, if a professional says it, why can’t it be true? – there are women with endometriosis who end up in the psychologist’s or psychiatrist’s office.
Having spent months feeling neglected, questioned, exhausted, it is very possible that they have developed a reactive disorder. But it is important to clarify that they should only go to the psychologist consultation to treat the disorders – which can affect various areas of your life – and which are a consequence of your main illness, a physical disease called endometriosis.
A significant percentage of women with endometriosis have fertility problems that will be solved – some – naturally, through IVF techniques, and for a group, it will not be possible to get pregnant. Therefore, when a woman wants to be a mother but knows that there is a physical possibility that she will not be able to be one, an emotional process begins with fears, sadness and hopes that are a challenge not only for the woman but also for the strength of the couple.
However, it must be remembered that many women find out the news without having a partner, which adds some difficulties. In this case, the patient is initially surprised and then goes through a mixture of anger, surprise again, frustration and a lot of sadness, with the desire to cry or profuse crying. It is at the stage when the woman asks herself: “Why does this have to happen to me?” A question that has no other answer than: there are no coincidences, there are causalities, everything happens for a reason…
However, it is not enough to calm the jealousy towards acquaintances, towards relatives who are mothers and the pain of seeing the children…