It's all in your head, You're being over dramatic.

That's just a normal period.

Yeah, periods can hurt cramping and bloating and back pain are kind of to be expected when your body is literally expelling the inside of one of its organs.

But at what point is a certain level of pain, not norm.

The whole idea that periods are supposed to hurt often means that folks may not get the help.

They need to manage certain conditions, conditions like endometriosis.

What endometriosis is is when you have cells that are similar to the lining of the uterus.

But those similar cells are found external or outside of the uterus.

Let's put that in the context of a period.

So each cycle, endometrial cells inside the uterus are reacting to changing hormone levels by breaking down and then being released through the vagina as a period.

But with endometriosis, the endometrial like tissue growing outside of the uterus is doing the same thing.

Except these cells have no way to get out of the body, symptoms of endo will vary, especially based on where the endometrial like tissue is growing in the body.

And often these symptoms aren't taken that seriously.

They're brushed off as just a bad period.

But for Jenna.

Her endo was found on her diaphragm, I was having nausea.

I was starting to have difficulty with running.

I was having crazy constipation bloating pain with sex and this gynecologist asked me if I had ever heard of endometriosis and I told her no, I'd never heard of it before.

Endometriosis.

Is this invisible disease and the way that so many patients describe the diseases like barbed wire being wrapped around their admin and those found anywhere in their body.

So the patient looks okay, they look healthy but they feel miserable.

The clumps of tissue that grow outside the uterus are called implants and they can literally pull on and distort internal organs and muscles.

Those degrading cells can also cause inflammation that spreads to surrounding areas and in severe cases, implants may eventually scar and basically act like glue, causing organs to stick together and they shouldn't.

All of this contributes to the increased risk that we see of issues like ectopic pregnancy and infertility in those with endometriosis because when it's found around the reproductive organs, rogue and demetrius like tissue can wreak havoc and prevent normal ovulation.

But the lack of awareness around this disease means that many who struggle with it may not get diagnosed for a long time.

On average.

It takes about 7 to 10 years.

You can't imagine what it's like in the office to see patient after patient tell their journey and tell their story This debilitating awful pain.

They're just not living their lives to the fullest.

So we just really need to do a better job at making sure that that doesn't continue and the weight to get diagnosed can seriously impact someone's life.

In the meantime, like Jenna whose diagnosis took four years, I lost my career.

I'm still not back in grad school, I have friends that I've lost, I thankfully have a really supportive family, but I know that it can fracture family relationships and marriages.

So why does it take so long to get a diagnosis and to get treatment?

And no, wasn't even discovered until the 1920s and it took decades for the condition to be regularly included in medical training in France.

For example, endometriosis was just added to the medical training curriculum and in many countries, education on effective treatment options is still not regularly included in training even for gynecologists and as if to add insult to injury, there's only one way to definitively diagnose endo and it's surgery, a doctor will go in through a tiny incision and take a biopsy to make sure that there really is un demetrius like tissue growing outside the uterus.

If we, as gynecologists were simply armed with the knowledge that the symptoms of endometriosis can cross all organ systems with the symptoms that I had mentioned before, we would be picking up so many more patients and we'd be really shortening the suffering and stopping that 10 year diagnostic delay.

But other factors play a role too.

A recent study found that black and hispanic women are typically diagnosed with endo at later ages than their white counterparts and this reflects the larger societal biases and inequalities related to race and ethnicity, I think that if I want a nurse and specifically a nurse at the hospital that I was working at.

I think that my experience would have been a lot different.

And that's not saying much because it still took me going from doctor to doctor to doctor, feeling like no one was listening to me.

So I can't even imagine how much more for someone who was not me.

So what's the good news?

There are ways to manage this condition.

Hormonal medications like the birth control pill can often ease symptoms.

Pain medication can also help, but it just masks the pain.

And it's really important to remember that none of these options actually make the endometrial like tissue go away.

Now, surgery is another treatment for endo.

There are two kinds of surgery.

Ablation and excision ablation is where the tissue is basically burned away and excision is where the implants are cut out.

Excision is the preferred treatment for most cases of endo, especially where that endometriosis has deeply infiltrated other areas of the body.

More research could help us better understand which treatments work best for different stages, locations and types of endometriosis.

And surgery isn't a perfect cure either.

Because while that endometrial like tissue won't grow back in an area where it's been cut out.

The tissue could develop in new areas of the body and pain can persist after treatment.

So, with all this going on, you can see why it's so important to speak with a specialist and make sure that your care plan for endometriosis makes sense for your specific situation.

Now, a glimmer of hope here in the last few years, more and more of the underlying cellular mechanisms have been explored for why this tissue is growing, where it's not supposed to.

But this research has yet to be translated into better treatment options.

And this comes down to what we talked about in our very first episode of this series.

Issues like Endo have only been acknowledged and thoroughly investigated by the medical community relatively recently.

So the more we talk about it, the more we advocate for more research and better solutions.

Hopefully, the faster we're going to get better outcomes for real everyday people, I know that the symptoms that come with endometriosis can kind of be a constellation and all over the place and you're seeing all these different specialists and no one's putting the pieces together.

Ultimately, though it's not in your head, your pain is real.

Your symptoms are real.

And to keep fighting until you find someone who believes that if you or someone you know, is struggling with pain or getting a diagnosis, we've left some resources for you in the description.

Thank you all so much for watching seekers.

Body language and we hope you learned something new in this episode.