“Women complain about their period pain and the health workers ignore it”

“Women complain about their period pain and the health workers ignore it”

Psychology

We spoke with Dr. Francisco Carmona, a reference in the diagnosis and treatment of endometriosis and other benign gynecological pathologies, about the symptoms of this disease and how to acquire an adequate lifestyle

“Women complain about their period pain and the health workers ignore it”

Endometriosis is a chronic gynecological disease that affects one in ten Spanish women of reproductive age and affects their lives. Dr. Francisco Carmona, a reference in the diagnosis and treatment of endometriosis and other benign gynecological pathologies, has just published ‘Endometriosis’, a book that delves into this disease and tells how even today it is still a great unknown to society and often forgotten by doctors themselves.

In his book he also explains in a clear and rigorous way what endometriosis is, why it occurs, what risk factors it has, what the symptoms are, how the diagnosis is made, what treatments currently exist, as well

 such as the emotional impact it can have on women and how it affects social relationships, the couple and the work environment.

How would you define endometriosis for those who are unfamiliar with it?

The endometrium is the tissue that lines the internal cavity of the uterus that each month, due to the effect of the hormones secreted by the ovary, prepares for the implantation of the embryo and that, if this does not happen, is detached in the form of a ruler to become a prepare in the next ovarian cycle. In endometriosis the endometrium appears outside its physiological place. It can appear anywhere in the body, but mostly it occurs in the pelvis: ovaries, tubes, intestine, bladder … In these abnormal places, the endometrium, following its nature, prepares for a possible pregnancy and, if this does not occur, it also comes off in the form of a “rule.” The problem is that this “rule” is actually internal bleeding within the tissues where the endometrium is abnormally implanted (what we call “foci of endometriosis”). This menstruation is the cause of the symptoms of the patients such as pain, infertility or alterations in the function of the affected organs …

Would you say that society knows little about this disease?

I think so. There is more and more talk, but when you diagnose it they don’t know what it is. They tell you: “endome … what?” The problem is that society continues to have many topics related to women as taboo, not only with endometriosis or menstruation.

In this case, what symptoms should one know to differentiate from the rule?

Your period shouldn’t be painful. We have assumed that the rule hurts and is a lie. Women complain about the great period pain they suffer and society and health workers ignore it. We think that this woman is a little lazy … when in fact we could be talking about her suffering from endometriosis or another related disease. Endometriosis not only causes pain, there are also symptoms in the genital, sexual sphere …

More than the pain, many times the biggest problem is the psychological one, right?

I would say that the psychological problem is secondary. Everyone says that it is normal to have pain during menstruation, but it is not. If you do not go to school or work because of the rule, even the doctors who treat certain women tell them that they are lazy, that it is not so bad and that it is more of a psychological problem than anything else, when it is not. They are not well treated by society because they are misunderstood, so it is very common that they end up suffering from anxiety or depression. Moreover, these women, when appropriate, lose friends, jobs and even their partners because it is difficult for them to have sex.

“Women with endometriosis are not treated well by society because they are misunderstood.”
Dr. Francisco Carmona

What lifestyle can these people lead?

As we do not know the etiology of the disease, we only have symptomatic and non-curative treatments. Therefore, the disease has a chronic course until, in menopause, after the end of ovarian function and hormonal secretion, most women experience the progressive disappearance of symptoms.

The ideal is to do an adequate treatment because there are effective treatments capable of alleviating the symptoms. We also know that there are complementary measures such as eating a diet rich in fresh fruits and vegetables, gluten-free cereals, legumes and nuts, as well as nutritional supplements. Exercising and meditation are essential, but the first thing is to know the diagnosis, consult an expert who will accompany you during the fertile stage, understand the disease and know that there is a remedy.

What is the main advice you would give to women who suspect they may have this disease?

A woman who experiences the typical symptoms of this disease such as period pain, pain during sexual intercourse (especially when penetration is deep), abnormal bleeding, difficulty in getting pregnant or other catamenial-like symptoms (that is, they appear with the rule) should consult your gynecologist. This should make the diagnosis of what is happening and establish the best treatment for each case or refer her to another specialist if he is not trained to carry out a good control.

What can we do as a society to help make this unknown disease visible?

Give a voice to all the sick, listen to them, understand that period pain is not normal. If a woman complains every month that she has crippling pain, she is not doing it to attract attention, but because she probably has a disease. If you have pain that prevents you from having satisfactory sex, it is not because you do not like sex, but because you probably have a disease.

About the Author

Dr. Francisco Carmona (Jaén, 1959) is the national benchmark in the diagnosis and treatment of endometriosis and other benign gynecological pathologies, including fibroids and ovarian diseases. He is a tenured professor at the University of Barcelona and head of the Gynecology Service at the Hospital Clínic de Barcelona. He has recently carried out the first successful uterus transplant in Spain.

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