*This article uses gendered terminology to refer to those with endometriosis. We acknowledge that not all people living with endometriosis identify as female
In recent years, many women have come forward to speak about their struggles of living with endometriosis. It is a condition that does not discriminate, affecting women in positions of power, in the world of fame, sports and more.
Endometriosis is both a progressive and chronic condition. It is when endometrial like tissue is found OUTSIDE the uterus. This tissue can be found on the ovaries, fallopian tubes, bowel, around the uterus and abdominal wall.
The most common symptoms of endometriosis are
- Pain, either during menstruation or/and throughout the cycle
- Pain with sexual intercourse, either upon entry and/or deep penetrating pain
- Heavy menstrual bleeding, either regular or irregular
- Bladder and bowel issues
Treatment of Endometriosis
Unfortunately there is no known cause or cure for endometriosis. Many treatments aim to treat the symptoms rather than treating the condition itself. The gold-standard of treatment is through laparoscopy and excision surgery. During a laparoscopy, a very thin tube is inserted via small cuts on the abdomen to access the abdominal space. During this time, a gynaecologist can diagnose endometriosis and perform excision surgery if needed. Another common management strategy is the use of hormonal treatments. These include the combined oral contraceptive pill, or IUD (intrauterine device), such as the Mirena. This might be useful for some to reduce the pain and severity of endometriosis by slowing growth of endometrial like cells. It can also stop menstrual bleeding, which reduces pain and heavy bleeding. Diagnosis of endometriosis takes an average of 7 – 10 years from the onset of symptoms.
One of the main impacts of endometriosis is a decreased quality of life, and ability to participate in work, social events and relationships. The impact that endometriosis on quality of life and mental health can be severely under estimated. When each activity in your daily life is interrupted by endometriosis-associated symptoms, it can be very isolating.
Athletes with Endometriosis
Some women who have spoken out about their endometriosis diagnosis in the sports world are Emily Seebohm (Australian Olympic Swimmer and gold medallist), Monique Murphy (Australian Paralympic Swimmer and silver medallist) and England women’s soccer national team captain, and Arsenal defender, Leah Williamson.
Leah opened up about her endometriosis struggles in December 2022. She noted that she “feared missing games during the Euro’s due to her condition”. This opened up a conversation around how deeply women are impacted by menstrual cycles in sports. An issue that would not affect their male colleagues. The increased level of tolerance around periods, and to “get on with it” as mentioned by Leah, is not something an athlete should have to manage.
It poses the question, are women simply never able to achieve the same levels of physicality and success as their male counterparts due to their gender?
It is evident that the pain and heavy bleeding experienced by athletes with endometriosis, severely impacts their ability to train, compete and perform at their peak. As already mentioned, the most common management option is surgery. This requires an increased amount of time of recovery, and missed competitions. As Emily Seebohm once said “you’ve still got to go out there and put on a brave face and pretend like everything’s fine when most of the time I feel like I’m dying on the inside”. Just having endometriosis could impact a person’s career, notably in sports. It could mean that these individuals are not chosen to be on a team, seen as unreliable, and unable to manage the demands of being a professional athlete. When this is paired with endometriosis-associated pain, it can have a major impact on mental health.
The issue with endometriosis is that although conversations are happening, there is still quite a delay in this being translated into everyday practice. The medical profession is still dismissive of women’s health issues. People are still subjected to medical trauma, medical gaslighting and disillusionment with the medical profession.
Women like Leah Williamson, Emily Seebohm, Monique Murphy and more, delay their surgeries, or treatments in fear that it will impact their future. They also continue to train, and fight hard to reach their dreams, as many other people do. We need better education for those involved in female sports teams. These athletes should be able to take control of their chronic health conditions, and manage chronic pain and/or chronic pelvic pain. Women should feel empowered, in control of their lives, and their health.
What research has been done in this area?
Despite the rise of females in sports, there are no published studies on the impact of endometriosis on athletes. A thesis by Kirstie Klingenberg, of Massey University New Zealand is the only one which has explored the impact of endometriosis on athletes. She found that pain minimisation and normalisation was common in athletic populations, and so was less likely to be acknowledged, and their burden of illness was also minimised.
In the population interviewed, experiences of pain and inability to participate were under-mined by coaches, health professionals and external support systems. These women were also more likely to have a delay in diagnosis due to fear of missing out on training and further opportunities. This highlights the need for coaches who work in female populations, to be aware of the issues that face female athletes compared with male counterparts. Those in the population interviewed also noted feelings of weakness and emotion as being negatively associated with females. This attributing this to delayed diagnosis and conversation around endometriosis. The impacts felt by this population were deep, in affecting mental and physical health.
Whilst there is some research around the impact of exercise, and regular exercise on endometriosis severity and development, a lot of the research is inconclusive. This research also looked at athletes experience of endometriosis and pain perception, and if exercise impacted this.
Some of the less invasive management strategies for endometriosis is nutrition and pelvic floor physiotherapy. These can be used alongside medical intervention to optimise quality and enjoyment of life.
Read more here about nutrition for endometriosis and adenomyosis.
If you would like some assistance with managing your endometriosis through nutrition click here to book in for a Discover Package.
