For years medical professionals have neglected women, when it comes to their health and receiving the proper care they need. This harsh reality especially impacts Black women as they are part of the underrepresented population that deals with endometriosis.
Underserved populations deserve advocacy organizations working on their behalf. They also need medical professionals to collaborate on the research that impacts their communities. 21Ninety spoke with gynecologist Kerry-Anne Perkins to get a better understanding of the impacts of endometriosis in Black women.
Understanding Endometriosis
Perkins defined endometriosis as “a chronic reproductive condition where tissue similar to the lining inside the uterus, the endometrium, grows outside the uterus.”
This tissue can attach itself to various organs, such as the ovaries, fallopian tubes and the outer surface of the uterus. It can even attach itself to areas like the diaphragm, liver and pancreas. Despite being located outside the uterus, this tissue continues to act as it normally would during a menstrual cycle, bleeding and breaking down. However, unlike the normal menstrual flow, this blood has no way to exit the body, leading to severe inflammation, scar tissue formation and significant pain.
Recognizing the Symptoms
Perkins highlights that the symptoms of endometriosis are varied and often severe. One of the most common and distressing symptoms is pain during menstrual cycles. Unlike typical menstrual cramps, endometriosis-related pain can occur anywhere in the abdomen or other parts of the body.
“Endometriosis related pain may be anywhere in the abdomen or even elsewhere in the body,” Perkins said. “If someone has endometrial implants in their upper left abdomen, they may have pain in that area while menstruating.”
Another symptom is heavy menstrual bleeding, which is often more intense for those with endometriosis, due to the increased amount of endometrial tissue.
“People with endometriosis may have heavier menstrual bleeding as they often have more endometrial tissue, leading to heavier bleeding,” Perkins said.
Research also indicates that some individuals with endometriosis may have underlying bleeding disorders, exacerbating their heavy periods.
The Nature of Endometriosis Pain
Painful periods are another hallmark of endometriosis. This pain stems from several factors. These factors include the uterus contracting to shed its lining, random spasms of the uterus and heightened sensitivity of nerve fibers in the pelvis, due to inflammation.
“In endometriosis, the perception of pain is linked with the responses of our nerve fibers,” Perkins told 21Ninety. “Inflammation affects nerve fibers in the uterus and pelvis, making them more likely to fire pain signals.”
Pain during intercourse is another significant issue, often linked to inflammation and the presence of endometrial implants in the pelvis. This can make sexual activity a painful experience, further affecting the quality of life and intimate relationships.
“The inflammation caused by endometriosis can cause pain in the pelvis, especially with the direct pressures and movement of sexual activity,” Perkins shared.
Infertility is also a major concern. Endometriosis can cause infertility in at least 20 percent of those who struggle to conceive.
“Endometriosis can physically cause blockages of the fallopian tubes, cause inflammation of the pelvic organs, and affect their function including ovulation,” Perkins said.
Perkins emphasizes that the pain associated with endometriosis is not merely a discomfort but a severe, often debilitating experience.
“The pain is not a simple discomfort,” she said. “It is identified as severe and causes people to seek pain relief in many ways.”
This pain can vary greatly from person to person. However, periods should not be debilitating, sexual activity should not be painful and severe pelvic pain should not be dismissed.
Diagnosis and Testing
Diagnosing endometriosis can be challenging. The standard for diagnosis is laparoscopic surgery. This allows doctors to visually confirm the presence of endometrial tissue outside the uterus. A pelvic ultrasound may reveal an endometrioma, an ovarian cyst filled with old blood, which can indicate endometriosis. However, a definitive diagnosis often requires surgery.
Perkins’s insights shed light on a condition that many Black women undergo. It is often overlooked and misdiagnosed. Raising awareness and improving education about endometriosis is crucial. It ensures that all women, especially those in underrepresented communities, receive the care and attention they deserve.