Photo by Adriana Parente.

A woman’s world is filled with different areas of shame, one being associated with periods and vaginal health. Yes, I said period and vaginal health in one sentence; I think we can handle it. If not, it might be because you are a boy and were excused from health class when the teacher turned to the page about periods. Or you watch too many tampon commercials of women swimming and playing tennis with a smile on her face and no sign of pain.

Nicole Tinker was in Grade 8, around the age of 13, when she first got her period. Or at least, that is when she says she thinks she got it.

“I can’t pinpoint exactly when it was because I had irregular periods,” she says. “It wasn’t until I started birth control in high school where I started getting more regular periods.”

The fourth-year fashion communications student says her period holds many memories of severe pain and a heavy flow. “In school, they don’t teach you about what periods should look and feel like, so I assumed it was normal,” says Tinker.

A normal menstrual cycle occurs every 21 to 25 days and can last up to one week. Some women experience a light or heavy flow and have a painful or pain-free experience. It is common to have cramps, but some women get them worse than others.

Dr. Yoav Brill, an obstetrician and gynecologist in Toronto, says that if a woman is experiencing discomfort in any way, it is important to be evaluated by a doctor. That is what Tinker did for seven years.

When Tinker realized that her monthly ritual of being crunched over to relieve period pain in her soaked overnight pads during the day was not normal, she did what any millennial would do: a Google search to learn what exactly could be wrong with her body.

She says she saw something about endometriosis and got her family doctor to refer her to a young women’s gynecologist.

Endometriosis is the growth of tissue; similar to the kind that lines a woman’s uterus, but elsewhere in the body. It grows commonly in the woman’s abdominal area; however, it can also reach to the lungs, bowels and brain.

Once a month, menstrual blood from the uterus flows out of the body through the vagina; however, the blood and tissue from endometriosis has no way of leaving the body. Brill says five to 10 per cent of the general female population has endometriosis.

After consuming over six brands of birth control to regulate her period and relieve her pain — none that worked — visiting three family doctors and one specialist who had a six-month waitlist, Tinker says she was finally being heard and her health was being dealt with.

“My old family doctor would just brush off my pain and tell me that it’s normal and to try a different pill.”

Birth control is essentially a mini pill bursting estrogen into the body, and Brill says it could make endometriosis progress and develop more growth tissue in the woman’s body.

Tinker was unofficially diagnosed in January 2017, but endometriosis doesn’t show up on ultrasounds. The only way to be sure is to have a laparoscopy and have the surgeon biopsy the tissue. She had her surgery on July 1, meaning she was then officially diagnosed.

“It’s crazy to think that I was actually pretty young to be diagnosed,” says Tinker. “Most women don’t get diagnosed until they are in their thirties or older.”

Photo by Adriana Parente. Illustration by Augustine Ng.

Brill says that most women won’t even know they suffer with endometriosis, or find out when they are much older and infertile, because they think the pain they are experiencing is normal.

“Around the time I was unofficially diagnosed, I was also diagnosed with depression,” says Tinker. “My doctor wasn’t even surprised because you can only imagine how your mental health would be affected if you can’t walk for more than 15 minutes without having a flare up.”

Although she says she had supportive family and friends, she couldn’t help but feel alone.

“It got to the point where I was missing almost every social event I was invited to because I was curled up in bed with a heating pad.”

Tinker isn’t the only one who feels the pain from endometriosis. Ryerson graduate Madison Good says she has had issues with her period and vaginal health since 2010.

“It absolutely frustrates me that because my problem isn’t life-threatening, they (doctors) take forever to talk to me,” says Good. “I’m frustrated that when my period is too painful I have to tell my work I have a stomach bug because they wouldn’t believe me when I say I have period pain.”

In December 2015, she says her period changed drastically to an extremely heavy flow for two days with severe pain. Not like normal period pain, but she says this pain was in her whole abdominal area and bowels.

“I went to the Ryerson doctor and she said that it sounded like endometriosis and referred me to a gynecologist and a hormone specialist,” says Good. Her referral appointment didn’t happen until May 2016, but the actual appointment was in September that year.

She says she did multiple ultrasounds only to find nothing, and again, the doctors suggested to put her back on birth control.

Brill says it is a lifelong battle for those who have to deal with endometriosis, and it is not a gynaecology issue, but a chronic pelvic disorder.

“There is no way to get rid of endometriosis,” says Brill, adding that treating endometriosis is a combination of medicine and surgery.

“I was put on Visanne, a progestin medication for endometriosis, as well as had a hormonal IUD (intrauterine device) put in. Being put on two hormonal medications at the same time messed with my body and I had my IUD removed, although my doctor protested taking it out,” Tinker says. “I’ve also been going to pelvic physiotherapy every week for the last five months and an osteopath monthly.”

Although she is getting a hold on her health, it is difficult to go to all the required appointments because they are with separate specialists in different locations.

Brill says that there is a need for a centre dedicated to women with endometriosis so that they have all the resources they need in one place. This means space that includes a team of doctors, surgeons, nurses, physiotherapists and more.

He says Ontario does not offer an excellence centre for women; however, B.C. Women’s Hospital & Health Centre does.

As of now, Tinker no longer has a period. She says it stopped in February of last year, something many women express jealousy about.

“I would gladly have a period every month if it meant I didn’t have to go through years of pain,” says Tinker. “It doesn’t bother me that I no longer have a period, it bothers me more that I had to artificially stop my period using hormones and medication because my body wasn’t having it. It’s crazy how your body can react negatively to something that is natural.”

After a long year of pain and appointments, Tinker says she finally got to the point where her endometriosis doesn’t bother her as much.

“There is no cure. Every so often, it hits me that I’ll have this chronic pain for the rest of my life. But now I’ve figured out how to deal with it, so I can put it in the back of my mind,” says Tinker. “I’m scared about the future…but I’ve learned not to dwell on things that haven’t happened yet.”

Infographic by Adriana Parente.

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