The Uterus: A Relationship Explored
The function of the uterus.
From a medial gynaecological perspective the uterus functions as a vessel that sole purpose is designed to carry a pregnancy to full term. The uterus sits in the centre of the pelvis behind and above the bladder. The opening being at the top of the cervix.
When viewed in a medical drawing, the uterus always reminded of one those drinking can bags cowboys always had in the Westerns. They’d drink from it when parched with thirst in the middle of the Rockies under the flaming midday sun. The bulbous oval shaped seemed to be familiar, even as a young girl watching Westerns with my Dad.
The average uterus is around 7cm by 5cm x in size. And, the average woman loses around 6 teaspoons of menstrual blood during a period. Generally ranging between 3 – 5 days long.
Yes, that’s average. But for a woman with endometriosis – the average female experience is no longer fitting.
Taking a punt on the average woman with endometriosis. That average woman: bleeds profusely, is besieged by pain, sickness, diarrhoea, skin tenderness and profound exhaustion, to name a few basic symptoms.
Until I was 23 my periods were normal. In fact, they would come and go in a flash of 4 days, be steady in flow, light on day 1 and heavier on day 2 or 3. By day 4 or 5 they’d become lighter and scant, disappearing to nothing but muddy marks. I had no clots, occasional stomach ache and could wear tampons with ease. By the time I was 24 everything about my periods had changed.
I remember the first time endometriosis made an appearance in my life.
I’d been at a friend’s flat. He’d cooked me dinner and we chatted late into the night. Being the gentleman he was, and my journey home being too long and late from his south London to my north London; he took the sofa, offered me his bed for a good night’s rest.
I awoke the next morning to a strange feeling of dampness and my lower stomach heavy and aching. I felt profoundly exhausted in a way that was unusual. When I threw the duvet back, to my utter horror the bedsheets were soaked in blood. Blood had circled around my hips radiated out and down my legs. I pulled off the sheet, wrapped it around me only to realise it had soaked through to the mattress beneath.
I felt the urge to pee. When I sat down on the loo – clots just fell away from me. I’d never known so much blood in a menstrual cycle, and my period wasn’t even due. I sat with a bloodied mess of sheet and attempted to clean myself up. It took me an hour to tell my friend I’d ruined his bed linen and mattress.
From that moment on, my periods became debilitating. They were heavy, full of clots and dark, dark red. Over the space of a few months my periods took over my life becoming extremely painful with no discernible cycle.
Bleeding and pain became my life. There wasn’t anything else. I had to adapt.
So began the strange relationship with my uterus and vagina.
You have a gynaecological condition: a new frame of reference.
When you have a gynaecological condition, you become very aware of your own gynaecology. The cycle of ovulation and menstruation become a constant countdown to the inevitable pain and then the countdown away from it.
The constant flow of menses requiring constant changing of pads meant my hands were always dealing with my girl’s bits. It something I grew tired of but couldn’t avoid. With gynea conditions you are constantly dealing with your vagina. Unwittingly, your relationship with your vagina, cervix, ovaries, sacrum, belly – changes.
You develop a relationship with the female in a way other women don’t have to. Simply because they do not have endometriosis. Women without endo don’t have to think about their own gynaecology, the function of it nor why it is so dysfunctional.
My uterus became something that was examined by Doctors. Although my gynaecologists were all very much hands off. My uterus became a part of medicine, enlarged with gas for laparoscopy, the uterine cavity examined, my ovaries observed for their polycystic nature. My gynaecology reports stated terms I had not bothered with before: uterus, pouch of douglas, ovaries, fallopian tubes, cervical canal.
I became the young woman of 24 watching and listening as my gynaecologist drew pictures, showed me scans, wrote detailed reports.
I read lines that said…
The uterus is obliterated by scar tissue and adhesions
A submucosal fibroid is in the anterior wall of the uterus
A mass is observed in the pouch of the Douglas.
A mass is observed between the uterus and bladder.
A protrusion was found in the bladder
In medical terms, this translated to: from the perforation of the uterus that occurred during my termination of pregnancy, a thick adhesion had formed between the uterus and bladder. This scar tissue had entered my bladder. Endometrioma were seen on the anterior and exterior wall of the uterus.
More simply, my uterus and bladder had become stuck together due to the perforation. The endometriosis scattered throughout the uterus and beyond was caused by the perforation. I had surgical endometriosis.
My life had a new dimension – a uterus with a ‘life’ of its own. Like another entity. It was problematic, dysfunctional, lumpy, scarred and the cause of endless unendurable pain that I didn’t understand.
My life became an ever increasing medical file. Tomb like , I watched it carried by medical students into the office of my gynaecologist. Who, after reading it, declared softly and directly you need to get better.
The Search for Understanding
The only thing I could find that remotely resembled my ‘experience’ and medical condition was women in Africa who had developed medical fissures caused through inadequate access to maternity services and delivery of their babies. Carrying them caused fissures which gladly, but sadly to my inadequate self, could be remedied through surgery.
It seems the uterus can withstand almost anything in stretched pregnancy state but not so in its non- pregnant state. My gynaecologist told me, due to the perforation: you will not be able to carry a baby full term, the first three months would be crucial and that the perforation had compromised the integrity of the uterus.
It was not the news I was hoping for or expecting in my twenties. Nothing in life had prepared me for the life I was about to live.
The onset of my surgical endometriosis coincided directly with me uncovering child sexual abuse in my birth family. In fact, you could trace the trajectory from my initial tentative steps into therapy aged 20, where I picked through the baggage left by my psychiatrically ill, hideously violent father and absent mother. To the three years later and the onset of painful endometriosis. All converged with the admittance, grappling and understanding of my father’s sexual abuse.
There was much I had to heal – mind, body, spirit, soul and self.
To my mind, it seemed inescapable that the sexual trauma of my life was represented in my body. It was the position I took to healing. And, it was both freeing and burdensome.
I hope my wisdom, brought about through withdrawal from society to heal things no one understood aids you to bring a better understanding of sexual abuse, trauma and gynaecology.
The truth is – without endometriosis, I would never have healed my child sexual abuse. There is not a bone in my body that does not wish it was not the case but quite simply: it be true.
Endo was my doorway to healing.