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The etiquette of endometriosis: Stigmatisation, menstrual concealment and the diagnostic delay

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  • Seear, Kate

Abstract

Endometriosis is a chronic gynaecological condition of uncertain aetiology characterised by menstrual irregularities. Several studies have previously identified a lengthy delay experienced by patients between the first onset of symptoms and eventual diagnosis. Various explanations have been advanced for the diagnostic delay, with both doctors and women being implicated. Such explanations include that doctors normalise women's menstrual pain and that women might delay in seeking medical advice because they have difficulty distinguishing between 'normal' and 'abnormal' menstruation. It has been suggested that the diagnostic delay could be reduced if women were trained in how to distinguish between 'normal' and 'abnormal' menstrual cycles. In this paper I argue that whilst these may be factors in the diagnostic delay, women's reluctance to disclose problems associated with their menstrual cycle may be a more significant and hitherto neglected factor. I argue women are reluctant to disclose menstrual irregularities because menstruation is a 'discrediting attribute' (Goffman, 1963) and disclosure renders women vulnerable to stigmatisation. Women actively conceal their menstrual irregularities through practices of the 'menstrual etiquette' (Laws, 1990) which involves the strategic concealment of menstrual problems. This argument is supported through an analysis of the experiences of 20 Australian women diagnosed with endometriosis. The ramifications of this analysis for chronic pain conditions more generally and for practical strategies designed to address the endometriosis diagnostic delay are considered.

Suggested Citation

  • Seear, Kate, 2009. "The etiquette of endometriosis: Stigmatisation, menstrual concealment and the diagnostic delay," Social Science & Medicine, Elsevier, vol. 69(8), pages 1220-1227, October.
  • Handle: RePEc:eee:socmed:v:69:y:2009:i:8:p:1220-1227
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    Cited by:

    1. Berndt, Virginia Kuulei & Bell, Ann V., 2024. "Beyond knowledge: Introducing embodied aversion through the case of contraception," Social Science & Medicine, Elsevier, vol. 341(C).
    2. Supriya Garikipati & Penelope A. Phillips-Howard, 2022. "Information, Choice and Menstrual Outcomes: Evidence from a CommunityBased Intervention in Indi," Working Papers 202211, University of Liverpool, Department of Economics.
    3. Elia Fernández-Martínez & Ana Abreu-Sánchez & Juan Francisco Velarde-García & María Teresa Iglesias-López & Jorge Pérez-Corrales & Domingo Palacios-Ceña, 2020. "Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    4. Juan Diego Ramos-Pichardo & Ángela María Ortega-Galán & María Teresa Iglesias-López & Ana Abreu-Sánchez & Elia Fernández-Martínez, 2020. "Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals?," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
    5. Ana Abreu-Sánchez & María Laura Parra-Fernández & María Dolores Onieva-Zafra & Elia Fernández-Martínez, 2020. "Perception of Menstrual Normality and Abnormality in Spanish Female Nursing Students," IJERPH, MDPI, vol. 17(17), pages 1-12, September.
    6. Supriya Garikipati & Penelope A. Phillips-Howard, 2021. "What’s the Bleeding Problem? Period Poverty, Information Failure and Consumer Preferences in the Global South," Working Papers 202107, University of Liverpool, Department of Economics.
    7. Luigi Della Corte & Claudia Di Filippo & Olimpia Gabrielli & Sabrina Reppuccia & Valentina Lucia La Rosa & Rosalia Ragusa & Michele Fichera & Elena Commodari & Giuseppe Bifulco & Pierluigi Giampaolino, 2020. "The Burden of Endometriosis on Women’s Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing," IJERPH, MDPI, vol. 17(13), pages 1-17, June.
    8. Elia Fernández-Martínez & Ana Abreu-Sánchez & Jorge Pérez-Corrales & Javier Ruiz-Castillo & Juan Francisco Velarde-García & Domingo Palacios-Ceña, 2020. "Living with Pain and Looking for a Safe Environment: A Qualitative Study among Nursing Students with Dysmenorrhea," IJERPH, MDPI, vol. 17(18), pages 1-15, September.
    9. Punita Bhatt & Supriya Garikipati, 2021. "Culture, Collectivism and Empowerment: The Role of Feminist Ideologies in Women’s Work and Organization," Working Papers 202108, University of Liverpool, Department of Economics.
    10. Federica Facchin & Laura Buggio & Dhouha Dridi & Giussy Barbara & Paolo Vercellini, 2021. "The Subjective Experience of Dyspareunia in Women with Endometriosis: A Systematic Review with Narrative Synthesis of Qualitative Research," IJERPH, MDPI, vol. 18(22), pages 1-14, November.
    11. Hanna Grundström & Siw Alehagen & Preben Kjølhede & Carina Berterö, 2018. "The double‐edged experience of healthcare encounters among women with endometriosis: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 205-211, January.

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