Without Sally Rooney’s hyper-specific narration to fill the silences in Conversations with Friends, the TV adaptation of her book of the same name, the affair between Frances (Alison Oliver), a college student and aspiring writer, and Nick (Joe Alwyn), a married actor, feels predictable and disappointingly dull. But in the background of the series is actually something quite revolutionary for television—Frances’ struggle with endometriosis.
Endometriosis occasionally pops up on medical shows through case-of-the-week storylines, but having a main character endure the pain and confusion that comes with the disease? Basically unheard of, and incredibly important. Frances’s experience isn’t universal, but the series captures the emotional and physical agony of endometriosis. Highlighting the condition could raise significant awareness of the severity of endometriosis, which affects about 1 in every 10 people with uteri globally.
In the simplest terms, endometriosis is a progressive gynecological condition where the tissue that lines the uterus builds up outside of it, usually on other reproductive organs. This leads to pelvic pain around and during periods, pain with intercourse, and/or infertility. Though these are the three primary symptoms medical providers use to identify endometriosis, it takes most women an average of eight to 12 years and trips to several different providers before receiving a diagnosis. That’s because it is insufficiently researched for a disease of its prevalence.
Enda Bowe
Throughout Conversations with Friends, we see Frances doubled over in pain, throwing up, unable to sleep, and passing out from cramps. She tells people it’s “just” her period, even though what she’s feeling goes far beyond “normal” period pains. But in Western society, menstruation is still treated like a taboo topic, and many women don’t even know what a typical level of pain is—or how it manifests.
“There’s a common misconception that all endometriosis is acute pain,” says James Segars, M.D., director of reproductive science and women’s health research at Johns Hopkins Medicine. “After several years of pain, the pain pathways get ingrained and entrenched, leading to chronic pain, which is different from acute pain–and this has neurological effects that affect the mind and happiness.”
