An ode to the wandering uterus and the warrior women bleeding for our collective healing

What if endometriosis is a physical presentation of the conflict women experience every day? A conflict between how they feel and how they desire to feel….. Please hear me out. There is no placing blame with this theory. Instead, I want to explore an idea and invite discussion from those with lived experience, as well as those learned in the history and current understanding of this disease.

Since at least 1900 BC, we have believed that what ails women is a mis-alignment with their natural ‘position’. It is said that by seeking more than our hierarchical position entitles us to, we have created conflict for ourselves. We have also danced with the devil and should be punished accordingly. We are at our core hysterical. And as Aristotle asserted “the woman is a failed man”. Whether you believe this to be true or not, it is a prevailing narrative woven through time. 

This belief is still so deeply embedded, that we apologise when we cry. We apologise when we express our deep emotions and we talk in loops as we attempt to explain how we feel and how we got here. We shrink ourselves to avoid making a scene, fearing repercussions of expressing our true selves. We refer to ourselves as loony across our menstrual cycle and allow others to do the same. Could these modern day behaviours be deeply rooted in a history of our unique feminine powers being held against us?

Since Papyrus, women’s mental states have been ascribed to a uterus that is wandering around the body negatively affecting other organs - hence the term hysteria - of the Greek word hystera meaning womb, the first (and prevailing) word used to describe a mental disorder of women. Here we are in 2024, some 3,923 years later, still afflicted by a wandering uterus, and in scientific terms no closer to understanding its cause, or being able to offer an effective strategy for relief, other than removing the offending organ.

Endometriosis is literally a disease of the wandering uterus. Affecting at least 10% of women, likely more, because many women suffer in silence. Endometrial stem cells find their way out of the uterus and come to reside in the peritoneal cavity. Hypotheses for how these cells get here include retrograde menstrual flow* and stem cell seeding of the peritoneal cavity early in life**. Both of these are profound representations of the incredible power that lies within the female physiology. Whatever it is, from a scientific standpoint we don’t know what causes endometriosis.

Here’s a little of why the modern day wandering uterus is so debilitating for women***. These ex-utero endometrial cells are as responsive to the cyclic female hormones as they would be in the uterus. In the uterus, these cells have the role of proliferating to form the thickened lining of the uterus in preparation for an embryo to implant. Every month, these cells grow in size and multiply in number preparing for an embryo. When pregnancy doesn’t occur, the menstrual bleed follows, as part of our beautiful natural monthly cycle. But it’s perhaps less beautiful when you are also bleeding within your peritoneal cavity. This internal abdominal bleeding, where the blood has no way to exit the body, causes inflammation. This on repeat every month, eventually leads to scarring and adhesions - where organs become attached to each other. Read pain, lots of pain. Add to this, that the time to diagnosis is typically ~7.5 years, these warrior women are literally bleeding and crying out in pain only to continue to be ignored. And as if that’s not enough, endometriosis impacts our capacity to reproduce, crippling the essence of being a woman. 

Here is where I have become more curious about the history of being a woman, at least for the last 3,923 years (or ~150 generations) and the wellbeing of many of today’s women. It is clear we need a new way of thinking to heal humanity. Here is my contribution…

What if it has taken our almighty powerful female spirits (and the men that love and hear us) 150 generations to move the feelings of discontent from our hearts and minds, where we are too easily dismissed, to our physical body where the evidence can be seen. Could this now visible evidence of a wandering uterus, the very same idea proposed by Papyrus and Hippocrates, be the pivotal moment for us?

I see endometriosis as the physical proof that we ARE living out of alignment with our natural position. But contrary to the musings of ancient men, our natural position is not to be their subordinates, worshipping the phallus. Instead it is to rise alongside men, to share our powers collectively, in balanced union and return humanity to wholeness.

With this balanced union, we will stop suppressing our emotions and start honouring our lunar cycle, connecting ourselves back to the cycles of mother earth. As we age further, we will embrace our wisdom and step into our power of guiding and supporting the young women alongside us. We will stop apologising for taking up space and we will continue our life giving work, shining light into the dark corners of oppression that have prevailed for far too long.

So here is my call, especially to those of us not bearing the toll of bleeding in our abdominal cavities and suffering agonising pain through 3 out of 4 weeks of the month, let’s pay attention to our sisters and hear their cries of pain. Let’s remember who we are, not who we’ve been told to be. Let’s do our work and remember that our mission is simple. It is to prioritise love and care of ourselves, those born of our womb, and the beautiful men who love them too. And it is to come together in community, raising our vibration so that we heal those that are suffering physically for our collective pains. 

Love Hayley#

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Notes

*retrograde menstrual bleeding refers to menstrual blood that doesn’t just flow out of the body, but it flows upward, exiting the uterus via the fallopian tubes where it finds its way into the abdominal cavity. I find this another extraordinary example of how women not living in their true flow and alignment might manifest physically in our bodies. At no fault of their own, but instead, perhaps it is a manifestation of the collective pain, born to those with the fortitude to take a big one for the team, to break the long-standing cycle of oppression.
The frequency of retrograde menstrual flow is not well known. Early reports observed retrograde menstrual bleeding in 90% of women, including 90% of those with endometriosis and 8 of 9 women taking the oral contraceptive pill. Recent summaries of known research, conclude that there is inadequate evidence to report these findings, nor is there enough evidence to determine how this translates to women not in either of these groups.

**stem cell seeding early in life refers to a hypothesis that during pregnancy or soon after birth, endometrial stem cells find their way into the pelvic cavity of the female baby and survive there, dormant until menarche activates them. There is a subset of newborn female babies that bleed from their vagina at or around the time of birth. This has not been well documented or explored and is a part of ongoing scientific research. Could these babies who bleed early in life, be providing an early signal for a risk of endometriosis later in life?

***I believe that endometriosis can be seen as a mirror symptom of a condition that too many beautiful women find themselves suffering - spending more time and effort taking care of others, people that are outside of themselves, rather than taking care of and honouring themselves and those that are of their womb. The fault here lies not in the individual woman, but in the history of oppression that precedes them. BUT, I believe that we now finally have the physical evidence for the harm this is causing us, and that from this position of awareness we can finally heal, together. 

# I don’t have personal experience with endometriosis. I found these words after meeting a beautiful woman who does and observing just a snippet of her inner journey. Her story reminded me of other women I have observed over the years, those crippled in pain as they walk to the bathroom; those unable to attend events and festivities due to being bed-ridden with pain.
I am a PhD trained reproductive physiologist who had the privilege of running a research laboratory alongside a prominent stem cell biologist Professor Caroline Gargett. She and her team continue to work on addressing the scientific root of endometriosis and she is responsible for putting forward the idea of stem cell seeding early in life. As I sat and wrote this piece, I was reminded of my interactions with the head of the gynaecology team at a prominent pharmaceutical company (the conversation that was the beginning of the end of my academic and research career). He said, in response to my question about research dollars spent on women’s health “we don’t spend as much on women’s health research because women don’t make as much noise as men.” This response hits me harder now. Because there it is, we have come full circle, the suppression of our voices has been so effective that we are now to blame for the poor state of affairs of our health.
It is always a risk offering a perspective. Especially when you do not have lived experience of the condition. But, as I continue to invite curiosity into my own life, especially around my beliefs and perspectives, the same happens for how I interpret science and how I think about how we as humans present with conditions, symptoms and disease. I no longer believe that these things simply happen. They are signs, beacons, highlighting the things that we need to pay closer attention to, and expand our thinking on. I have known of the statistics and clinical presentation of endometriosis for many many years, but it’s not until I came into community with a woman experiencing all that this condition means for her life, that the story really came to life for me.
I invite commentary and expansion of this idea because I do not believe my thinking to be complete or definitive.