âI want my womb removed but doctors say Iâm too youngâ
Emily Griffiths wants to have an operation to remove her womb, known as a hysterectomy.
At 26, with no children, she knows it is a big step. But endometriosis and adenomyosis have left her housebound, in debilitating pain, and unable to see a future as a mum.
Right now, she simply dreams of being able to go for a walk unaided. But she says she has been unable to find a clinician who will discuss the procedure because of her age.
âDoctors are too busy planning ahead for the child I might want in the future and canât see where I am right now,â said Emily, from Carmarthenshire.
Emilyâs symptoms started when she was 12, with periods so painful and heavy that she missed school and became anaemic.
She said GPs told her the pain was normal.
âThey would say it was all in my head and I was just trying to be off school,â she said.
Emily was diagnosed with endometriosis aged 21, after collapsing with sepsis.
She was referred to a specialist centre in Cardiff, but said the wait was so long that her family self-funded private surgery.
Emily, who has been unable to see an NHS specialist, said she had lost count of the private clinicians she had seen and felt there was âzero supportâ from the health service.
A hysterectomy would leave Emily infertile and prompt the menopause, which in turn could increase her risk of osteoporosis, heart disease and dementia.
Yet for the past three years she has been given a monthly injection to chemically induce menopause, pausing her periods in an effort to alleviate her symptoms.
Scans show that has caused her bone density to deteriorate.
âA hysterectomy isnât a cure for endometriosis, but it is for adenomyosis,â she said, adding she was 23 when she received that additional diagnosis.
âEven though itâs a big step, I could have the possibility of maybe going for a little walk when Iâm really struggling⊠but at the moment Iâm stuck in a very dark place.â
What is a hysterectomy?
A hysterectomy is a major operation with a long recovery time which is only considered following less invasive treatments.
It is carried out to treat health problems affecting the female reproductive system.
A total hysterectomy is the surgical removal of the womb and cervix.
In some cases the fallopian tubes, ovaries, lymph glands, and part of the vagina, can also be removed.
What are endometriosis and adenomyosis?
Adenomyosis is a condition where the lining of the womb starts growing into the muscle in the wall of the womb.
It can cause painful periods and heavy bleeding, as well as pelvic pain, bloating and pain during sex.
Endometriosis is where cells similar to those in the lining of the womb grow in other parts of the body.
Symptoms happen when those patches break down and bleed but cannot leave your body.
Endometriosis is currently widespread across both of Emilyâs ovaries as well as her uterus, bladder and part of her bowel.
Her menopausal symptoms have also been severe, but hormone replacement therapy (HRT) makes her endometriosis worse.
Because of the complexities of her case, Emily would need an endometriosis specialist to carry out the hysterectomy as it would also involve excision of the endometriosis.
A hysterectomy is listed as one of a number of treatment options by NICE for endometriosis and adenomyosis.
Endometriosis UK said a hysterectomy could not guarantee total loss of pain and symptoms, but âitâs important to remember that the final choice is yours â it is your bodyâ.
Emily said that sentiment was at odds with her own experience.
âTold Iâm too youngâ
âI donât really think that women do have the freedom to make a choice over their own bodies,â she said.
âIâve been told that if I settle down âyou may want to have a child with your husbandâ â itâs just planning ahead and not seeing where I am right now.
âBasically fertility has been put way above any of my illnesses and what Iâm going through.â
Emily said she had been advised to stay in a chemically-induced menopause, try the contraceptive pill or anti-depressants, along with ârunning, pilates or yogaâ.
âI canât walk without support, so to tell me about pilates or running is not the nicest comment,â she said.
Emilyâs work to raise awareness of the issues she faces has earned her recognition from the King and the Princess of Wales.
âIâve had some really amazing opportunities⊠and thatâs whatâs keeping me holding on to some sort of hope,â she said.
There are currently two accredited NHS endometriosis centres in Wales, in Swansea and Cardiff.
The centre in Swansea does not currently accept patients from outside the health board area, while Cardiff said it considers outside referrals âwhere appropriateâ.
Every health board has endometriosis nurses to support patients, but Emily, who lives in the Hywel Dda health board region, said lengthy waits meant she had little option but to seek private care.
âThereâs been two privately funded surgeries so far, with possibly another one coming,â said Emily.
Follow-up care and advice also comes at a cost.
âNo one on the NHS will monitor me currently, so it does become a never ending cycle of funding and finding the right person,â she said.
âIf you have a question, maybe a certain medication theyâve prescribed isnât agreeing with me, it always comes at a cost, you canât simply ring them and find out.
âI understand thatâs the route you take when you have private care, but if the NHS arenât there to help either, then thereâs no choice.â
Sioned Williams, Plaid Cymruâs spokesperson for social justice and equalities, was made aware of Emilyâs case after she raised it with her local Member of the Senedd (MS).
âThe Welsh government has been too slow in delivering their womenâs health plan,â Ms Williams said.
âPeople with endometriosis such as Emily just want to be heard and believed and this should not be too much to ask.â
Sam Rowlands, the Welsh Conservative health spokesperson said: âThe Welsh Conservatives would immediately scrap the restrictive NHS guidance that locks patients in their local area, blocking cross-community and cross-border working, to make use of extra capacity to reduce excessive NHS waits in the short term and look to enact a substantial workforce plan to tackle the more deep-seated issues in the longer term.â
A Welsh government spokesperson said it had made womenâs health âa key priorityâ and would publish a 10-year womenâs health plan in December.
âThe Womenâs Health Network, led by the first ever clinical lead for womenâs health in Wales, has been established to deliver improvements including in endometriosis care, treatment and support,â they said.
âHealth boards are responsible for delivering services and we have funded dedicated endometriosis nurses within each health board.â