Understanding language used to describe endometriosis pain could help cut diagnosis time, study shows

Understanding language used to describe endometriosis pain could help cut diagnosis time, study shows

Women use metaphors to describe and communicate endometriosis pain to attempt to create understanding and empathy from listeners, according to new research.

Phrases such as feeling “like my womb is going to explode” and “like a burning golf ball” are commonly used by woman to emphasise their pain and an understanding of this language could be important to improve the typically very long diagnosis time.

Endometriosis is a debilitating condition that affects one in 10 women in the UK. The research published in the British Journal of Health Psychology found that out of the 21 women interviewed, they each experienced symptoms for an average of 11 years before receiving a formal diagnosis.

Linguist Dr Stella Bullo and psychologist Dr Jasmine Hearn, both at Manchester Metropolitan University, said that this could be due to the challenge of communicating endometriosis pain to others and it could be having a severe impact on mental health.

All of the women interviewed in the study used metaphors to describe their pain and over the course of the interviews a total of 221 metaphorical expressions were used.

Dr Bullo and Dr Hearn say the descriptions of pain are worrying and the phrases used go beyond the standard descriptors of pain and highlight both the physical as well as the cognitive, emotional and social impact on the women experiencing endometriosis pain.

Valuable insights

Dr Stella Bullo, is a Senior Lecturer in Linguistics at Manchester Metropolitan and experiences endometriosis herself, said: “The role of language is vital in both clinical and social settings, in particular in ensuring that women with endometriosis feel heard.

“Using metaphors to describe pain highlights a challenge of communicating endometriosis pain to others. These descriptions may be an attempt to emphasise the urgency of pain and provoke emotional responses, care provision, empathy, and understanding from the listener.

“Making health professionals aware of the valuable insights presented in this study may help to enhance doctor–patient communication, with health professionals being less likely to dismiss, minimise, or misunderstand pain when it is expressed through metaphor.”

Language

The choices of language the women used were split into three main categories; some referred to pain as physical properties of elements such as temperature and pressure, using phrases like “hot pokers” and “coals” inside them.

Pain was also described in relation to physical damage, such as “stabbing” or “twisting”.

And finally, pain that felt as though it was from an external attacker, using phrases such as “like someone cutting you”.

The descriptions all suggest the feeling of vulnerability, helplessness and pain being incomprehensible.

Some women used phrases as severe as “I thought I was dying”, suggesting real pain-related distress, depression, and illness intrusiveness and highlights a need for future work in this area.

The researchers hope that integration of metaphor in endometriosis pain education and assessment tools could provide benefits in understanding the condition.

It also highlights the importance of merging linguistics and psychology expertise to provide a more vivid analysis of the experiences of women with endometriosis going forward.