BBC/Element Pictures/Enda Bowe

Conversations with Friends: 'Endometriosis plot might make someone visit GP'

Hannah Price

Kirstie Millar was 11 when her periods started.

"Every month I would bleed, pass out and vomit. I couldn't eat or sleep or function," she says.

"I felt like I was dying, but no-one seemed to care."

Ten years later she was finally diagnosed with endometriosis, a chronic illness that sees tissue like that in the lining of the womb grow elsewhere in the body - often around the reproductive organs, bowel and bladder. The tissue builds up and bleeds every month, but with no way to escape the body, the blood is trapped, leading to inflammation, pain and formation of scar tissue.

Endometriosis can cause severe period pains, pain during sex, chronic pelvic pain and in some cases infertility.

Kirstie's symptoms are mirrored on screen by Frances' experience in the adaptation of Sally Rooney's Conversations with Friends. Frances can be seen lying on the bathroom floor in agony and fainting in public from the pain.

"It's the first time I've seen endometriosis depicted on screen. I felt such a sense of relief, it was actually incredible to see a character experience what I suffered with.

"It shows how endometriosis comes with so much shame and guilt," Kirstie says.

"It's the first time I've seen endometriosis depicted on screen," says Kirstie

Dr Fiona Reidy, a gynaecologist who specialises in endometriosis, advised the team behind the production of the new drama on their representation of the chronic illness.

"Endometriosis is a very common inflammatory condition affecting approximately 10% of women. It has a significant impact on women's quality of life," she tells BBC Three.

"But it's still very poorly understood and still under-researched, underfunded and these women have been underserved for a long time."

Dr Reidy says many women with the condition say their symptoms are initially dismissed by their doctors, with the average time taken to diagnose the condition in the UK and Ireland being eight to nine years.

"At the moment, the only way to diagnose endometriosis definitively is surgery," she adds.

While the condition can be managed with surgery and medication, there is currently no cure.

'I felt a responsibility to portray it on screen'

Alison Oliver, who plays Frances, consulted both medical and personal accounts of what endometriosis was like to make her portrayal "as authentic as possible".

"I think our big thing was we didn't want to shy away from the pain of it, and how even when you're not on your period it totally affects your life and mood," she tells BBC Three.

"It's such a massive thing that so many women deal with.

"It's something that I felt such a responsibility to portray on screen. It's so under-discussed."

BBC/Element Pictures/Enda Bowe
Frances, played by Alison Oliver (right), can be seen lying on the bathroom floor in agony and fainting in public from the pain of endometriosis

Dr Reidy, who is currently undertaking a fellowship in endometriosis in Dublin, says for so long women's health and menstrual issues were just not talked about.

"With endometriosis it isn't someone that has really bad periods once and that's it, it's ongoing, it's chronic and it's worsening. That's one thing that I wanted to get across [to production].

"The most important thing with Conversations with Friends was just to have something on mainstream telly highlighting this problem.

"I think just having a storyline that might get people talking, might get people asking questions, is so important," she says.

Dr Reidy hopes the show's depiction of the disease will help some women realise their symptoms aren't normal and make someone think to go to their GP.

'My 20s have been obliterated by this disease'

Kirstie says when she first started experiencing severe periods, her school and doctors made her feel like she was "faking it" and "trying to get attention".

"No-one believed I could possibly be as ill as I claimed. My period was terrifying and it changed my life forever," she says.

"I've had endometriosis for 18 years, which means I've spent more than half of my life having periods that make me very sick."

Kirstie has severe endometriosis and so far has had four surgeries, three of which she says didn't work.

"The last one has really helped, but I still deal with chronic pain on a daily basis and can't function normally around my period. It's been hard to hold down a job," she adds.

"I'm now 29 and it feels like my twenties have been obliterated by this disease."

When she was finally diagnosed with endometriosis, Kirstie says she felt immense relief: "After being dismissed by doctors over and over again for a decade, having surgery and being told by a surgeon 'there is something wrong, you have a disease' felt like winning the lottery."

'I'd never seen it portrayed before'

Contraceptive options, like the combined and progesterone-only pills, can be used to help treat the condition. International guidelines advise that patients presenting with symptoms of endometriosis should be started on medical treatment as soon as possible - even before a confirmed diagnosis from surgery, which can take some time.

Brontë Schiltz, a 27-year-old from Manchester, went from severe pain to feeling much better after being prescribed the mini-pill for her endometriosis.

"Very similar to Frances, I would be screaming in pain, vomiting, fainting. I'd be completely incapacitated for two days a month - I couldn't even lift my head to drink, my mum would have to pour water into my mouth. I would faint in public," she says.

Brontë hopes the representation of the illness in Conversations with Friends will raise awareness about the condition

"Seeing it on screen was really amazing, I'd never seen it portrayed before."

From the age of 15 to 22, Brontë says she was "completely dismissed" by her doctor, who she says told her it was normal for periods to be painful.

"For years I would go back regularly begging for someone to look into something," she adds.

Brontë says her endometriosis symptoms made her suicidal: "It would make me so depressed. I remember feeling terrified because I thought, 'I cannot do this for the rest of my life.'"

Brontë hopes the representation of the illness in Conversations with Friends will raise awareness about the condition and its debilitating nature. She also hopes it will help direct other people suffering to some of the treatments available that might help, like they did for her.

"For me the medication didn't change my life, it saved my life," she says.