The nurse was holding my hand as I opened my eyes. She leant in close. “The operation was a success,” she whispered. “You’ve got endometriosis, but we’ve removed the cells we found. They were in your pouch of Douglas.’
My first response was relief. I had a diagnosis. It wasn’t all in my head.
My second was to laugh. Probably in part due to pain relief, but mostly because they’d found endometriosis in my… what? It sounded like something from a Dickens novel: “my pouch of Douglas? Oh, you’ll find it in my sow’s ear purse with my popsy wopsy.”
Since I learned of its existence, I set out to read as much as I could about my pouch of Douglas.
The pouch is a cul-de-sac between the walls of the uterus and rectum in females. It’s one of the most commonly affected parts of the body for endometriosis. It’s also one of the most overlooked places, as it’s hard to get to and is difficult to see because it’s behind things.
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The nurse was holding my hand as I opened my eyes. She leant in close. “The operation was a success,” she whispered. “You’ve got endometriosis, but we’ve removed the cells we found. They were in your pouch of Douglas.’
My first response was relief. I had a diagnosis. It wasn’t all in my head.
My second was to laugh. Probably in part due to pain relief, but mostly because they’d found endometriosis in my… what? It sounded like something from a Dickens novel: “my pouch of Douglas? Oh, you’ll find it in my sow’s ear purse with my popsy wopsy.”
Since I learned of its existence, I set out to read as much as I could about my pouch of Douglas.
The pouch is a cul-de-sac between the walls of the uterus and rectum in females. It’s one of the most commonly affected parts of the body for endometriosis. It’s also one of the most overlooked places, as it’s hard to get to and is difficult to see because it’s behind things.
They’d found endometriosis in my… what? It sounded like something from a Dickens novel. “My pouch of Douglas? Oh, you’ll find it in my sow’s ear purse with my popsy wopsy.”
Acknowledgement at last
On average it takes nearly *nine* years from the first GP visit to get a diagnosis of endometriosis. Yet it’s the second most common gynae condition in the UK. On reflection I’d had symptoms for 10 years, ones that came and went.
Symptoms that made my partner speed back from my aunty’s caravan in the Lakes at 2am, on an almost empty tank of petrol, to get me the antibiotics I thought would get rid of the pain. Symptoms that made me pay privately for a cystoscopy (camera in my bladder) to try and work out what was wrong. Symptoms that created a general underlying sense of anxiety, and led me to have 14 lots of antibiotics in 2022, as I was constantly misdiagnosed.
Then one day, the symptoms came back and never left, so I dragged myself between my GP and A&E departments across the North West.
Assessing pain is tricky. But I would say at its best, it was similar to a kidney infection, where sitting in a lukewarm bath all night was the only way to get slight relief. At its worst, it was all-consuming. I thought of pain as an invisible cage with thick bars. One I was living in, while also trying to pretend that it didn’t exist because who wants to listen to someone banging on about pain. When I asked my GP if it could be cancer, he said no, as the pain I was describing would mean it was stage 4.
On average it takes nearly *nine* years from the first GP visit to get a diagnosis of endometriosis. Yet it’s the second most common gynae condition in the UK... I thought about the times I’d been gaslighted by medics... They told me to take up gardening, get a dog to distract myself, and that I needed to learn to live with pain.
A bitter-sweet diagnosis
To have confirmation the pain was real felt amazing. And now I know what to say to the doctors if symptoms return: “get in that Pouch and have a good rummage around!”
I thought about the times I’d been gaslighted by medics. The ones who told me, “on paper, there’s nothing wrong with you”, as I begged to be sent to a gynae ward. Those who asked what job I do and then advised me to “get away from sitting at a desk”. They told me to take up gardening, get a dog to distract myself, and that I needed to learn to live with pain. Ironically, that came from a female consultant on International Women’s Day.
A 'pouch of Douglas' is named after an eighteenth century Scottish anatomist. From there, I went down a rabbit hole, discovering all the other parts of the body that are named after men – many of which, interestingly enough, are not part of the male anatomy. Fallopian tubes are named after an Italian priest, for example.
What's in a name?
On my medical report after the op were the words: Excision of endometriosis from pouch of Douglas.
I thought about those seven words repeatedly, as I waited eight months for a follow-up to see the consultant who’d operated on me.
I pondered the origins of them, and discovered that a pouch of Douglas is named after an eighteenth century Scottish anatomist. From there, I went down a rabbit hole, discovering all the other parts of the body that are named after men – many of which, interestingly enough, are not part of the male anatomy. Fallopian tubes are named after an Italian priest, for example.
Eventually, when I met the consultant again she said, “yes, we found endometriosis, it was on the side of your ovary, your rectum, your uterus”. I interrupted to check she was reading the right records, because my endo was in my pouch of Douglas. What was she talking about?
She confirmed that, yes, this was indeed my record, and that these body parts sit within the pouch. So that was it – apart from being whispered to me post-operation, then written in my summary notes, my pouch of Douglas was never mentioned again.
And because of this, I've tried to raise awareness of its existence. To anyone who might have undiagnosed, or misdiagnosed symptoms: the pouch is a hiding spot for rogue cells, it’s difficult to see on ultrasounds, scans, MRIs, you need a laparoscopy (a camera) to get in there to have a proper look.
So, this year, I thought a lot about the women who have not yet been diagnosed with endometriosis, are fighting to advocate for their own health, and the women who may have been diagnosed, but are not yet sure what’s next in their journey to manage symptoms.
Visit endometriosis-uk.org
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