Some 200,000 girls and women in Finland suffer from a painful medical condition called endometriosis, which doctors often fail to diagnose. Journalist Anne Ignatius says in her new book that one in 10 Finnish women have some form of the disorder.
Endometriosis is a condition in which cells similar to those in the layer of tissue (endometrium) that covers the inside of the uterus grow outside of it. The growths can cause debilitating pelvic pain, infertility and bowel symptoms.
Ignatius says it is important that the issue be discussed openly, as social stigma and lack of understanding worsen the psychological effects of the condition.
The chronic disorder is presently incurable but treatable with hormones and pain medication; in some cases surgery is also necessary.
Pia Suvitie, deputy chief of the obstetrics and gynaecology department at Turku University Hospital, says she frequently comes across patients with endometriosis who have received no medical treatment at all from numerous doctors.
"The basic healthcare system is very poor at identifying endometriosis. Not even all gynaecologists know to look for it," Suvitie says.
One of the most common symptoms is severe pain during menstruation or intercourse.
"The pain can be completely crippling," says Suvitie. "Sufferers may be unable to function for days or even a week at a time, and regular painkillers do not help."
On top of that, the disorder can lead to bowel symptoms such as diarrhoea and constipation.
While endometriosis most commonly affects women aged 30-40, Suvitie's recent dissertation finds that 5-10 percent of 15-19-year-old girls report intense pelvic pain that often keeps them from attending school.
Ignatius says she was shocked by how many women reported being belittled by doctors and acquaintances alike.
"It affects a patient's self-image immensely if no one seems to believe they are in pain," Ignatius says.
Not only that, but Ignatius says that the Social Insurance Institution of Finland (Kela) tends not to cover the costs of endometriosis medication, which patients have to pay for themselves. Even when support is granted, the sums are minimal.
One top worry for patients is the possibility of infertility. Fortunately, says Suvitie, modern fertility treatments show promise. About half of endometriosis patients are able to become pregnant without problems.