Conversations With Friends, the BBC adaptation of Sally Rooney’s novel, sparked numerous discussions upon its release. While the character Frances, portrayed by Alison Oliver, might be seen as complex and sometimes frustrating – a young writer navigating life, relationships, and family issues – one significant aspect of her story deserves particular attention: Frances has endometriosis. This depiction is noteworthy because endometriosis is rarely shown in literary fiction and television dramas, despite its prevalence.
Frances from Conversations With Friends, portrayed by Alison Oliver, brings endometriosis into mainstream media, raising crucial awareness.
Endometriosis affects a significant portion of the female population, estimated to be between 10-15% of women of reproductive age and 30-50% of women in general. However, despite these numbers, public awareness of endometriosis remains strikingly low. For many who live with this condition, Conversations With Friends‘ honest portrayal of its challenges is a welcome and important step forward. As someone preparing for endometriosis surgery, the series’ timing and depiction are particularly impactful, highlighting the vital need for greater understanding and recognition of this condition.
The Critical Need for Endometriosis Awareness
The journey to diagnosis for endometriosis is often lengthy and arduous for many women. Symptoms are frequently dismissed or misattributed to “just bad periods,” causing significant delays in receiving appropriate care and support. Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. This misplaced tissue behaves like endometrial tissue, thickening and bleeding with each menstrual cycle. This process can lead to the formation of scar tissue, adhesions, blood-filled cysts (often referred to as “chocolate cysts”), and a range of debilitating symptoms. These symptoms include chronic pelvic pain, heavy and prolonged menstrual bleeding, pain during sexual intercourse, infertility, and bowel and urinary problems.
While the severity of endometriosis varies among individuals, its impact on quality of life can be profoundly debilitating. Treatment options include surgery to remove endometrial tissue, pain management strategies, and hormonal therapies. It’s crucial to understand that currently, there is no cure for endometriosis, making ongoing management and support essential for those affected.
Conversations With Friends: A Realistic and Unflinching Portrayal
Conversations With Friends distinguishes itself by presenting Frances’s experience with endometriosis in a remarkably unreserved manner. The series doesn’t shy away from depicting the harsh realities of living with this condition. Viewers witness Frances grappling with intense pain, resorting to painkillers for relief, collapsing in public, being urgently hospitalized due to concerns of miscarriage, and confronting the potential impact of endometriosis on her future fertility. This latter concern even becomes a pivotal factor in her decision to end a relationship she deeply values, underscoring the profound influence endometriosis can have on personal life and choices.
The debilitating pain of endometriosis, often underestimated, is realistically depicted in Conversations With Friends, fostering empathy and understanding.
While some viewers have questioned the speed of Frances’s diagnosis in the show, which contrasts with the typical seven-year average diagnosis time reported by Endometriosis UK, the series’ overall contribution is significant. Conversations With Friends effectively breaks the silence surrounding endometriosis by illustrating the lived experience of a condition that, while not life-threatening, is undeniably “complicated,” as described by Frances’s doctor in the show.
Highlighting the Hidden Struggles of Endometriosis
The realistic portrayal extends to capturing the physical manifestations of pain on Frances’s face and body language. The series portrays her discomfort during intimate moments with her partner, Nick, particularly when the topic of having children arises. It also depicts her distress and panic as she experiences bleeding and vomiting in the bathroom, reaching out to her mother for help. Importantly, the series avoids minimizing or trivializing these experiences, presenting them with the gravity they deserve.
The importance of such depictions lies in the often-private nature of gynaecological health issues. Endometriosis, like many others, can be difficult to discuss openly. This is why on-screen representations like Frances’s are invaluable. Dr. Nitu Bajekal, a senior consultant gynaecologist and co-author of Living PCOS Free, emphasizes the significance of showing the diagnostic process in television programs. This not only increases awareness but also demonstrates that help and treatment are available, encouraging viewers to seek medical advice if they recognize similar symptoms.
Dr. Bajekal notes that quicker diagnoses can occur in certain cases, such as when individuals have a family history of endometriosis or when they consult doctors who ask pertinent questions and conduct appropriate tests. However, she also acknowledges that endometriosis symptoms are frequently overlooked, leading to years of suffering from chronic pelvic pain before a diagnosis is even considered. Often, the condition is only identified when women face difficulties conceiving, and laparoscopy, a keyhole surgery, remains the only definitive diagnostic method.
Dr. Bajekal advises women to be attentive to their bodies and note any changes, especially if over-the-counter pain relief is ineffective for period pain. She encourages seeking medical advice if endometriosis is suspected. Additionally, she suggests lifestyle adjustments such as avoiding smoking and alcohol and adopting a whole-food, predominantly plant-based diet, which may offer some benefits.
Empowering Through Shared Experience and Open Conversation
Conversations With Friends goes beyond the physical symptoms to illustrate the less visible challenges of endometriosis, including its impact on mood and self-perception. Chloe Smith, a 25-year-old SEO manager with endometriosis, found Frances’s portrayal deeply “empowering.” She notes that the series depicts symptoms that women often conceal, even from their closest confidantes.
Alison Oliver and Sasha Lane in Conversations With Friends, a series praised for bringing endometriosis to the forefront of public conversation.
Smith highlights the scene in episode one where Frances is shown in severe pain in the bathroom, even before her endometriosis diagnosis is revealed. This resonated deeply with Smith, mirroring her own experiences. She expressed feeling “seen” in a way that many other shows fail to achieve. She also appreciates the series’ exploration of Frances’s emotional response to the potential impact on her fertility, a sensitive and often central topic in discussions surrounding endometriosis. Smith points out the frequent and often insensitive questions women with endometriosis face about their plans for children, despite potential fertility challenges. Highlighting this aspect in Conversations With Friends is crucial as it reflects a common and often unspoken concern for many women with the condition.
While Smith acknowledges that Frances’s diagnosis timeline might be unrealistically rapid and that depicting the frustrations of the diagnostic process could have been beneficial, she emphasizes the overall importance of open dialogue about endometriosis. She stresses the need to “not shut up about it,” encouraging women to speak out and share their experiences.
Like many women’s health issues, discussing endometriosis can feel like oversharing or even shameful. However, initiating these conversations, even when uncomfortable, is essential for destigmatizing the condition and demonstrating that help and support are available. Conversations With Friends serves as a valuable catalyst for these crucial conversations, bringing endometriosis into the light and validating the experiences of countless women worldwide.
Conversations With Friends is available on BBC iPlayer.
