'Grin and bear it.' Socio-cultural constructions of endometriosis.

Women from minority ethnic communities with reproductive health conditions represent diverse conceptions of health, disease and healing practices. They also experience physical, emotional and spiritual needs that require consideration in their care planning. This paper is based on findings from focus group discussions with women from minority ethnic groups, conducted as the first phase of a qualitative study that seeks to explore endometriosis (a debilitating condition affecting women’s reproductive system) and cultural diversity. Five focus groups were carried out with women from each of the minority ethnic groups being recruited to the main study (n=42). These are women of Greek, African-Caribbean, Indian, Pakistani, and Chinese origin. The discussions aimed to understand the socio-cultural context of women from these groups and explored cultural meanings of menstruation, reproduction, sexuality, awareness of endometriosis and access to health services. Findings reveal cultural constructions and taboos around menstruation, and fertility appeared to be of particular significance to the women who participated in these focus groups. The focus groups also inform of a limited awareness of endometriosis and a tendency to normalise menstrual pain, a common symptom of endometriosis. This paper examines the main themes identified in the focus groups and suggests that in order to provide culturally sensitive care there is a need to take into account specific issues around sexuality and reproduction which may constitute barriers to care for women from particular ethnic groups with endometriosis