It’s normal for periods to hurt.
Every woman goes through this — you’re overreacting.
It’s all in your head, dear.
If you’re among the 1 in 10 women who experience agonizing periods and other symptoms of endometriosis, you may have heard these comments.
But Monika Neely wants you to hear something different: I believe you.
That’s what Neely, 34, finally heard after almost two decades of pain. And now she’s on the road to recovery, thanks to a doctor who listened and a surgeon who cared.
Advanced surgical procedures for greater benefits.
‘I’ve been gaslit for years’
When Neely was growing up in Poland, she said it was “still kind of taboo talking about women’s health.”
She started menstruating at 14. “When I was 16, though, it started getting bad,” Neely said. “I was really hurting. I was bloating. I was fainting. I was skipping school for two days because my bleeding was so bad. I was having cramps from my pelvic area to my knees.”
The intensity of her pain during her period felt wrong, Neely said, but no one took her concerns seriously.
“I kept hearing, ‘It's all normal,’” Neely said. “It was coming from my closest relatives, it was coming from doctors: ‘It's natural. You have periods, so you have to hurt.’”
At 21, she finally went to a gynecologist to talk about how her painful and long periods were affecting her life. By now, she was experiencing back pain all month, and digestive issues, joint inflammation, and sciatica around her period as well.
She was prescribed hormonal birth control and muscle relaxers, which helped but didn’t eliminate her pain. She was still in agony for a week each month.
She visited other doctors, including a neurologist, an orthopedic surgeon and six gynecologists. She completed physical therapy, steroid injections for her sciatica, and even visited the emergency room a few times due to intense pain. No one had answers.
“It's very defeating,” Neely said. “You're going to the doctor, knowing something is wrong, and the doctor is like, ‘No, it's not.’ I’ve been gaslit for years, like, ‘everybody’s hurting, everyone has to go through it, you’re overreacting.’ I have been dismissed so many times that I started dismissing myself.”
A possible answer — and then a pandemic
When Neely was 29, a gynecologist finally introduced a possible explanation for her symptoms: endometriosis.
In this condition, tissue similar to the lining of the uterus grows outside the uterus, in places that it shouldn’t. The tissue swells and bleeds each month like uterine lining does, but doesn’t leave your body like uterine lining would during your period. This causes possible complications like cysts, inflammation, scar tissue, and bands of scar tissue called “adhesions” between tissue and organs.
The gynecologist wasn’t certain that Neely had it, but said it was worth exploring. Neely’s follow up appointment was scheduled for March 2020. At that precise moment, the pandemic shut everything down.
Due to COVID-19 restrictions in Poland, only pregnant women and emergencies were allowed to access gynecological care. Neely didn’t think the term “emergency” applied to her, so “I dismissed my pain again,” she said. “I kind of gave up.”
A flare makes it impossible to ignore
In July 2021, Neely moved from Poland to Statesville, North Carolina, and started experiencing new symptoms, like anxiety, dizziness, migraines and an erratic heartbeat. At first, Neely thought the new food, water and environment were to blame, or maybe the stress of the move.
Then the symptoms began happening all month, not just around her period.
“I just never knew if I’m going to wake up and have a good day,” Neely said. “I used to go for hikes with my friends for miles or kayaking rivers for hours. It feels so different and so bad when you can't even get out of your bed and walk to the kitchen, make your tea, make a meal. If not for my husband Jake, who works from home, I wouldn't really be able to do anything.”
By the time Neely became eligible to work in the United States in late spring 2022, her symptoms had become so debilitating that she knew she wouldn’t be able to hold down a job.
Despite her past encounters, Neely steeled herself for yet one more shot at getting help. She read reviews of doctors online and found gynecologist Dr. Jessica Van Kooten of Novant Health Harbor Point OB/GYN.
“I just wanted to talk to someone who would listen,” Neely said.
‘Every patient deserves to be heard’
Van Kooten was that person. She chose obstetrics and gynecology because of the opportunity to build long-term relationships with patients — “from celebrating joyous moments like childbirth to supporting women through challenging times,” Van Kooten said.
As she heard Neely’s story, her heart went out to her. “Every patient deserves to be heard,” Van Kooten said, “their concerns validated, and their symptoms thoroughly investigated.”
Van Kooten ordered an MRI which — as she suspected — indicated scarring and probable endometriosis. (Endometriosis cannot be totally confirmed without a surgical procedure.) At first, Neely tried a non-hormonal medication that often reduces symptoms for women with endometriosis, but when it failed, Van Kooten didn’t give up on Neely.
Instead, she made a referral.
A surgeon who cared
As the decades went on, he found himself spending more and more of his clinical time performing minimally invasive gynecological surgeries. Smaller incisions made possible by robotic devices controlled by the surgeon make for much faster recovery with a lot less pain and discomfort.
“In medicine, we are often dealing with conditions that are difficult to correct,” Bohmer said. But with the minimally invasive gynecological surgeries he specializes in, “You can really make a significant difference in somebody's quality of life, whether that be in reducing their pain, bleeding or anemia or improving their fertility, with a dramatically shortened recovery time. It’s very gratifying.”
Bohmer identified what Neely needed most: “She wanted answers,” Bohmer said.
He also wanted to relieve as much of her pain as possible. He believed he could do this by removing two fibroids he had found, and excising (cutting away) some of the endometrial tissue growth.
So in December 2023, a “terrified, but desperate” Neely went into surgery at Novant Health Minimally Invasive GYN Surgery - SouthPark.
The last thing she remembers as she gazed up from the operating table? That thanks to the staff and Bohmer’s caring explanations of what would happen, “I was feeling safe.”
An official diagnosis, and the rest of her life
After surgery and pathology review, Bohmer shared Neely’s diagnosis with her: stage 4 endometriosis.
“That’s about as bad as it gets,” Bohmer said. “The ovaries and everything between the uterus and rectum were one amalgamation of inflammatory tissue. When you have it on the small bowel like she had, that's extensive. In both ovaries like she had, that's extensive. She had complex problems.”
As he discovered earlier, she also had fibroids, which are uterine growths that can change the size of the uterus if they get too big.
In addition to confirming Neely’s endometriosis, “we tried to essentially restore her pelvis too, as normal anatomy as we possibly can,” Bohmer said.
Although her surgery was complex, it was done with four incisions, and Neely was walking with help the next day.
Neely said the recovery was quicker than she expected, and just a few weeks later, she had a moment she hadn’t experienced in a very long time.
“Around Christmas, I was watching a movie with my husband and I was just sitting and drinking my tea, and I started crying. My husband was like ‘What's up?’ and I was like, ‘I'm just not hurting right now. At all.’ It was that moment it hit me,” Neely said. “I keep feeling better. I have more energy at this point. The pain is really minimal. I have better and worse days, but it’s definitely better.”
With her newfound health and energy, Neely walks her dogs and cares for her 20 quails and chickens. She plans to continue expanding their farm this year.
A message for other women: You don’t have to hurt
Neely is sharing her story today in hopes that other women will stop “dismissing” themselves like she did for so many years.
“This is an invisible disease, and when people can’t see, they have a hard time believing,” Neely said. “All those years, I've been dismissed so many times, and even I was giving up. … I didn't feel seen. I was being told to believe it is normal, which it's not. Don't give up. Find someone who will listen to you.”
Van Kooten echoed Neely’s thoughts, and said, “To patients experiencing symptoms like Monika's, I want to say: Your experiences and pain are valid. Do not hesitate to seek help and advocate for your health. Finding a health care provider who listens and understands your concerns is crucial. You deserve to receive the care and support necessary for a better quality of life.”
Neely said she has found that support with Van Kooten and Bohmer. “I'm glad I trusted both of them,” she said. “It feels way better to be heard.”
Your questions about endometriosis surgery, answered by Dr. Van Kooten and Dr. Bohmer
Can endometriosis be ‘cured’?
While hormonal treatments can manage symptoms and slow the progression of endometrial tissue growth, they do not eliminate existing tissue that cause the pain.
Surgery offers dual benefits: it can confirm the diagnosis and potentially remove endometrial tissue, which may relieve pain and improve fertility prospects (infertility is often a complication of endometriosis). However, it's important to understand that surgery is not always a permanent solution, and ongoing medical treatment may be necessary to keep endometriosis from recurring.
Surgery is not suitable for everyone due to the potential risks involved. The decision to undergo surgery should be made after a thorough discussion between the patient and their doctor, taking into account the individual's specific circumstances, symptoms and goals.
What actually happens during endometriosis surgery?
Using the da Vinci Surgical System, the surgeon will make a small incision through the belly button, and two to three tiny incisions on the abdomen. Then the surgeon puts a thin tube that contains a video camera (called a “laparoscopy”) through the incision and fills up the abdomen with gas to “inflate” it like a balloon, which allows for increased visibility. Using the newly created space, the surgeon looks for signs of endometriosis and takes samples of suspected endometrial tissue growth, which will be analyzed by a pathologist to confirm the diagnosis. The surgeon will also excise (cut away) any endometrial tissue growth that can safely be removed. Usually, patients can go home the same day.
Since endometriosis can be anywhere in the body (it has even been found in the lungs and eyes), it may not be possible to remove all endometriosis, but removing some of it should reduce symptoms.
I think I may have endometriosis. What do I do next?
If you are experiencing symptoms like chronic pelvic pain (especially around menstruation), pain during intercourse, pain with bowel movements or urination, or very painful and long periods, don’t dismiss it as, “I just have terrible periods.” Be proactive and get evaluated with an OB-GYN.
If symptoms persist, ask your OB-GYN or primary provider to refer you for a surgical evaluation (or you can simply call for an appointment). And remember, you are not alone — in 2024, Novant Health Minimally Invasive GYN Surgery - SouthPark will perform an estimated 500 to 600 surgeries for issues like endometriosis, fibroids, hysterectomy and ovarian diseases.
