Why ‘Conversations With Friends’ realistic portrayal of endometriosis is so important

By Catherine Lough

Conversations With Friends – the new Sally Rooney BBC adaptation – has certainly got people talking. It’s fair to say central character Frances, brilliantly played by Alison Oliver, is a little irritating. A navel-gazing 21-year-old trying to make her way as a writer, navigate complex relationships and support her alcoholic dad – we see her bully a poor Tinder date for admiring Yeats, and get called out by her ex, Bobbi (played by a luminous Sasha Lane) for being patronising.

But one thing we can thank her for? Frances has endometriosis – and depictions of the condition in literary fiction and TV dramas are rare.

In fact, despite being relatively common, affecting around 10-15 per cent of women of reproductive age and 30-50 per cent of women in general, endometriosis suffers from a severe lack of awareness in general.

And for me – as I gear up for endometriosis surgery next month – Conversation With Friends’ honest portrait of how difficult the condition can be, could not have come at a better time.

Many women wait years to get a diagnosis and help for endometriosis, with symptoms often dismissed as ‘just bad periods’. It causes tissue similar to the lining of the womb to develop outside the uterus, which grows and bleeds with each menstrual cycle – leading to scarring, adhesions, ‘chocolate’ blood-filled cysts, and symptoms including pelvic pain, heavy periods, pain during sex, infertility, plus bowel and urinary problems.

While severity can vary, is can have a debilitating impact. Surgery to remove endometriosis tissue can help, as well as pain relief and hormonal treatments, but there’s no cure.

In Conversations With Friends, the producers have opted to show Frances’ experiences with a notable lack of squeamishness – we see her crouch on the floor with painkillers, faint in the street, be rushed to hospital with a suspected miscarriage, and struggle with how endometriosis could impact her long-term fertility – which even leads her to end a relationship she values.

Some viewers have questioned how quickly Frances is diagnosed. Typically, it takes around seven years. But in revealing what it is really like to live with a condition that – whilst not fatal, is certainly ‘complicated’, as Frances’ doctor tells her – Conservations With Friends has broken the mould.

The pain Frances experiences is etched onto her face; we see her discomfort when her partner, Nick, tells her how much he wants a child, and her panic as she calls to her mother whilst bleeding and vomiting in the bathroom. None of it is minimised.

As with many gynaecological health issues, it can feel difficult to openly discuss how endometriosis affects you – which is why depictions like this are so important.

Often, endometriosis is only picked up when women are struggling to conceive, and keyhole surgery – a laparoscopy – is currently the only means of a definitive diagnosis.

It’s gratifying to see some of the more hidden difficulties endometriosis causes reflected on screen. In Conversations With Friends, not only do we see Frances in pain, we also see how the condition affects her mood and sense of self.

Chloe Smith, a 25-year-old SEO manager, who also has endometriosis, says seeing Frances grapple with the condition is “empowering, because symptoms like that are ones we often hide, even from people we are closest with.

“Seeing Frances on the floor in the bathroom in episode one, even before endometriosis is mentioned, resonated with me, because I’ve been in that situation so many times,” Smith adds. “It made me feel seen in a way a lot of shows don’t.”

As with so many women’s health conditions, speaking up can sometimes feel like oversharing, or even shameful. Having these conversations may be uncomfortable, but they also help to destigmatise the condition, and ultimately show that help is out there.