- Tuli Kamati
Severe period pain is often dismissed the world over. What makes the Namibian context even more jarring is that not only do we have an under diagnosis problem as a continent, the discussion around what constitutes severe period pain is also had in a vacuum in the mainstream. As a result, women are being told to simply endure or growing up being told that it is “normal”.
But pain that disrupts your life is not normal. As someone living with endometriosis while training in clinical medicine, I know what it means to move between being the patient and the medic, to understanding the anatomy and still feel unseen inside the system.
WHAT IS ENDOMETRIOSIS?
Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows outside it, on the ovaries, fallopian tubes, bowel, bladder and sometimes beyond. It can cause debilitating menstrual pain, heavy bleeding, fatigue, painful sex, infertility, chronic pain even outside the menstrual cycle and mobility issues. Globally it affects approximately 1 in 10 women of reproductive age. Yet the scale at which it is discussed in Namibia is rare.
Many young women present to clinics only after years of unmanaged pain. By then, they have missed school, lost income or internalised the belief that their pain and suffering is exaggerated. Our public health systems, especially the specialty departments, are understaffed and overstretched – getting an appointment with a gynaecologist takes a long time. Chronic pelvic pain is often attributed to “bad periods”.
Diagnosis is another barrier. Endometriosis is difficult to confirm, especially in our context. It is clinically confirmed with medical imaging or laparoscopic surgery, both of which are not always readily accessible in public hospitals. Most women are treated symptomatically with pain killers, hormonal contraceptives, hormonal treatments such as Visanne, which is commonly used in Namibia. However, women often get those prescriptions without a clear explanation of what might be happening in their bodies or a clear understanding of a condition that still has no cure.
WHAT’S THE COST?
The silence around endometriosis is not only medical, it is economic and emotional.
Pain has a cost. Lost workdays, missed exams, lost opportunities. Transport to referral hospitals with backlogs. Sanitary products. Medication. Surgery. For women navigating unemployment or without medical aid, these costs compound. For women with disabilities or those living far from these referral hospitals, delays can stretch into years.
It’s 2026 and believe it or not, stigma around periods still exists in many households. Talking about painful sex is even harder, with women feeling shame discussing bowel symptoms, infertility or admitting that their period immobilises them, not because it is rare but because it is unspoken.
So what should we look out for?
- Period pain that stops you from taking part in your daily activities
- Pain that not improve with standard pain medication like mefenamic acid
- Pain during or after sex
- Heavy bleeding that interferes with daily life
- Chronic pelvic pain outside of menstruation
If this sounds familiar, you deserve to ask questions and this is not something you must simply tolerate.
The new political administration under President Netumbo Nandi-Ndaitwah has promised to strengthen public health systems including the reproductive health system. We must expand awareness of chronic menstrual conditions, train providers to recognise early signs and create referral pathways that do not depend on financial privilege. Menstrual health is not only about products, it is about diagnosis, dignity and access to care.
Pain should not be the price of existing.
- Tuli Kamati is a clinician and reproductive justice activist. Follow her on Instagram @tuli_kamati.
