When the sharp, stabbing pain in her abdomen became so severe she had to be substituted at half-time during a match last season, Katja Snoeijs knew what she was experiencing was not “normal period pains”.
The 29-year-old Everton and Netherlands striker has since been diagnosed with endometriosis, which affects roughly one in 10 women of reproductive age. She says she counts herself lucky because she received her diagnosis within 12 months and was shocked to learn the average wait in the UK is nine years.
The condition involves cells similar to those found in the lining of the womb growing elsewhere in the body, which can lead to inflammation and chronic pain. This year, Snoeijs had keyhole surgery to treat it and, having recovered to resume full training before Saturday’s Merseyside derby with Liverpool in the WSL, has decided to open up about her experiences in the hope of encouraging more women to seek help.
Snoeijs, who joined Everton in 2022, spoke exclusively to the Guardian and recalls being unable to stand up straight during a match when her symptoms came on strongly. “Probably since I was a teenager I had symptoms around my period, but back then I was like: ‘Oh, it’s normal period pain,’” she says. “But in the last two years, it would also impact me on the football pitch.
“There was one national team session where I couldn’t run, I was in so much pain. I felt like I had to throw up and I had to leave the session. But even then, it was so hard to acknowledge something was not right.
“Then at Everton, there was a game last season where I got my period and I tried to push through. I was starting that game, but walking out I couldn’t stand up straight so I took a lot of pain medication. At half-time I had to be subbed off because of the pain. That was the moment where I was like: ‘I need to do something about it.’
“It’s a little bit hard to predict. Whenever it’s there, it goes from zero to a hundred. It’s like a very sharp stabbing pain in your abs. As an athlete, it’s always hard to acknowledge when you feel something. It’s natural to ‘push through’. In your head you’re thinking: ‘I can still do something’, but you’re only making it worse for your body. I didn’t want to be weak so I wanted to try to push through, help the team [but I couldn’t] physically run any more.”
The worst experience she had away from the pitch came this Christmas. “Suddenly I could feel the cramps, something was wrong,” she says. “The next three days I had to lay in bed because I was in so much pain. A lot of women either get told it’s normal period pain or you think it yourself. But we all know it’s not normal to lay in your bed for three days because of period pain.”
March is Endometriosis Action Month and Snoeijs says since first writing about her condition on social media two weeks ago it has prompted more, helpful conversations. “Everyone has been really nice and supportive. In our changing room, it opened up conversations about period pain and I know there are other teammates that have been struggling. It’s helping us to understand each other better.”
Last season, Snoeijs sought help via the club doctor and private gynaecologists. One gynaecologist initially appeared unconcerned by her symptoms, but a second opinion led to an MRI that indicated endometriosis and she was recommended to have a laparoscopy. Having the surgery, in the middle of her career, was a tricky decision. “I had this chat with the team doctor and he said: ‘Whatever you want to do, we’ll support you in it.’ We went through different scenarios and decided it would be best to do it as quickly as possible.
“It went really well. They found a little bit more endometriosis than expected, but they were able to burn as much as possible away. Initially, I just needed to recover from the general surgery, the anesthesia and the scars, but once that settled down a little bit, my recovery went really smoothly.
“It’s crazy that it takes so long to get the right diagnosis. Hopefully, talking about it more will help women to understand that their symptoms are not normal and encourage them to go to the GP.”
Emma Cox, the chief executive of Endometriosis UK, says: “We’re incredibly grateful and thankful to Katya for speaking out. To have someone of her calibre talk about a disease like endometriosis really makes a difference. For elite sportspeople, endometriosis can be really challenging because you can’t change the fixture date or the dates of a national tournament.
“While period pain is normal, if that is interfering with your day-to-day life we’d say go and seek help from a doctor. The common symptoms are pelvic pain, heavy period pains, heavy menstrual bleeding, painful bowel movements, pain when urinating, pain during or after sex, difficulty getting pregnant and fatigue when you’ve got one or more of the other painful symptoms.”
Snoeijs has shown resilience to overcome medical hurdles throughout her life. Born with a hole in her heart and growing up with one leg longer than the other, her early years were not easy with several major surgeries as a child. “It makes me proud to think what I was able to reach with those kind of challenges,” she says. “And hopefully that will motivate people that go through the same.”
She is now focusing on the showdown with Liverpool at Goodison Park. Their rivals got the better of them in their most recent meeting, in the FA Cup. “We’re all really motivated. We all feel that was not our best game and that we have something to set right. And the derby is always special.”
There is a bigger public health focus on her mind, though, as she concludes with a passionate message to any women who think they may have endometriosis: “Trust your own feelings and your own body.
We, as women, are really good at understanding ourselves. Try to be confident and don’t let yourself be pushed away if you feel like you’re not being heard or not getting the right treatment. Even with a condition like this, it doesn’t need to impact your sport career. You can still play at the highest level.”
