My Story: Padma Lakshmi Talks to PPM about Living with the Emotional and Physical Toll of Endometriosis

The Top Chef and Food Network producer shares her painful diagnosis - a journey that began when she was just 13.

For Padma Lakshmi, the last week of September of 2018 was both gut-wrenching and gratifying. On September 25, in a powerful op-ed published in the New York Times, she revealed – as she had a few days earlier on Twitter—that she’d been molested at the age of 7 and raped when she was 16 and a virgin. Her decision to come forward was sparked by the hearings in Washington, DC. Writing about those incidents evoked strong emotions. “In the past three days I have been anxious, depressed, nauseous, sobbing…,” she posted on Instagram, “Doing this very difficult thing has been for me a necessary step… So many of you have messaged me with your own experiences and I am truly sorry that we share this trauma. But the only antidote is taking our power back by being as open as possible, and sending young girls and women the message that there is no shame in speaking out.”

A few days later, Lakshmi, 48, addressed the audience at a forum held at the Massachusetts Institute of Technology’s Gynepathology Institute where the model, author, activist, advocate, producer, host of the Emmy Award-winning TV show,  Top Chef, and co-founder with Dr. Tamer Seckin, of the Endometriosis Foundation of America, is now a visiting scholar. This time she spoke out about endometriosis, the disease that “impacted every aspect of my life as a woman and as a human being, professionally, personally, physically, psychologically and emotionally,” she said.

Reclaiming power, listening to your body, taking control of your own health and speaking out without shame to help others are principles that Padma Lakshmi practices daily. But her willingness to speak out about endometriosis didn’t come easily. Then again, neither did her diagnosis. It took 23 years.

Lakshmi was 36 when she first heard the word “endometriosis.”  Before that day in 2006, none of the gynecologists she’d consulted in the US and abroad had ever mentioned the disease.  For more than two decades, Lakshmi had struggled to manage the chronic pain that arrived in tandem with her monthly menses. She was 13 when she got her period and, like so many young girls, she was told that painful cramps—even severe ones—were part of the burden of being a female. But over the years, the pain steadily increased, worsening month by month and year after year. Eventually, she ended up in bed for days at a time desperately trying to alleviate the pain with hot water bottles and heating pads, drinking herbal teas and downing over-the-counter or prescription pain relievers such as Tylenol with Codeine or Vicodin when the piercing, relentless pain overwhelmed her. She also “suffered a lot from digestive issues,” she told Practical Pain Management (PPM).  “Around my period, I’d get constipated and feel nauseous.” She had headaches, backaches, and shooting pains down her leg.

Lakshmi didn’t let her monthly misery hold her back. After graduating from college in 1992, she snagged a modeling contract and decamped to Europe where she modeled, co-hosted an Italian TV show, did some acting, and honed her love and knowledge of the culinary arts. Back in the States, she published Easy Exotic, her first cookbook, and soon after hosted Padma’s Passport, her own show on the Food Network. A few years later, she landed at the Emmy Award-winning Top Chef, where she is now executive producer.

Top Chef, Food Network Producer Padma Lakshmi Padma Lakshmi shares details about being diagnosed with endometriosis (Source:123RF)

At Last, a Diagnosis

In 2006, during a photo shoot for her second cookbook, Lakshmi recalls that she began to bleed heavily in mid-cycle. Aware of her ongoing menstrual issues, her doctor recommended she see the laparoscopic surgeon and endometriosis specialist Dr. Tamar Seckin.

That appointment and the treatment that followed would change her life.  “It was the most thorough exam I ever had,” said Lakshmi. Even before the physical examination, Dr. Seckin asked questions of delicate nature, “very personal questions unlike anything I’d been asked before,” she said. In her memoir, Life, Loss and What We Ate, published in 2016, Lakshmi details that first appointment. He asked her about her sex life, her libido and her relationship with her then-husband, the author, Salman Rushdie.  He asked about her emotional and mental state during the week of her period. He asked about gastrointestinal symptoms: Did she experience constipation and gas around her period? He asked a lot of questions. And then during the physical, he performed a rectal exam, something no doctor had done before then, she said.  

Afterward, in his office, Dr. Seckin told her he believed she had severe endometriosis. “Endo what?” he remembers her saying.

Endo Revealed

According to the Endometriosis Foundation of America (EndoFound.org) endometriosis occurs when tissue similar to the lining of the uterus, or endometrium, migrates or grows outside of the womb invading areas of the body where it is unwelcome and unwanted. The endometrial-like tissue can move into the pelvic cavity and attach itself to one or more of the female reproductive organs including the fallopian tubes, and ovaries or crowd into the spaces between the bladder, uterus, intestines, vagina, and rectum. And because this invasive endometrial-like tissue responds to estrogen and progesterone, it continues to grow and thicken causing inflammation, lesions and scar tissue. Over time, these endometrial growths can wrap themselves around an organ, the intestine for example, causing severe complications.

Causes

Why this disease process occurs is still not clear. One theory suggests that endometriosis is present at birth and lies dormant until the tissue is activated by hormones released during a girl’s first menstrual period. Dr. Seckin and many others believe there’s a genetic link and that the disease can be inherited, a theory he explores in-depth in his book, The Doctor Will See You Now: Recognizing and Treating Endometriosis.  Retrograde menstruation is another theory that refers to a woman’s menstrual blood flowing back into her body during her period. “If the menstrual blood does not exit as it should, it may flow back into the body through the natural openings in the fallopian tubes,” said Dr. Seckin. With no way to exit, this menstrual blood is literally stuck inside a woman’s body where it implants in areas outside of the uterus in the pelvis and “creates and abnormal growth of cells and inflammation.” The ever-watchful immune system identifies these errant cells as invaders and tries to fight them off leading to more inflammation “with new blood vessels and stem cell activity resulting in deep and thick scar tissue,” said Dr. Seckin.

Food Network Producer and Top Chef Padma LakshmiPadma Lakshmi pictured at a 2018 awards show (Source:123RF)

Potential Link with Childhood Abuse

And just last month, days before Padma Lakshmi revealed her sexual abuse, in a study, published in in the journal Human Reproduction, researchers posited that endometriosis, has been linked to childhood physical and sexual abuse. In the study, sexual abuse was defined as mild (sexual touching); moderate (forced sexual activity during either childhood or adolescence); or severe (forced sexual activity during both childhood and adolescence).   Epidemiologist Dr. Holly Harris of Fred Hutchinson Cancer Research Center, lead author of the study, called the association between abuse and endometriosis “particularly strong,” since women reporting severe to chronic abuse had a 79  higher risk of developing the condition. “Both physical and sexual abuse were associated with endometriosis risk,” she said. “And it’s a strong association. There’s also a dose-response, meaning the risk increases with increasing severity and type of abuse.”

Dr. Seckin wasn’t surprised by the study findings. Dr. Seckin said he gives his patients a lengthy questionnaire. “And I ask for a psychological consultation for one of every four patients,” he said.  “Quite a few of them have experienced sexual abuse,” he said.  The reasons for the association aren’t clear but “it’s an interesting finding,” says Dr. Seckin. “And understanding the why may lead to a better understanding of the disease.”

 

Part 2 of this article addresses Lakshmi’s personal treatment plan for endometriosis.

 

 

Updated on: 10/18/18
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My Story (Part 2): Padma Lakshmi Talks to PPM about Treating Her Painful Endometriosis
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