When I was nine years old, I noticed blood in my urine, and it scared me. Most girls don’t start their period until they are around the ages between twelve and fourteen, so my mom didn’t think to explain what a period was to me until that day. I remember it vividly: being nine and seeing blood in the toilet bowl is pretty horrific if you don’t know what’s going on. My mom wasn’t too sure why I had gotten mine so young, my sisters were older when they started theirs, and my mom was older as well, but she explained that it was something I would face every month until my forties. If only it were that simple for me.

The older I got, the worse the periods became and the more pain I experienced. Were cramps supposed to be this painful? Doctor after doctor, year after year, nothing changed for me. I would take 800mg of ibuprofen for two weeks at a time to make it through the dreaded shark week. For several years, I thought that this was normal. It wasn’t. My friends were not going through the same pain that I was, and their hot flashes never lasted as long as mine did. Something was wrong with me, but no one seemed to grasp that concept.

Through puberty and most of my teenage years, I spent quite a bit of time in the hospital. I have had two surgeries where I have needed painful cysts removed through a cystectomy. They are small operations, and usually, patients are sent home on the same day, but it is stressful. I started to question everything, such as if I would ever have children, am the I higher risk for certain cancers, and will I always be in pain?

I have PCOS, which stands for polycystic ovarian syndrome. It is a hormonal disorder that completely throws my balance off. It is the most common hormonal disorder that affects women in a reproductive age range. Some of the symptoms I suffer from are hair loss from my scalp, excess facial and body hair, weight gain, depression, irritable skin, and an irregular menstrual cycle. There are months where I won’t get my period, and there are months where I get it multiple times. It is a struggle not knowing when it’s going to hit me. When it does, Aunt Flow packs quite the punch.

Between 1 in 10 and 1 in 20 women of childbearing age has PCOS and it may affect over 5 million women. There is no known cause of this problem, but many believe that it’s genetics. It isn’t curable either. Right now at 21 years old I have PCOS, and I will die with it, too. Though not curable, it is treatable. Treatment options vary from person to person. For some, proper dieting and weight loss can help, but others need to go through hormonal therapy which usually includes birth control and other prescriptions like metformin.

PCOS is the most common cause of infertility and doesn’t just affect your hormones, it is also harmful to your heart and blood vessels as well. It causes anxiety and depression and can take a hard hit on appearance which is stressful in itself. I worry about young girls fighting PCOS and their self-esteem. Growing mustaches, balding, and gaining weight throughout puberty and the teenage years is tough, the added anxiety and depression do not help. Coming from my experience, this isn’t easy to handle.

September is PCOS and ovarian cancer awareness month. Take time during the month to learn more about the female reproductive system. The world is so concerned about reproduction, but no one seems to be too concerned with the complications that can arise in that department. It is hard to deal with a menstrual cycle, once you throw complications in things can get a little messy. When you see a person struggling, be kind. You have no idea what kind of silent civil war they may be fighting. Not all diseases are visible, keep fighting for reproductive health rights.