How endometriosis led Paralympian swimmer Murphy to infertility

When Paralympian swimmer Monique Murphy lost her leg in 2014 after falling from a balcony after a suspected drink spike, she knew her life would look different.

But what she couldn't have guessed was that almost 10 years later, she would be losing another body part - her uterus.

In 2023, Murphy underwent a hysterectomy - the surgical removal of the uterus and cervix - after almost a decade of suffering with endometriosis and adenomyosis, the pain of which, she says, has been worse than losing her leg.

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'I had to listen to my body, even if it wasn't what I wanted to hear'

Since her accident, Murphy has had more than 15 surgeries, and despite that, she won a silver medal in the women's 400m freestyle S10 at the 2016 Rio Paralympic Games - exactly 900 days after her fall.

But throughout her training, she suffered agonising pain because of her endometriosis, a situation made worse after coaches disregarded it.

"Every surgery was getting worse and worse," Murphy told Sky Sports.

"The option was to either keep my uterus and risk having even more surgeries or have it removed. It wasn't easy.

"It was a difficult decision for me because I wanted to have kids, but I was not ready. I want to be a parent, and being pregnant would have been an incredible experience, but I had to get realistic about my body's capabilities.

"I've put my body through a lot, not just by being an elite athlete, but after my endometriosis started affecting my lungs, that was the last line for me.

"It was about listening to my body, even if it's not what I want to hear. There is a limit to what our bodies can go through, and I have tested that limit well and truly."

Murphy had to go through 14 doctors until she received her endometriosis diagnosis.

It currently takes an average of eight years and 10 months to get an endometriosis diagnosis, according to the charity Endometriosis UK.

The number of people waiting for treatment on the NHS has doubled to 7.5 million, and even though targets state that 92% of patients should begin treatment within 18 weeks, that target has not been met for nearly a decade.

Around one in 80 to 100 pregnancies end up as ectopic - when a fertilised egg implants itself outside of the womb. That risk is more than doubled in those with endometriosis.

Endometriosis also increases the risk of having a miscarriage.

'The finality of these decisions is not new to me'

When Murphy told her doctor she wanted a hysterectomy, she was already familiar with the enormity of that decision, having chosen to amputate her leg previously.

Murphy references Friends, the American television sitcom, in which all three women become mothers in different ways. It is an example of how conversations about infertility have been represented in mainstream media, unlike disability.

"From the age of 15, I was already aware of the concept of surrogacy, but there wasn't any representation of amputees or disability," Murphy added.

"As sad as it is to never have children [through pregnancy], it's something I can envision a bit easier than learning to live without a leg at 19.

"I was also very comfortable with the idea that when I amputated my leg, it's not growing back. The finality around these decisions is not new to me.

"Some people have asked: 'Would you want your leg back?' but it's not like a choice I have, so I don't entertain it.

"I have the life I have and I live it to the best of my ability, whatever that looks like. It's the same with the hysterectomy, I don't want to look back and wonder what may have happened because you don't know.

"I can't do anything about my disability, I have to manage that. There's nothing that will grow my leg back.

"I had been trying to manage my endometriosis for years and spent a lot of money on it. This wasn't the first idea that came into my head, I had exhausted all the other options."

Murphy went through a process of grieving her uterus and ability to get pregnant, something that hit her harder in her thirties.

"As I got older and more people around me started getting pregnant, it was challenging because I was watching someone do something my body couldn't and I had chosen that," Murphy added.

"There is a bit of sadness, and when you're going through a loss, it can feel isolating.

"Whenever I question the decision, I have to remind myself that if I had chosen to get pregnant, there would have been hurdles in that as well, like having a pregnancy on a prosthetic leg."

Exploring surrogacy and parenthood

While Murphy no longer has her uterus, she still has her ovaries and her eggs, meaning she can become a parent via a surrogate, an option she has started exploring.

"Anything to do with reducing my pain, my partner [Andrew] is on board with," Murphy said.

"Him supporting me means he is giving something up as well, and when you start going through the process of surrogacy, you realise how little education we have on these things.

"He wasn't with me during my accident, whereas my family was, so their understanding is a bit different.

"I was on life support for a week and nearly died, I have to remember that.

"Our bodies excel in different ways, and being pregnant is something I marvel at. I've got friends having kids at the moment, and it's amazing.

"The end result is a baby, and there are still ways my partner and I can do that; it will just be different."

Murphy is an ambassador for QENDO, an organisation that advocates for those affected by endometriosis and other pelvic health-related conditions across Australia and New Zealand.

QENDO has backed The Global Alliance for Female Athletes (GAFA), an international collaboration that sees health practitioners and sports scientists from Australia, the United States, the United Kingdom, and New Zealand work together to help female athletes overcome prevalent health issues.

This pioneering initiative aims to close the critical gap in health literacy and research surrounding female-specific conditions that impact athletic performance, such as endometriosis, adenomyosis, menstrual health disorders, and hormonal imbalances.

QENDO put Murphy in touch with other women who had gone through similar experiences, all of whom relayed a positive experience allowing her to find support.

'There is more than one way to be a woman'

Pregnancy is often seen as the pinnacle of womanhood, but that association can become quite damaging for women who struggle with infertility.

After her accident, Murphy was aware of how quickly identity can shift and change.

"Having gone through my accident and journey as a swimmer, I proved so much to myself in terms of my identity, who I was, and what I was capable of," Murphy said.

"I got so good at advocating for myself and spent the last 10 years building up that identity that it was quite rock solid.

"I don't have a sense of needing to do something to prove I'm capable because I've well and truly done that, and part of that is because my life has turned out so differently from what I might've envisioned as a child.

"There are women who don't get periods, or are going through menopause, or can't conceive naturally, that doesn't mean you're less of a woman, you're still who you are."

"There is no one experience that makes you a woman, there is more than one way to define us."

For more information, go to the Endometriosis UK website