‘Virgin River’ Shines A Rare Spotlight On Endometriosis In Season 5

Virgin River returned for its highly-anticipated fifth season on September 7, and after tackling fertility and pregnancy issues, cancer, traumatic brain injuries, Huntington’s Disease, macular degeneration, and more medical diagnoses, the Netflix drama is shining a rare spotlight on endometriosis this time around.

Season 5 welcomes several new characters to town, including Lily’s daughter and Tara’s oldest sister from Portland, Ava. Played by actor Libby Osler, Ava returns to the small town she escaped from to visit her family and the barn, and health complications and compatible personalities lead her and Mel to become fast friends.

After Ava inexplicably collapses from pain in front of Mel at the end of Episode 1, we learn that she has endometriosis, a medical condition rarely talked about on television that’s still being learned about and stigmatized in the real world today.

So what is endometriosis? And why is Virgin River‘s Season 5 storyline so important? Here’s what to know about the condition and Ava’s Virgin River experience. Just be mindful that some Season 5 spoilers lie ahead.

What Is Endometriosis? Understanding Ava’s Condition On Virgin River:

First things first, what is endometriosis? Per John’s Hopkins, endometriosis is a condition in which endometrial tissue grows outside the uterus that can result in “inflammation, scarring and painful cysts.” The disorder, which reportedly affects up to 10% of women between ages 15 and 44, can lead to incredibly painful period cramps, pelvic pain, pain during or after sex, and other symptoms. Though the cause of endometriosis remains unknown, experts have learned the condition is linked to infertility. And while there isn’t a cure for endometriosis yet, pain can be managed with hormone therapy, laparoscopic surgery, a laparotomy (larger incision than a laparoscopy to remove tissue), a hysterectomy (removal of uterus), and other treatment options.

Why Virgin River‘s Endometriosis Storyline Is So Important:

Despite its soap opera qualities and small town charm, Virgin River has never been a show to shy away from tackling serious topics or highlighting health issues that remain under-discussed in media. Ava’s endometriosis storyline is another perfect example of the series actively pushing boundaries.

After Ava collapses in pain at the end of the Season 5 premiere, she grabs lunch with Mel post-hospital and shares that she had laparoscopic surgery for endometriosis a few years ago and always knew there was a chance it could recur. The severe pain she experienced was caused by an endometrioma, or a cystic lesion that stems from endometriosis, and though the endometrioma didn’t rupture, the tissue started spreading again, so her doctor told her to consider a hysterectomy.

Later in the season, Ava passes out from her endometriosis pain again and hits her head, endangering her and Chloe’s lives during the wildfires. After talking through the life-altering decision to have a hysterectomy with Mel, Ava decides to go through with the surgery — but not without freezing her eggs first. Because endometriosis can impact fertility and a hysterectomy eliminates the chance of becoming pregnant, showing Ava and Mel chat about the implications the condition has on her ability to give birth was incredibly important, as was Mel reminding Ava that “being a parent is so much more than how you got there,” and that other options like surrogacy and adoption would still be viable should she ever want to start a family.

The endometriosis conversations — and Ava’s scenes in general — were scarce in the grand scheme of Virgin River Season 5, but the on-screen exploration of the condition was crucial for viewers. Representation of all sorts — in this case, of a medical condition that’s still stigmatized in today’s society — helps raise awareness and educate people on endometriosis, its impact on fertility, the toll it can take on a person’s quality of life, and treatment options. Ava may be leaving town soon, but here’s hoping the series continues giving us updates on her down the line. (And that endometriosis doesn’t solely define her character.)

Virgin River Season 5 is now streaming on Netflix.