Guam : Endometriosis Care & Support

Satellite image of Guam that reads Greetings from Guam

Hafa Adai!

I’ve been wanting to look into territories and countries around the world to see how they are dealing with Endometriosis.   Not only does it give me a chance to learn about other areas in our world, but it is a very fun research tool for me (I love to look things up, to reach out to facilities, physicians, and people)…This blog lets me know where my viewers are located, so it’s fun when I see views from places I either have NEVER heard of, or places that I don’t know much about…

As of today (1/4/21), our blog has received 230 views from people in Guam.  That to me shows that someone in Guam is searching for answers about Endometriosis; which made me wonder what sort of medical care and support there is in Guam for someone suffering from Endometriosis.  So…I’ll start this geographical project off with GUAM!

Guam is considered a territory of the United States and anyone born on this small island is a citizen of the U.S.  Yet, it is only inhabited by 162,000…and when I say small, Guam is 30 miles long and 12 miles wide and could take a little over an hour to drive from tip to tip (but that’s in a perfect world without any traffic or stop lights…).  It’s about a 3.5 hour flight to Tokyo (and for perspective, it’s about an 8 hour flight from Guam to Hawaii).

Most of the medical care facilities are in the northern central portion of the island.  The island’s main healthcare facility is Guam Memorial Hospital in Tamuning, which is run by the Guam government.  There is the US Naval Hospital in Agana Heights for active-duty personnel and their dependents.  It boasts of 42 beds and offers inpatient and outpatient services.  Guam Regional Medical City is a privately owned hospital in Dadedo which opened it’s doors in 2015 after four years of planning and construction.  It has 130 beds and was a $240 million investment by The Medical City.

With Endometriosis proving to be such an expensive disease to have and handle, I thought I’d look into the economics of Guam.  The standard household brings home roughly $50,000 per year, although these figures may be skewed by the presence of military jobs and families.  A friend of mine who lived on Guam said that most non-military families make less than $40,000 per year.  That means that household makes about $24.00 per hour, assuming they work full-time.  Keep in mind, though, that Guam has a 13% unemployment rate and 20% of it’s citizens are uninsured.  The passing of the Affordable Care Act (aka Obamacare) has left Guam in a bit of an insurance tizzy…some of the policies of Obamacare apply to Guam, but not all.  However, since Guam is considered a US territory Medicare is an option for certain people, although I’ve been told a lot of medical facilities don’t take Medicare in Guam.

In 2007, an editorial report was published which identified various toxins and chemicals that may be found in Guam’s air, water, and food.  Many people believe Endo may be caused or aggravated by exposure to certain elements, many of which are identified in this paper.

An article was published in the August 3, 2015, edition of the Pacific Daily News, following the story of Catherine Manlapaz and her Endometriosis journey.  Her OBGYN, Dr. Thomas Shieh, also offers some insight into Endometriosis.  It’s exciting to see the media of Guam sharing such stories!

There are also about a dozen other physicians identified around Guam that treat Endometriosis.  If you’re in Guam you can search for a physician.   All appear to practice out of Tamuning.  I emailed as many of these physicians as I could hoping to get further information their practices and Endo experience, but realize that they are all so very busy.  To date, I haven’t received a response.

Catherine Manlapaz now works at Mantrasana Fitness Studio in Barrigada, furthering her passion of health, diet, and exercise.  I got in touch with Catherine and she agreed to answer some questions for us.  If you would like to, you can email her.   See below for my Q&A with Catherine about her experience with Endometriosis while living in Guam:

  1. How long had you been suffering from your symptoms before going to your doctor to be checked out?

I was diagnosed in 2009, suffering for how long is questionable. I was age 24 when diagnosed. It’s possible I had it since high school. Of course as a young girl I was unaware that having a menstruation period for 2 days was abnormal especially with major abdominal pain. I thought it was part of having a period growing up. A month before I was diagnosed, I felt an annoying slight pain thinking it was appendicitis. After a month I went to the doctor to have it checked (April 2009), turns out it was my ovary was the issue in which they saw was a cyst the size of golf ball. By June 2009 I had my first surgery to remove it.

  1. How was your diagnosis process? Lots of women get bounced around from doctor to doctor or receive multiple misdiagnoses. Do you feel Endo is well understood in Guam?

Dr. Shieh was my main doctor at that time and still is my doctor till now. My mom wasn’t too comfortable with Guam’s hospital, so we did go Manila for a second opinion. My mother also has endometriosis also, and preferred I see her doctor. I don’t think Endometriosis is understood in Guam by women, because not many individuals share their stories. I only know of two women who are twins about 10 years older than me that have Endo. I only know because mainly they had miscarriages and have no kids until now.

  1. I know you were referred to a specialist.  Was that specialist Dr. Shieh, or someone else? If someone else, who?

Dr. Jose Moran of St. Lukes Philippines was the main doctor to do my surgery, and it turns out he has quite few patients from Guam. He is also part of the Guam Regional Medical City, as he travels to Guam once a year for them.

  1. Did you have medical insurance to pay for your surgery/Lupron/BC?  Or was it all out-of-pocket?

I had medical insurance to pay for my surgery.

  1. Was your surgery a laparotomy (big incision across abdomen), a laparoscopy (little incisions and little tools), or was it a robotic-assisted laparoscopy?

The surgery performed was actually oophorocystectomy in which was a small bikini cut (like modern day c-section I’ve been informed). A tool was utilize to vacuumed the cyst out. I did not have the laparoscopy as most women do. I think the reason for a different type of surgery is that St. Luke’s Philippines is advanced.

  1. Do you know of other women in Guam with Endo?

Yes, the twins I mentioned that are 10 years older than I.

  1. Are there support groups for Endo in Guam?  

No support groups.

  1. What do you do for the fitness studio?  Anything I can say to point gals to the studio?

My studio was just newly opened on February 15. I am the instructor for Prenatal Yoga, Mommy Baby Yoga, and the Aerial Yoga classes. Other types of classes are taught by instructors. The studio is open to both male and female, all levels are welcomed. No experienced required. Only the advanced classes in future will require the experience, but because Aerial Yoga is brand new to Guam. Everyone has to take the basic classes first.

  1. Do you know of any other “Endo experts” or “specialists” in Guam?

Unfortunately No.

  1. Any words of advice for EndoSisters on Guam, and worldwide, you’d like me to share?

I recommend everyone to do research. What really helped me battled Endometriosis is my diet (which doctors never told me). Basically, estrogen is good for women, but not for those with Endometriosis. Any food that affects hormones will aggravate the pain. I stay away from tofu and edamame (my favorite food too), but they contain soy, which affected me most in my symptoms. They say wheat and dairy is bad also, however, after testing what’s good for me or not. I eat wheat and dairy in moderation, the effect they have on me is very low – it’s possible because I work out at the same time as well. Before, I didn’t work out much that wheat bread really got to my body that my hands would swell a lot. Now, I eat wheat every day and it doesn’t bother. Only soy products affect me much.

  1. Are you on any medications now? Or just keeping your Endo in check with diet and exercise?

I stay away from medications such as Lupron and the pills because they have a huge side effect on my mood. It made me unhappy or emotional. I’m more happy not being in medication and focus on the diet and exercise, less symptoms as well. If I feel bad symptoms it’s a sign I’m not working out much or I’m eating bad. Therefore, I work out harder and be more mindful of my diet

You’re welcome to follow Mantrasana Fitness Studio on Facebook.

However, me opening the studio didn’t relate much to Endometriosis. I pursued Yoga on a different level of inspiration. For me working out was going to the gym and lifting weights. I always figured, if estrogen is bad for me, I need more testosterone then to battle Endometriosis. Somehow, it worked for me that way.  Unfortunately, I don’t have time for the gym weights anymore. But Aerial Yoga works the body out a lot that it helps me exercise still.


I would like to thank Catherine for taking the time out of her busy schedule to answer our questions!

If you’re living in Guam and have Endometriosis, let me know!  I’d love to be able to get you women together…you are not alone!

Or if you’d like me to research your area, drop me a note 🙂

(Updated January 4, 2021)


Blue Water Navy

Dr. Shieh’s Clinic

Global Security

Guam Chamber of Commerce

Guam Memorial Hospital

Guam Regional Medical City


Military Installations

Pacific Daily NewsDiet & Exercise to Combat Endometriosis

The Washington PostThink Your State has Obamacare Problems? They’re Nothing Compared to Guam


~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s