Country music icon Dolly Parton raised the roof during the halftime show of an NFL game in Texas yesterday, as the legend sang two of her biggest hits, ‘Jolene’ and ‘9 to 5’.

The 77-year-old sent the crowds wild as she flaunted a daring cheerleading outfit, but despite her youthful appearance, Dolly has battled health problems for a large part of her career. The Islands in the Stream star found fame in 1967, and has sold more than 100 million records worldwide, with 25 reaching top spot on the Billboard country music chart.

In 2017, she opened up about her health issues in her book titled ‘Dolly on Dolly: Interviews and Encounters with Dolly Parton’. The musician was just 35-years-old when she first became unwell, as she confessed: “I was getting away with murder. I wasn’t watching what I ate, I wasn’t conscious of nutrition, wasn’t taking care of myself.

“I was working hard, and underneath I was a pile of personal and emotional problems. All at once I fell apart. It was stomach problems and female problems—all over health problems actually.” Issues emerged after Dolly found huge success with her hit-song ‘9 to 5’, and her film debut with ‘The Best Little Whorehouse in Texas’ in the 1980’s.

In 1984, Dolly’s health exacerbated when she collapsed on stage in Indianapolis, after ignoring doctor’s orders not to perform. She was eventually diagnosed with endometriosis, which is a condition where tissue similar to the lining of the womb grows in other places, such as the fallopian tubes and ovaries, explains the NHS. At the age of 36 she was forced to undergo a partial hysterectomy, ending her chances of conceiving naturally. John Hopkins Medicine notes that this surgery involves the removal of the uterus, leaving behind the cervix.

This pulled Dolly into a deep depression, which saw the star binge eat, consume excessive alcohol, and even contemplate suicide at one point. Writing in her book, she said: “Suddenly I was a middle-aged woman. I went through a dark time, until I made myself snap out of it.”

The tragic events led to Dolly quickly gaining 50Ibs, as she admitted she would eat three pizzas, but still crave McDonalds and French fries. This led to an unhealthy eating pattern, as she said: “On top of being medicated, Dietin’ Dolly would go on liquid protein, Scarsdale, Atkins, the water diet, then I’d binge, diet, gain, start all over again. Eventually my system wouldn’t work anymore. My body couldn’t hold up under that strain. Overeating is as much a sickness as drugs or alcohol.”

What is endometriosis?

Around one in 10 women of reproductive age in the UK – between puberty and menopause – suffer from endometriosis, highlights Endometriosis UK. The World Health Organisation (WHO) explains that the condition occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to inflammation and scar tissue forming in the pelvic region. It is the second most common gynaecological condition in the UK, but it takes on average eight years for symptoms to be diagnosed. Unfortunately, the cause of endometriosis is unknown and there is no way to prevent it. However, WHO explains that symptoms can be treated with medicines, and in some cases, surgery.

Symptoms

Symptoms of endometriosis can differ from person-to-person, however the most common warning sign is dysmenorrhoea (painful periods). The NHS has highlighted other red flags to watch out for, these include:

• Pain in your lower tummy or back (pelvic pain) – usually worse during your period
• Period pain that stops you doing your normal activities
• Pain during or after sex
• Pain when peeing or pooing during your period
• Feeling sick, constipation, diarrhoea, or blood in your pee or poo during your period
• Difficulty getting pregnant
• Heavy periods – You might use lots of pads or tampons, or you may bleed through to your clothes

Treatment

You should write down your symptoms and visit a GP, especially if they’re having a big impact on your life. It’s important to note that these symptoms do not necessarily mean you have endometriosis, as they are often mistaken for other health conditions such as irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID). The health body has also shared the treatment options available, these include:

• Painkillers – such as ibuprofen and paracetamol
• Hormone medicines and contraceptives – including the combined pill, the contraceptive patch, an intrauterine system (IUS), and medicines called gonadotrophin-releasing hormone (GnRH) analogues
• Surgery to cut away patches of endometriosis tissue
• An operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy)

In most cases, people who have a hysterectomy can be in hospital for up to five days after surgery, with full recovery taking about six to eight weeks.

Dolly Parton recorded “Puppy Love,” her first single, when she was a teenager. (Jon Morgan/CBS via Getty Images)

“Work is everything to me,” she told the outlet. “That’s all I know. It’s what I do. It’s how all these things have come to pass.” She believes that songwriting is her “gift” but said, “I love to sing, too, and I love to perform. So, it’s just all one thing to me.”

“I was silly enough to believe it could be done, and I didn’t know it couldn’t be done, until I did it, as they say,” Parton explained of her impressive career. “I’d worked in the fields, being a country girl, and I’ve done all that menial labor because that was just the chores and stuff we had to do back home. But I hated every minute of it. I didn’t like school, either.”

Dolly Parton grew up in a one-bedroom cabin with her parents and 11 brothers and sisters. (Michael Ochs Archives | Suzanne Cordeiro)

She famously moved to Nashville to pursue a music career the day after she graduated from high school, saying now, “I thought, ‘Well, what’s the worst that can happen? I can always go back home, study to be a beautician and still get cheap makeup and bleach and all the stuff that I was going to always do, no matter what.'”

Parton has always been open about her appreciation for “cheap makeup and bleach,” and even though, these days, she has more than enough money for high-end makeup and has said she has several wigs, she still maintains the same aesthetic.

“But I thought, ‘Well, at my age, if I can pull it off, it’s going to be good. And if I don’t, I can just pass it off as an old woman doing a stupid-a– thing,'” Parton said. “I’ve always said my desire to do something is greater than my fear of it.”