What Is Endometriosis?
Or better titled: Why does it feel like my uterus is trying to kill me?
If your period pain feels less like a dull cramp and more like your insides are being twistedup like a wrung-out dish towel — you’re not being dramatic. You might be dealing with endometriosis.
Endo-What?
Endometriosis (or “endo” for short) is a condition where tissue that’s similar to the lining of your uterus (you know, the stuff that comes out during your period) starts growing in places it’s not supposed to. Most often, that means the pelvis — either on or near your ovaries, fallopian tubes, bladder, uterus, and rectum. Rarely, endometriosis can show up elsewhere in the body — but those cases are uncommon — so let’s just focus on the basics for now.
Once a month, this rogue tissue acts like it’s still inside the uterus — it responds to your hormonal cycle, swells, bleeds, and inflames. But since it has nowhere to go, it builds up. Your body, trying to help, kicks off a big cleanup response — but that response often makes things worse. Think of it like tossing water on a grease fire: your body means well, but it might just be adding fuel to the flames.
What Does It Feel Like?
Endo pain hits different. It’s not just “cramps.” It can feel like:
- Sharp, stabbing, or burning pelvic pain
- Pain during sex (especially deep penetration)
- Pain with bowel movements or urination
- Chronic lower back pain
- Pain that radiates or shoots down the legs
And endo isn’t just physical. It can also cause:
- Nausea or vomiting
- Fatigue that feels like your energy has been siphoned
- Mood changes or emotional shifts that don’t feel like “you”
Can It Affect Fertility?
For some people, yes. Endometriosis can interfere with getting pregnant — usually in more advanced or severe cases. If you're trying to conceive and it's not happening as expected, or if you're planning to in the future, bring it up with your doctor early. There are options.
How Do You Know It’s Endometriosis?
Most of the time, endo doesn’t show up on imaging like ultrasounds — unless it’s caused a visible cyst (like an endometrioma) or is very advanced. It also usually can’t be confirmed with a standard pelvic exam — unless you’re seeing someone who knows exactly what to feel for.
The only definitive way to diagnose endometriosis is through a procedure called laparoscopy, where a surgeon looks inside your abdomen with a camera — and if trained, removes any endometriosis they find during the same surgery.
That said, if your symptoms strongly suggest endometriosis, a good provider may begin treatment even without surgery. Not everyone needs to go straight to the OR.
If your doctor dismisses your pain or makes you feel like you’re overreacting, it may be time to get a second opinion — ideally from someone who specializes in endometriosis. On average, it takes people seven years and seven doctors to get a correct diagnosis. (Let’s change that, shall we?) With better provider and patient education — hint hint, Femanual — we’re hoping to make that timeline a whole lot shorter. But until then, keep advocating for yourself. You’re not imagining it.
What Can You Do About It?
Endometriosis often needs a multi-pronged approach to get under control. Some of the most common options include:
- Hormonal medications – These can suppress the endometriosis tissue or stop your cycle altogether.
- Hormone blockers – (like GnRH agonists or antagonists) to temporarily shut down your reproductive system and reduce symptoms.
- Laparoscopic surgery – To remove the endometrial tissue, and in some cases, to remove pelvic organs depending on fertility goals and other individual factors.
- Other treatments – Such as pelvic floor physical therapy, pelvic nerve blocks, or targeted pelvic injections.
- Anti-inflammatory diets or supplements – Some people report finding symptom relief through dietary changes or specific supplements. We love an all-natural sister - but just know that these are less well-studied than prescription medicines. Always check with your provider first. Some that have been suggested include: Omega-3 (Fish Oil), Curcumin, NAC, Magnesium, Zinc, Resveratrol
Managing the Pain in the Meantime
Even with a good plan in place, finding the right treatment — or getting access to surgery — can take time. And pain doesn’t hit pause while you wait.
Here are some options that may help you manage day-to-day symptoms:
- Over-the-counter anti-inflammatories like ibuprofen or naproxen
- TENS units for pain modulation
- Heating pad for localized relief
You don’t have to suffer in silence while “waiting it out.” The most important thing is finding a doctor who takes your complaints seriously and is willing to work through the process with you — not against you.
A Note on Medical Gaslighting
Too many people with endometriosis are told they’re just bad with pain, overly sensitive, or “probably just stressed.” Or worse — that having a uterus means you’re supposed to suffer. Let’s be clear: that’s BS.
Pain is real. Your body is real. And if something feels off, it probably is.
If it feels like your uterus is staging a coup, you deserve a doctor who’s ready to join the rebellion.
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