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March: Endometriosis Awareness Month

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Understanding Endometriosis: What You Need to Know

Image of uterus and fallopian tubes with flowers growing out of the uterus to symbolize femininity and healing.

If you’ve been struggling with painful periods, unexplained pelvic pain, or even infertility, you may have found yourself asking: Could it be endometriosis? Maybe you’ve already been diagnosed but feel like you’re still searching for answers. If that sounds familiar, you’re not alone.

Endometriosis affects at least 1 in 10 women of reproductive age worldwide. It’s a complex condition that has no official cure—yet—but there are ways to manage symptoms and improve quality of life. In this post, I want to break it down in a way that makes sense, give you the most up-to-date medical insights, and point you toward trusted resources.

So, let’s dive in.

What is Endometriosis?

At its core, endometriosis is an estrogen-dependent inflammatory disorder where tissue similar to the endometrial lining (the lining inside the uterus) grows outside of the uterus. Unlike normal endometrial tissue that sheds during a period, this ectopic tissue has no way to exit the body.

Instead, it reacts to hormonal changes just like the uterine lining—thickening, breaking down, and bleeding with each cycle. This can cause inflammation, irritation, scarring, and adhesions (where organs and tissues stick together, creating even more pain and dysfunction).


Where Does It Grow?

While endometriosis is most commonly found in the pelvic organs, such as:

  • Ovaries

  • Fallopian tubes

  • Uterine ligaments

  • Bladder

  • Rectum

It can also spread to less common areas, including the diaphragm and even, in rare cases, the lungs.


What Causes Endometriosis?

Unfortunately, we don’t have a single answer yet. But here’s what we do know:

  • Hormones Play a Role – Endometriosis is estrogen-driven, which is why many treatments focus on hormone regulation.

  • It Has a Genetic Component – If your mother or sister has endo, you’re at a higher risk of developing it.

  • Retrograde Menstruation is a Leading Theory – This means menstrual blood flows backward into the pelvis instead of exiting the body, potentially leading to implantation of endometrial-like cells in places they don’t belong.

  • The Immune System Might Be Involved – Some research suggests immune dysfunction plays a role in allowing endometrial tissue to grow outside the uterus unchecked.

  • It’s Often Linked to Other Conditions – There’s a strong association between endometriosis, IBS (Irritable Bowel Syndrome), fibromyalgia, and even autoimmune disorders.

Symptoms: It’s Not Just “Bad Periods”

Reproductive aged woman holding her abdomen with her hands as if it is hurting

One of the biggest misconceptions about endometriosis is that it’s just “bad cramps.” While period pain is one symptom, endo can show up in many different ways, including:

  • Severe menstrual cramps (Dysmenorrhea) – The kind that isn’t relieved by over-the-counter pain meds and interferes with daily life.

  • Pain during sex (Dyspareunia) – A deep, aching, or sharp pain that occurs during or after intercourse.

  • Painful bowel movements (Dyschezia) – Endometrial lesions near the rectum can make bowel movements excruciating, especially around menstruation.

  • Chronic pelvic pain – Some women experience pain all the time, not just during their period.

  • Spotting or bleeding between periods – Especially if you notice consistent spotting a couple of days before your cycle starts.

  • Pain during ovulation – Some women feel intense pain mid-cycle when the ovary releases an egg.

  • Infertility – Many women don’t realize they have endometriosis until they struggle to conceive.

  • “Silent” Endometriosis – Not everyone with endo experiences pain. Some cases go undiagnosed for years because the symptoms aren’t obvious.

💡 Biggest Red Flag! If your period pain is so severe that it affects your daily life and you are running through your Advil bottle just to get by, that’s not normal. Pain that stops you from going to work, school, or getting out of bed needs to be taken seriously. If your current doctor does not ask about the nature, status, and frequency of your pain you should seek out an OBGYN familiar with endometriosis.

How is Endometriosis Diagnosed?

Endometriosis cannot be diagnosed with a simple blood test or ultrasound. While imaging can suggest the presence of endometriosis (especially deep infiltrating endometriosis or ovarian cysts called endometriomas), the gold standard for diagnosis is:

  • Laparoscopic Surgery – A minimally invasive procedure where a surgeon inserts a small camera into the abdomen to look for endometrial lesions. If found, a biopsy can confirm the diagnosis.

  • 🔎 Why is surgery necessary? Many endometrial lesions are too small to be seen on an ultrasound or MRI. This is why some women are misdiagnosed for years.

Treatment: What Are Your Options?

There is no single "one-size-fits-all" treatment for endometriosis. The best approach depends on your symptoms, goals (pain relief vs. fertility), and how your body responds to different treatments.


Western Medicine Options

  • Hormonal Medications – Birth control pills, progesterone, or GnRH agonists (which put you in temporary menopause) to suppress endometrial growth. But, these don’t work for everyone and symptoms often return when the meds stop.

  • Pain Management – NSAIDs like ibuprofen can help, but they don’t address the root cause.

  • Surgery – Excision surgery (removing the endometriosis lesions) is considered the best surgical treatment. However, if not done correctly, tissue can regrow.



Holistic & Alternative Support

Abstract image with a pink heart in the center

Western medicine focuses on symptom suppression, but a whole-body approach can provide additional relief:

  • Acupuncture & Herbal Medicine – Help with pain relief, hormone regulation, and reducing inflammation.

  • Dietary Changes – Many women find relief by reducing inflammatory foods (sugar, dairy, gluten) and increasing omega-3s, leafy greens, and gut-friendly foods.

  • Pelvic Floor Therapy – If pain during sex or chronic pelvic tightness is an issue, working with a pelvic floor physical therapist can be life-changing.

  • Stress Management – Yoga, meditation, and breathwork can help regulate the nervous system and reduce pain perception.

Final Thoughts: You Deserve Answers

If you suspect you have endometriosis, trust your body. Advocate for yourself. If a doctor dismisses your pain, seek a second opinion—ideally from an OBGYN who specializes in endometriosis. (See here for Dallas specific endometriosis support)

And don’t stop there. Consider seeking support from other alternative medicine providers who understand the complexities of this condition.

You are not alone, and you do have options.

Further Resources