Living with Endo? Read This Before Your Next Appointment

Everything You Actually Need to Know About Endometriosis

Let’s break it down: endometriosis is when tissue similar to the lining of the uterus (aka the endometrium) grows outside the uterus — where it definitely doesn’t belong.

During a typical cycle, estrogen causes your endometrial lining to thicken in prep for pregnancy. No baby? No problem. Estrogen drops, progesterone rises, and that lining sheds. Hello, period. 👋

But with endometriosis, this endometrium-like tissue grows in places it shouldn’t — think ovaries, fallopian tubes, bladder, intestines, and in rare cases, even the lungs. And here's the kicker: it still responds to hormonal changes each month, meaning it thickens, breaks down, and bleeds… with nowhere to go. The result? Chronic inflammation, scarring, severe period pain, pain with sex, digestive issues, infertility — and often, not being taken seriously.

Who Gets Endometriosis?

Endometriosis can show up at any stage of hormonal life: before your first period, during your reproductive years, and even after menopause. It most commonly affects women between 25 and 35 — but like most things in pelvic health, age isn’t the only factor.

And here's the real talk: no two people with endo experience it the same way. For some, it’s monthly pain that wipes them out. For others, it’s daily symptoms that just won’t quit. Either way, it’s real, it’s valid, and it’s often misdiagnosed or brushed off for years.

Symptoms to Look Out For:

• Debilitating period pain – Cramps so bad they stop someone from going to school, work, or doing everyday activities. These are not your average period cramps.

• Heavy bleeding – Bleeding a lot more than normal during periods.

• Chronic pelvic pain – Ongoing pain in the lower belly or pelvic area, even outside of periods.

• Ovarian cysts – Painful lumps on the ovaries (called endometriomas) that sometimes need to be removed surgically.

• Bloating – Feeling bloated or like the belly is full, even without eating much (common but often overlooked).

• Pain during sex – Sharp or deep pain during or after sex, especially with penetration.

• Infertility – Endometriosis can affect the ovaries, fallopian tubes, and eggs, making it harder to get pregnant. Infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse for women under 35.

• Combination of symptoms – Having more than one of these symptoms raises the chances of it being endometriosis.

Suspect Endometriosis? Here’s What Diagnosis Actually Looks Like

If your body’s throwing up red flags — pelvic pain, fatigue, pain with sex, gut issues, or all of the above — and you think endometriosis might be behind it, it’s time to loop in your care provider.

Your doctor will start by asking key questions:
📍 Where does it hurt?
📅 How often?
⚡ How bad is it?

From there, they may do a pelvic exam, ultrasound, or MRI to get a better look at your reproductive organs (think uterus, ovaries, and surrounding tissues). These less-invasive tests help rule out other conditions that can mimic endo — because yep, chronic pelvic pain can come from a lot of places.

But here’s the real deal:
👉 The only way to officially diagnose endometriosis is through laparoscopic surgery.
This minimally invasive procedure involves a small incision in your abdomen and a tiny camera that lets your surgeon look around. If they spot tissue that looks like endo, they’ll often remove it right then and send it to a lab for confirmation.

It’s frustrating that such a common condition still requires surgery to diagnose — but you deserve answers, not guesswork. And if you’re tracking symptoms over time (👋 hi, Lasa Health app), you’ll walk into that appointment with receipts.

Causes & Risk Factors

While the exact cause of endometriosis isn’t fully known, certain factors may make someone more likely to develop it. Some risk factors include: 

• Never giving birth

• Menstrual cycles more frequent than the average 28 days

• Heavy and prolonged periods

• Higher levels of estrogen

• Low body mass index (BMI)

• Structural issue with the vagina, cervix, or uterus that prevents menstrual blood from exiting the body

• Family history of endometriosis

• Starting your period at an early age 

• Starting menopause at an older age

Treatment & Management Options

First Step: Medicines

• Pain relievers like ibuprofen help with cramps and pain.

• Hormonal birth control (pills, patches, shots, or rings) control the levels of estrogen and progesterone in your body, reducing the growth and activity of the ectopic tissue present with endometriosis. As a result, symptoms are reduced.

• Stronger hormone therapies (like Gn-RH drugs or progestin) stop periods and shrink endometriosis tissue, creating an artificial menopause. As a result, this treatment often comes with menopausal side effects. To reduce side effects it is recommended to take a low dose of estrogen or progestin as well.

• Aromatase inhibitors lower estrogen to reduce tissue growth, often combined with other hormone treatments.
  

Following Step: Surgery

• Conservative surgery (laparoscopy) removes endometriosis tissue while keeping the uterus and ovaries; good for pain relief and improving fertility.

• Hysterectomy (removing the uterus and sometimes the ovaries), is typically considered a last resort for severe cases when other treatments have failed. While it's not a direct treatment for endometriosis, it is effective for adenomyosis—a condition with very similar symptoms. If endometriosis was misdiagnosed and the true cause is adenomyosis, this approach may provide significant relief.

Resources & Support

Lasa Health® is dedicated to supporting people suffering with endometriosis through personalized care, education, and a community.

Here's how we help:

• Our mobile Lasa Health® app creates individualized plans to help manage endometriosis, offering insights into symptoms, treatment options, and at-home flare-up strategies.

• Our 24/7 chatbot, provides instant answers to questions, suggests coping strategies, and assists with pain management techniques like pelvic floor and breathing exercises.

• An AI-powered online Endometriosis Assessment Tool helps users understand their symptoms and receive guidance on next steps toward diagnosis.

• Online support groups provide a platform for people to share patient stories and foster a sense shared experience among those affected by endometriosis.