Editor’s Note: In this fortnightly column, top doctors share how they deal with their own health challenges, offering readers expert insight grounded in experience. .
I am a doctor, and most women I meet do not know what endometriosis is.
I remember her clearly. She was 32, neatly dressed, composed, the kind of woman who had learnt to manage everything: work, family, expectations, pain.
For years, she had organised her life around her periods. She avoided travelling on certain dates. She kept painkillers everywhere: in her handbag, her office drawer, and next to her bed.
She planned meetings carefully. She cancelled dinners at the last minute. Every month, she prepared herself for pain strong enough to make her nauseous and light-headed.
She had been told, more than once, that she simply had a “low pain threshold.”
When I explained that she had endometriosis, she didn’t react immediately. She just looked at me and asked quietly, “Why didn’t anyone tell me this earlier?”
I have heard that question many times.
A WORD MANY WOMEN HEAR TOO LATE
Endometriosis affects an estimated one in ten women of reproductive age. Yet most women who sit across from me have never heard the word before.
They come in saying:
- “My periods are just very bad.”
- “I think I’m weak.”
- “Maybe this is normal?”
It troubles me that so many women believe suffering is part of being a woman. It troubles me even more that they have been made to believe that.
WHAT I EXPLAIN IN MY CONSULTATION ROOM
When I diagnose endometriosis, I take a deep breath before I begin explaining. For many women, this is the first time someone is connecting the dots for them.
Endometriosis occurs when tissue similar to the lining of the uterus grows outside it on the ovaries, fallopian tubes, bowel, bladder, or the lining of the pelvis.
Every month, this tissue responds to hormonal changes. It thickens, breaks down, and bleeds.
But unlike menstrual blood, which exits the body, this bleeding has nowhere to go. It causes inflammation, swelling, and irritation. Over time, scar tissue forms. Sometimes organs begin to stick to one another.
This is why the pain can be so deep and relentless.
When I describe this, I often see something shift in my patients’ faces: recognition, relief, validation.
MORE THAN “JUST BAD PERIODS”
Many women minimise their symptoms when they first speak to me. Only after gentle questioning do the details emerge:
- “Yes, I do miss work sometimes.”
- “Yes, painkillers don’t always help.”
- “Yes, intercourse can be painful.”
- “Yes, I felt bloated and uncomfortable for days.”
They say it almost apologetically.
Endometriosis is not just about cramps. It can cause chronic pelvic pain that extends beyond the menstrual cycle. It can affect bowel movements and cause bladder discomfort. It can make intimacy stressful instead of comforting. For some women, it affects fertility in ways they do not anticipate until they begin trying to conceive.
This is not minor discomfort. This is life being rearranged around pain.
WHY SO MANY GO UNDIAGNOSED
One of the hardest parts of managing endometriosis is explaining why it took so long to diagnose.
- Routine ultrasounds often appear normal.
- Blood tests do not detect the condition.
- Even examinations can miss it.
Unless someone is specifically looking for it and looking carefully, it can remain hidden.
But beyond the medical limitations, there is something deeper: women’s pain is often normalised.
I have patients who were told:
- “Periods are supposed to hurt.”
- “Relax.”
- “Marriage or pregnancy will fix everything.”
Over time, many stop asking.
THE EMOTIONAL TOLL I WITNESS
Chronic pain changes behaviour. I see it in small ways:
- Women who hesitate before committing to events.
- Women who carry medication everywhere.
- Women who feel guilty for calling in sick.
- Women who avoid intimacy because they anticipate pain.
And perhaps most heartbreakingly, women who doubt themselves.
When pain is repeatedly dismissed, self-doubt replaces self-trust. Part of my job is not only to treat the condition but to restore that trust.
WHEN FERTILITY ENTERS THE CONVERSATION
Some women come to me only when they struggle to conceive, and sometimes endometriosis is part of that story.
It can distort anatomy, create inflammation that interferes with fertilisation, or affect ovarian function.
Not every woman with endometriosis will have difficulty conceiving. But a delayed diagnosis can reduce options. Early recognition gives us time, and time is often crucial.
WHAT I TELL EVERY PATIENT
I tell my patients that severe, life-disrupting pain is not normal.
- If your period forces you to miss work every month, that matters.
- If pain worsens year after year, that matters.
- If medication barely helps, that matters.
- If intercourse is painful, that matters.
- If bowel or bladder symptoms flare with your cycle, that matters.
Your body is not exaggerating. It is communicating.
I encourage them to track patterns, seek doctors who listen carefully, and ask directly whether endometriosis has been considered. And if their concerns are dismissed without explanation, I encourage them to seek another opinion.
Not because every painful period is endometriosis, but because every woman deserves to be heard.
WHY EARLY DIAGNOSIS CHANGES LIVES
Endometriosis is chronic, but it is manageable. With a timely diagnosis, we can:
- Use hormonal therapies to suppress progression.
- Manage pain more effectively.
- In some cases, perform surgery to remove the disease and restore anatomy.
When identified early, we can preserve fertility options, prevent extensive scarring, and improve quality of life.
But none of that begins without awareness.
WHY I SPEAK ABOUT IT
Most women I meet do not know what endometriosis is until they hear it from me. I wish that were not true.
I wish young girls were taught that mild discomfort during periods can be common, but incapacitating pain is not. I wish conversations about menstrual health were open and informed, not whispered and dismissed.
Every time a patient asks me, “Why didn’t anyone tell me earlier?” it stays with me.
Pain is not weakness. Pain is not an overreaction. Pain is information.
And when we start listening to it early, seriously, and without judgment, we give women back something invaluable: control over their own bodies and their own lives.
(The author is a gynaecological surgeon at Parikh Hospital, Ahmedabad)
