March is Endometriosis Awareness Month.
By: Dr. Stephanie Peltz ND
If you live with endometriosis — or suspect you might — you likely don’t need a calendar to remind you. Your body already does.
Pelvic pain that intensifies with your period. Pain that lingers throughout the month. Discomfort with intercourse. Bowel pain that flares cyclically. Months — sometimes years — of wondering whether what you’re experiencing is “normal.”
Let me say this clearly: Debilitating period pain is not normal. Endometriosis is a chronic inflammatory condition in which tissue similar to the uterine lining grows outside the uterus. It can affect fertility, digestion, intimacy, energy, and mental health. And despite how common it is, diagnosis is often delayed.
Listening Carefully Is Powerful Medicine
The gold standard for diagnosing endometriosis remains laparoscopy. But newer research reinforces something deeply important: a thorough history can significantly improve diagnostic accuracy.
Patterns matter. Cyclical pain matters. Family history matters — and recent guidelines now recommend screening for endometriosis in those with a first-degree relative affected. Your story is not “just cramps.” It is clinical information.
Imaging and Lab Work: Helpful, But Not Definitive
Transvaginal ultrasound is now recommended as an accessible first step in evaluation. It can detect certain forms of endometriosis, particularly when performed by experienced providers. But a normal ultrasound does not rule the condition out if your symptoms are suggestive. That nuance is important.
There is no single blood test that confirms endometriosis. Certain markers, such as CA125, may support suspicion but cannot exclude it. Vitamin D deficiency has been associated with greater risk and severity, and iron levels are important to assess when heavy bleeding is present. If surgery is required for ovarian endometriosis, ovarian reserve markers can help guide fertility planning afterward.
The throughline here is this: normal testing does not invalidate real pain.
The Lifestyle Layer: Consistency Over Intensity
Endometriosis care is rarely one-dimensional. There is no single lever that fixes everything. But small, consistent changes can meaningfully influence symptoms.
Exercise is one example. A single intense workout may temporarily aggravate pelvic pain, but consistent movement three times per week has been associated with improvement over time. This isn’t about pushing through discomfort — it’s about steady, supportive regulation.
Nutrition also plays a role. Many people with endometriosis experience overlapping IBS symptoms, and research shows that a low-FODMAP dietary approach can reduce pelvic pain in a meaningful percentage of patients within weeks. Certain dietary patterns are associated with risk as well: higher intake of red meat and butter has been linked to increased risk, while low-fat dairy intake appears protective. Alcohol likely has a bidirectional relationship with the condition, meaning each may influence the other.
This is not about restriction or perfection. It is about informed, sustainable choices.
Medical and Integrative Support
Progestin therapy is one of the most studied medications for reducing endometriosis-related pain and is often used after surgery to reduce recurrence. Some patients benefit from hormonal oral contraceptives or a levonorgestrel IUD, though responses are individualized and estrogen-containing therapies may not be ideal for everyone.
Alongside conventional care, research has explored several integrative supports aimed at reducing inflammation and modulating pain pathways. Antioxidants, vitamin D repletion when deficient, curcumin, melatonin, PEA, ginger, and omega-3 fatty acids have all been studied to varying degrees. Some show promising results, particularly when layered thoughtfully with medical therapy. The key is personalization. What works for one patient may not work for another.
The Emotional Reality
Endometriosis is not just misplaced tissue.
It is cancelled plans.
It is bracing before your cycle begins.
It is the quiet grief that can accompany fertility struggles.
It is feeling dismissed when imaging looks “normal.”
If you have been told that your pain is simply part of being a woman, I want you to hear this:
Persistent, disruptive pain is a signal — not a personality trait.
And signals deserve thoughtful investigation.
A Science + Soul Approach
Endometriosis care requires both rigor and compassion. It requires listening closely, not dismissing symptoms after a normal scan, and building layered treatment plans that may include medical therapy, nutrition, movement, supplementation, and ongoing reassessment. It is rarely linear. But it is navigable.
This month, if you recognize yourself in these words, consider this your invitation to advocate — gently but persistently — for answers.
You deserve care that is evidence-informed. And you deserve to feel deeply heard. ��
