Endometriosis: Shedding Light on a Silent Epidemic (posted March 26, 2025)

By Adam Behnke, BCPH Communications Specialist 

March is Endometriosis Awareness Month, a globally recognized observance intended to increase understanding and support for a condition affecting 190 million people worldwide. Endometriosis is an inflammatory condition in which the endometrial tissue, or the inner lining of the uterus or womb, grows outside of it. These growths most commonly happen on the ovaries and Fallopian tubes. This disorder can cause painful periods, discomfort during sex, irregular bleeding, and infertility. Today’s edition of the Healthy Herald will explore this complex condition that goes largely unknown and is often misunderstood. 
Understanding Endometriosis 

Endometriosis is a chronic inflammatory condition characterized by endometrial-like tissue growing outside the uterus. Unlike normal endometrial tissue that sheds during menstruation, this displaced tissue cannot exit the body and causes inflammation, scarring, and often severe pain. This misplaced tissue responds to hormonal changes of the menstrual cycle, making symptoms worse each month. 

The most common symptom of endometriosis is chronic pelvic pain that often worsens during menstruation. Additional symptoms include pain during intercourse, excessive bleeding, and bowel or urinary disorders. The wayward tissue can attach to various organs nearby, including the ovaries, fallopian tubes, intestines, bladder, and even the lungs in rare cases. This wide possible spread of the tissue means there are a lot of possible symptoms and makes diagnosing and treating endometriosis difficult. 

Endometriosis affects approximately one in ten women of reproductive age, making it a leading cause of both chronic pelvic pain and infertility. Despite the relative commonplace of the condition, the causes of endometriosis are not fully understood. Research spearheaded by the Endometriosis Association since 1992 has shown that environmental toxins such as dioxin and PCBs, which act like hormones in the body and damage the immune system, can cause endometriosis. Dioxins are highly toxic chemicals which come from the production and use of pesticides and herbicides; municipal, medical, and hazardous waste incineration; chemical and plastics manufacturing; and pulp and paper production.  

Other theories about the cause of endometriosis include the belief that endometrial tissue is distributed to parts of the body through the lymph or blood systems, that some families have predisposing factors for the disease in their genetics, or that some menstrual tissue backs up through the fallopian tubes during menstruation and implants in the abdomen. 
While there is no cure for endometriosis, there are avenues of treatment. Management of the condition may involve a combination of pain medication, hormone therapy, and in some cases, surgery to remove the endometriotic tissue. In 2018, the U.S. Food and Drug Administration (FDA) approved elagolix (Orilissa®) for the treatment of pain associated with endometriosis. This is the first and only pill specifically approved for endometriosis pain relief, although long-term use (for more than 24 months) is not advised due to the medication causing bone loss. 
The Endometriosis Association reports a 1990 study by Dr. Rona Susan Silverton identified coping mechanisms employed by women to help them live successfully with the condition: 

• Optimism: Staying hopeful while at the same time realistic about the disease; displaying a balanced outlook. 
• Acceptance: Acknowledging that you are experiencing pain is a positive first step in dealing with it. 
• Reaffirmation of Healthy Functioning: Placing an emphasis on staying healthy and functional rather than focusing on the fear of becoming dysfunctional. Women displaying this coping skill acted in ways they felt were health promoting, such as eating healthy, exercising, and relying on stress reduction techniques. This strategy helps women build an internal image of being in control. 
• Tension release: Some may find the need to “let go” or “vent their emotions.” Having a good cry is an example of this strategy. Tension release is used to let out anger, sadness, and despair. 
• Seeking out social support: Seeking out support through groups and from friends, family, doctors, and co-workers helps in coping with endometriosis. 
• Problem-solving: This strategy adopts an active “take charge” attitude toward their own medical care and treatment. These women typically become walking encyclopedias on the illness. They’re also willing to try nontraditional treatments, such as acupuncture, diet, and creative hobbies. 
• Reordering of priorities and goals: Taking inventory of priorities and goals, assessing those which may need to shift, including decisions about childbearing, relationships, marriage, or career planning. 
• Active participation: Becoming an active participant in one’s healthcare and medical treatments also helps in coping with endometriosis. Women who perceive themselves as more assertive adjust better to medical treatment overall. 
• Selective ignoring: Women focused on the positive consequences of having the illness, a strategy characterized by attitudes such as “I have endo, and it’s a big problem, but this crisis brought me closer to my family and/or friends.”

The same study also identified negative coping mechanisms that some women use when faced with endometriosis: 

• Denial: Some women use this strategy to cope with particular aspects of the disease, such as a threat of recurrence, concerns of chronicity, or infertility. Women using this method are more likely to delay getting medical treatment and tend to deny the chronic nature of the disease. 
• Negativism: This strategy focuses on bad consequences and anticipates the worst outcome. 
• Avoidance: Women who use this coping strategy try to relieve the pain or anxiety caused by endometriosis by distracting themselves or pushing endo-related stress out of their minds. They participate in activities to escape, such as reading, sleeping, and watching television. 
• Withdrawal: Going to or staying in bed, avoiding friends, family, or other women with the illness, is typical of this strategy. 
• Passive resignation: Women employing this strategy demonstrate helplessness and passivity. They want to be taken care of by family, friends, and their physicians. In extreme cases, they rely on others to make decisions for them. 

The Importance of Awareness 

Endometriosis is underdiagnosed, underfunded and misunderstood. To combat these challenges, the Endometriosis Assocation was founded in Milwaukee in 1980. As an independent self-help organization of women with endometriosis, doctors, and others interested in the disease, it is a recognized authority in its field whose goal is to work toward finding a cure for the disease as well as providing education, support, and research.  

A 2024 review of academic studies reaffirmed the diagnostic challenges faces by endometriosis patients. The average time ranges from seven to 10 years, during which time women are frequently told it’s ‘just bad period cramps’ or prescribed birth control as a one-size-fits-all solution. A 2016 review of academic studies estimates that endometriosis costs the U.S. economy $78 billion a year in health care costs and lost productivity.  A study by the Yale School of Medicine in 2023 also revealed a genetic correlation between endometriosis and mental health conditions like depression, anxiety, and eating disorders. 
 The observance of Endometriosis Awareness Month was instituted by the Endometriosis Association in 1993. It has become known worldwide to women and families affected by endometriosis, bringing awareness to the disease and its pain. The primary objectives of Endometriosis Awareness Month go beyond simply increasing visibility. This observance focuses on educating the public about the symptoms, challenges, and available treatments for those affected by endometriosis. It also serves as the primary time for rallying support for advanced research, improving diagnostic processes, and enhancing the quality of life for people living with this condition. Throughout the month of March, yellow ribbons and informational materials are distributed globally as symbols of solidarity and awareness. 
How to Get Involved 

Endometriosis Awareness Month offers multiple ways to get involved, whether you're personally affected by the condition or just interested in amplifying the awareness message. 

• One of the easiest ways to show support during Endometriosis Awareness Month (and any time of year!) is by wearing yellow, the official color of the cause. This eye-catching act serves as both a conversation starter and a symbol of solidarity with those affected.  
• On social media, using hashtags like #EndometriosisAwarenessMonth can help draw people into global conversations that feature personal experiences, educational content, and support resources.  
• Organizations including the Endometriosis Foundation of America (EndoFound) and EndoMarch coordinate numerous events throughout the month of March. These events range from patient education days to advocacy initiatives addressing policy and research funding.  

Conclusion 

For the estimated 190 million people who live with endometriosis, this month offers them hope — specifically acknowledgment that their experiences matter and that better care is possible. For the general public, it presents an opportunity to learn, listen, and then contribute toward improving outcomes for those affected. Because the battle against endometriosis deserves recognition not just in March, but throughout the year. 

Stay Healthy, Brown County! 

Resources 

https://endometriosisassn.org/endometriosis-awareness-month-2021/ 

https://nationaltoday.com/national-endometriosis-awareness-month/ 

https://guavahealth.com/article/endometriosis-awareness-month-why-march-matters 

https://www.myrhc.org/blog/endometriosis-awareness-month/ 

https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-orilissa 

https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17973?af=R 

https://academic.oup.com/humrep/article/31/4/712/2379946?login=false 

https://medicine.yale.edu/news-article/women-with-endometriosis-also-genetically-predisposed-to-depression-anxiety-and-eating-disorders/ 

https://drseckin.com/march-endometriosis-awareness-month/