For five years, I knew something wasn’t right.
I knew because every month, my body reminded me.
The pain wasn’t just “bad period cramps.” It was the kind of pain that made me dread my period before it even arrived. The kind of pain that eventually became normal enough that I started wondering if I was the problem for struggling with it.
And then, after years of pain, I finally got a diagnosis: endometriosis.
You would think having an answer would feel like the end of the story.
Instead, it feels like the beginning of one of the hardest decisions I’ve ever had to make.
Now I’m left asking: What do I do with this diagnosis?
Do I have surgery? Do I try to manage my symptoms through diet and lifestyle first? Do I keep trying to conceive while I figure it out? And, perhaps most importantly, could one decision help my fertility while another potentially make things harder?
I don’t have all of the answers. But I’m learning, researching, asking questions, and trying to make the best decision I can for my body and my future family.
So I wanted to share where I am right now.
Five Years of Pain Before My Diagnosis
Looking back, I think one of the hardest parts of my endometriosis journey is realizing just how long I lived with the pain before anyone seriously investigated it.
For years, painful periods were just something I was expected to deal with.
And I did.
I learned how to plan around my period. I learned what days I would probably feel awful. I learned to push through the pain because I had things to do.
But eventually, I couldn’t ignore it anymore.
My periods were incredibly painful. I also experienced heavy bleeding and painful bowel movements—symptoms that, in retrospect, fit with what we now know about endometriosis.
Endometriosis is a chronic inflammatory condition in which endometrial-like tissue grows outside of the uterus. It can cause inflammation, scarring and adhesions, and pain can occur around menstruation as well as with bowel movements or sex. It can also be associated with infertility. (ACOG)
The frustrating part is that knowing something is wrong and getting someone to investigate it are two completely different things.
It took me about five years of pain before I was finally referred for surgery.
And that delay is something I think about a lot.
ACOG’s updated 2026 guidance specifically recognizes the long delays that people with endometriosis can experience and emphasizes earlier clinical evaluation and shared decision-making. (ACOG)
I can’t go back and change those five years.
But I can make sure I don’t spend the next five years ignoring what my body is telling me.
Finally Having an Explanation
Getting diagnosed was complicated.
There was relief in finally having an explanation.
At the same time, there was anger.
Because if this really was the reason I’d been in so much pain, why did it take so long to get here?
And then came another realization:
Having a diagnosis doesn’t automatically tell you what to do next.
There isn’t one universal endometriosis treatment plan.
Treatment depends on things like symptoms, the extent and location of disease, reproductive goals, and personal preferences. Surgery is one option, but it isn’t automatically the right answer for every person with endometriosis. (ACOG)
And that’s where things get complicated for me.
Then There’s the Fertility Question
If I weren’t trying to have a baby, I think some of these decisions might feel different.
But I am TTC.
And suddenly every decision feels like it has another layer.
Endometriosis and infertility can be connected in several ways. Inflammation may interfere with reproductive processes, and more extensive disease can cause adhesions that affect pelvic anatomy. (ACOG)
So when you’re trying to conceive, it’s natural to wonder:
Would treating my endometriosis surgically make it easier to get pregnant?
But then another question comes up:
Could surgery itself affect my fertility?
And unfortunately, the answer isn’t as simple as yes or no.
The European Society of Human Reproduction and Embryology (ESHRE) recommends that decisions about endometriosis surgery in people trying to conceive consider factors including pain, age, personal preferences, other infertility factors, ovarian reserve and the estimated Endometriosis Fertility Index. (OUP Academic)
In other words, there isn’t a one-size-fits-all answer.
And that is both reassuring and incredibly frustrating.
The Surgery Question
Surgery is something I’m seriously considering.
The idea of having the endometriosis lesions removed is appealing. After living with pain for years, there is a part of me that wants to just fix the problem.
Surgery can help reduce endometriosis-associated pain, and in certain situations it may improve the chance of natural pregnancy. But the strength of the evidence depends on the type and severity of endometriosis. (OUP Academic)
There are also risks and tradeoffs that I can’t ignore.
One of my biggest concerns is my ovarian reserve.
This is especially important when surgery involves ovarian endometriomas, because surgical treatment can sometimes negatively affect ovarian reserve. ESHRE specifically advises against routinely performing surgery on ovarian endometriomas before assisted reproductive treatment solely to improve live birth rates because the evidence does not show a benefit and surgery may negatively affect ovarian reserve. (OUP Academic)
That doesn’t mean surgery is bad.
It means the reason for doing the surgery matters.
Am I doing it because I’m in significant pain?
Because the disease is affecting my anatomy?
Because my doctor believes it could improve my fertility?
Because I want a definitive diagnosis?
Or because I’m scared that if I don’t do something, I’ll regret it later?
Those are very different reasons.
And I want to make sure fear isn’t making the decision for me.
What About Diet?
This is where I’ve become really interested in nutrition and an anti-inflammatory lifestyle.
I’ve been reading about inflammation, whole foods, exercise, sleep, stress, and different approaches to eating with endometriosis.
And honestly, I love the idea of starting with things I can control every single day.
I can choose what I eat.
I can move my body.
I can prioritize sleep.
I can work on managing stress.
I can build meals around whole foods and nutrient-dense ingredients.
Those things aren’t a replacement for medical treatment. And I don’t want to pretend that eating a certain way will make endometriosis disappear.
Because the research doesn’t support that claim.
In fact, ESHRE’s guideline states that there isn’t currently clear evidence that nutritional or other non-medical interventions increase pregnancy rates in women with endometriosis. (OUP Academic)
That’s an important distinction.
I can believe that an anti-inflammatory lifestyle may support my overall health without believing that it can cure endometriosis.
Those are two very different statements.
And for me, that’s actually a much healthier way to approach it.
I’m not looking for a miracle diet.
I’m looking for ways to take care of my body while I’m trying to conceive and while I figure out what medical treatment makes sense for me.
Why I’m Considering Diet While TTC
There’s another reason this matters to me.
I’m already trying to get pregnant.
I don’t want to spend months and months doing something simply because I feel like I should without understanding what I’m gaining from it.
At the same time, I don’t want to rush into surgery simply because I have a diagnosis.
That’s the tension I’m sitting with right now.
I want to be proactive.
But I also want to be thoughtful.
And I want to remember that my body isn’t a problem that needs to be aggressively fixed just because I finally have a name for what is happening.
My reproductive goals matter.
My pain matters.
My ovarian reserve matters.
My quality of life matters.
And my preferences matter, too.
That’s actually one of the things I found encouraging in the current guidance around endometriosis: treatment decisions should be individualized and involve shared decision-making between the patient and their healthcare team. (ACOG)
What I’m Doing Right Now
For now, I’m focusing on the things I can control.
I’m working toward an anti-inflammatory lifestyle—not because I think it will cure my endometriosis, but because I want to give my body the best environment I reasonably can.
That means focusing on:
- Whole, minimally processed foods
- Plenty of fruits and vegetables
- Healthy fats
- Adequate protein
- Regular movement
- Getting enough sleep
- Staying hydrated
- Managing stress
- Limiting foods that I personally notice make me feel worse
I’m also continuing to learn.
I’m asking questions.
I’m talking with doctors.
And I’m trying to separate what we know from what sounds promising on TikTok or Instagram.
Because there is a lot of endometriosis advice online.
Some of it is helpful.
Some of it is based on very limited research.
And some of it makes women feel like their endometriosis is their fault because they ate the wrong food or didn’t take the right supplement.
I don’t believe that.
Endometriosis is a real medical condition. And while lifestyle choices can absolutely support our health, I don’t think women should be made to feel responsible for developing or “failing to cure” a disease.
I Still Don’t Know What I’m Going to Do
I wish I could end this post by telling you exactly what I decided.
I can’t.
I’m still weighing surgery.
I’m still learning about endometriosis.
I’m still trying to understand what the research actually says about fertility, inflammation, diet and treatment.
And I’m still trying to figure out what makes the most sense for my body.
Maybe I’ll ultimately have surgery.
Maybe I’ll focus on lifestyle changes for a while first.
Maybe I’ll decide that surgery is the right choice after talking with the right specialist.
Maybe the answer will be somewhere in between.
I don’t know yet.
But after five years of pain, I do know one thing:
I don’t want to ignore my body anymore.
For so long, I felt like I just had to live with painful periods because that’s what women do.
Now I know that isn’t true.
I know my pain was real.
I know there is a reason for it.
And I know I deserve to be part of the conversation about what happens next.
Maybe the hardest part of an endometriosis diagnosis isn’t finally getting the answer.
Maybe it’s realizing that the answer comes with a whole new set of questions.
And right now, I’m learning to be okay with not having all of those answers yet.
I’m just grateful that I’m finally asking them.
