What Menstruating With Endometriosis Is Like

Menstruating with endometriosis makes the already dreaded “time of the month” genuinely unbearable. Every cycle is different and I’ve personally even had a continuous period that lasted for three months, made me anemic and caused me to pass out, though that’s an extreme example. Most of the time, they’re about a week long and the start of it is when the pain is the most severe. To explain this better, here’s a day by day guide to one of my typical menstruating weeks — without being on anything to manage my cycles — as an individual with endometriosis.

Day One:

This day is generally the worst. I’m bent over in the fetal position on the couch, crying from the pain. It feels as though a knife is being jabbed into my abdomen and twisted slowly. The pain is excruciating. I can’t sleep and likely have to pull an all-nighter the night before or after because the pain is so severe that sleeping is impossible. The bleeding is heavier than it should be for the beginning of a cycle and I’m going through pads faster than I can keep up with.

Day Two:

This day is maybe a little bit better, but not by much. I’m not bent over on the couch in the fetal position anymore, but the pain is still severe enough that it’s hard for me to focus. It worsens a bit more intermittently now and is more responsive to medication or heat, so there’s a chance I can get some things done, but it’s still likely not a good idea for me to try to go to work or study for extended periods of time. I’m still going through pads quickly and my bleeding is likely even heavier than the day before.

Day Three:

This is where it seems to finally begin to turn a corner. I’m able to function now. It still hurts a lot, but the pain is more manageable and the bouts of severe pain are lessening in frequency. I may still have heavy flow, but sometimes it goes towards medium on this day. I can perform activities of daily living with minimal to moderate difficulty and am able to go to work or do homework, but I might still be needing to keep a hot pack around and am likely still taking medication for the pain.

Day Four:

Things are really noticeably improving now. I can see a light at the end of the tunnel. I’m still having bouts of moderate pain, but the severe pain is finally over. I’m likely transitioning from medication to intermittent heat now, or using medication just while I am at work and don’t have access to a hot pack. I’m having medium flow.

Day Five:

It’s almost over. My flow is finally light, the pain is crossing into mild. I can do just about anything I need to do without heat or medication, but I may still be utilizing them if I know I have a lot that I need to get done.

Day Six:

The pain is gone. I’m still having a little spotting, but the hard part is over. I know I only have a week of reprieve before the pain starts back up again, but I’m grateful to finally have a bit of a break.

After my cycle is over, I generally have about a week without pain before some cramping starts up again. It starts relatively mild and continues to worsen as I get closer to my cycle, before beginning to ease off about halfway through and then being gone for a week. This is, however, assuming that my cycle is lasting a full 28 days, which is rare. It’s not uncommon for the first day of one cycle to be two or three weeks from the start of the next, meaning I have very little, if any, reprieve from the pain. And that is what makes endometriosis such a debilitating chronic pain disorder.