{"paper_id":"3ae68ff9-af6c-40e9-b424-48b49b560097","body_text":"WHAT YOUR PATIENT IS THINKING\nCollaboration is key in managing endometriosis\nHeather Guidone describes how endometriosis affected many aspects of her life and how collaboration\nin care is key\nHeather C Guidone\nMy journey with endometriosis started with severe\nmenstrual cramping, irregular and heavy bleeding,\nand significant gastrointestinal distress and urinary\ndysfunction. What initially seemed like“bad periods”\nquickly became something much more disruptive,\nand as time went on my symptoms escalated.\nDebilitating, chronic non-menstrual pelvic pain\nbegan to dominate my days. Lower back and leg pain\nand excessive fatigue became a constant presence.\nLater, painful intercourse and infertility emerged as\nchallenges.\nOver time, these symptoms took an increasing toll\non my physical and mental health and wellbeing.\nEndometriosis was affecting everything from my\nearnings capability to my reproductive choices,\nself-esteem, and body image.\nDespite the persistence and severity of my symptoms,\nit was years before anyone linked them to\nendometriosis, and I was routinely assured my pain\nwas “normal.” Following diagnosis and treatment\nthrough laparotomy, scant additional options were\noffered for management.\nThink beyond menstruation\nHealthcare professionals often treat endometriosis\nas just a“bad period.”My experience was that fertility\nwas emphasised over pain relief, and pregnancy was\n“prescribed” as though it were a treatment. This came\nat a time when I was struggling with infertility linked\nto endometriosis. Treatment was approached in a\none-size-fits-all manner that didn’t align with my\nneeds, and health professionals did not engage me\nin conversations about my symptoms and goals. I\nwas left feeling disempowered and unheard,\ncompounding the isolation that already comes with\nliving with a chronic, poorly understood disease like\nendometriosis.\nI would encourage health professionals to reflect on\nhow to provide a truly patient centred approach.\nListen without judgment. Consider a patient’s\npersonal goals and daily challenges when discussing\ndiagnostic and treatment options. Try to understand\nthat endometriosis affects so much more than just\nthe reproductive organs.\nWorking together\nAfter decades of pain, more than 20 surgeries, and\ncountless drug therapies, I finally connected with a\nspecialist who changed everything. Combining\nexcision surgery and postoperative collaboration with\nspecialists in pain management, gastroenterology,\nurology, and pelvic health physical therapy, they\ndevised a comprehensive care plan tailored to my\nneeds and treatment directed goals. This brought\nimmediate, dramatic, and longlasting relief.\nThe path ahead lies in patient-physician collaboration\nto achieve the best possible outcomes for this\ncomplex, chronic illness. We must work together to\ndispel the persistent culture of misinformation and\nsocietal biases against endometriosis pain and\nsymptoms, and ultimately prioritise the expertise of\nthe real authorities on endometriosis: those living\nwith the disease.\nWhat you need to know\n• Think beyond menstruation. Endometriosis is not just\na “bad period” and can affect many aspects of a\npatient’s physical and mental wellbeing\n• Endometriosis manifests differently in each patient;\ntreatment plans must be tailored to individual needs,\npreferences, and life circumstances\n• Interdisciplinary care and collaboration are key, with\npatients themselves holding important insights into\nhow best to manage their condition and support\nothers\nEducation in practice\n• How do you address the patient’s personal goals and\ndaily challenges in your approach to diagnosis and\nmanagement of endometriosis?\n• How might you ask a patient living with endometriosis\nabout their mental wellbeing?\nCompeting interests: none\n1the bmj | BMJ 2025;388:q2725 | doi: 10.1136/bmj.q2725\nPRACTICE\nPatient author\nHeather@centerforendo.com\nCite this as: BMJ 2025;388:q2725\nhttp://doi.org/10.1136/bmj.q2725\nPublished: 31 January 2025\nProtected by copyright, including for uses related to text and data mining, AI training, and similar technologies. \n. by guest on 21 May 2026 https://www.bmj.com/Downloaded from 31 January 2025. 10.1136/bmj.q2725 on BMJ: first published as","source_license":"public-domain-us","license_restricted":false}