I feel it’ll be easiest to show my symptoms in a simple list and then dive into them. Because I wish this kind of list existed for me without having to parse through someone’s stories (though hopefully the stories will also help). I’ve marked the symptoms that started when I got off birth control with an *.

• Painful cramps, often so bad I’d become nauseous

  • Mostly in my lower back, lower abdomen

• Headaches, sometimes migraines

• Heavy periods with hemorrhaging*

  • Aka bleeding through a super tampon or an overnight pad in ~1 hour

• Weakened immune system / super susceptible to getting sick no matter immunizations, precautions

• Bloody noses the first few days of my period*

• Unexplained inflammation, pain, swelling, and itching in my joints

• Constant bloating no matter diet

• Unexplained weight gain*

• Unexplained vaginal bleeding -- more than just spotting, between periods and/or lasting for long periods of time

• Pain with any kind of insertion in the vagina- tampons, medical devices for exams, penetrative sex*

• Low/lack of libido

• Full body fatigue

• Difficulty sleeping / feeling rested

• Pain with urination/bowel movements during my period*

• Unexplained changes in bowel movements*

• Multiple cyst ruptures*

• Unexplained significant abdominal pain*

It’s impossible to talk about my symptoms without also talking about my history with birth control. (Sorry, Dad.)

Before I started birth control at 14, I had painful periods with cramps so bad I would get nauseous. The first year I was getting my period, the delightful adolescent school year of seventh grade, my dad thought something else was wrong with me. He had to keep picking me up from school essentially every month because I would vomit or be so nauseous the nurse would send me home. I was too embarrassed to tell him it was because of my cycle and the incredible pain I was in. When I got a little older, this back and abdominal pain was coupled with headaches. I’d often be at home on the first or second day of my period with a migraine.

One of the main reasons I started birth control was the pain I experienced. My mom and older sister suffered from painful periods, too, and our OB/GYN brushed it all off as PMDD, or Premenstrual Dysphoric Disorder. Being on birth control helped some of my symptoms, but others persisted. I continued to brush them off, accepting it was normal and just what I have to deal with; it’s “part of being a woman”.

When I stopped using birth control pills and instead had the Nexplanon arm implant (I cannot dissuade you from getting this enough—it WRECKED me), I noticed that some of my symptoms changed. My weight fluctuated (surprise!), my mood and temperament were much more volatile, and overall, my periods became much more irregular. That last bit was horrible for my mental health as a college student; it would send me into a spiral every month I was late. I still keep a “just in case” pregnancy test in the back of my bathroom cabinet as a result of that time of my life.

The arm implant served its purpose and thankfully there was never anything more than a scare. When I got towards the end of its life and was told by the OB/GYN at Planned Parenthood that it could last another two years if I wanted, I decided to get it removed and swapped out for a hormonal IUD. This was also largely informed by the reactions my body was having to it; I was bleeding nonstop for three months while trying to figure out a new antidepressant and was concerned I had bipolar disorder because of my inability to regulate my emotions. Thankfully, my Mirena seemed to be the perfect form of birth control, though we had our trials and tribulations when I first had it inserted.

If you’d asked me before this year what my most painful experience had been, I’d have said my IUD insertion. It was November of 2020. I had it done at a very understaffed Planned Parenthood in San Diego. I was not given any information about how the insertion would go until it was happening. I was given 600 mg of ibuprofen to take 5 minutes before the insertion and a hot pack to put on my abdomen while it was happening. That was it.

The very kind women who performed the insertion dilatated my cervix 3 cm to get it in there, coaching me on my breathing and saying they knew how much it hurt. Afterward, they told me it took twice as long as it usually does because my uterus is tilted; they couldn’t quite get it in there. And it was also the first time that practitioner had inserted an IUD for someone. That piece felt cruel to share; I know that practice makes perfect and someone has to be the first but to tell me the most painful experience I had was because of someone’s inexperience?? Absolutely not.

I had spotting and horrible cramps for a few days after the insertion. I was also very aware of the strings that were in there since they were so stiff and honestly a little sharp. I had three bouts of BV (Bacterial Vaginosis) which I didn’t even know existed and ultimately had my first yeast infection in the months that followed. I had a fever and an elevated white blood cell count. My body was fighting this little IUD with everything it had.

About two months passed before I felt normal. And surprisingly, I did feel great after my hormones balanced and I was able to proceed with my life. I consider that IUD to be my MVP. Without it, I’m more than certain that the cysts I had on my ovaries at the time would have expanded into something much worse, and even potentially ruptured.

So when I had my Mirena taken out, it was an immediate reversal. It was the first time in 13 years that I wasn’t taking any form of birth control. I had asked my OB/GYN what to expect and she told me she wasn’t really sure; everyone’s body reacts differently. She told me to keep track of all my symptoms, changes in my body, things I feel are unusual. All of it was information. And she also told me to be exceptionally kind to myself in this transition.

Two weeks later, I was in the ER for a ruptured cyst, which replaced the IUD insertion as my most painful experience.

This cyst rupture was the main signal that led to my OB/GYN considering a diagnosis of endometriosis. She still wasn’t sure, though, so it was another seven months of tracking my symptoms, tuning in to my body, and being gentle with myself while I dove into my education on the disease and sought out a specialist. After four months of being off any birth control, I started taking a pill to just get through my life. This helped my symptoms a bit, but it still felt like the floodgates had opened and I was using a piece of wood to stay afloat. Once I started really paying attention to what was happening, I was able to recognize just how connected everything I was experiencing is.

Which is why I firmly believe the best thing anyone who thinks they have endo can do is listen and pay attention to their body. Endometriosis is a whole-body inflammatory disease. It can affect any organ, any tissue, any muscle. And it can do so silently, presenting as something else which leads to a frustrating misdiagnosis or no diagnosis. The biggest piece of it all is zooming out, seeing how you’re being affected. Because even if it seems like there’s no link, it’s still happening in your body. And your body is one connected system.

If you feel like there’s something going on, there probably is. Even if it’s not endometriosis, it could be something else that you can get relief from instead of just toughing it out. Trust your gut. Advocate for yourself. Remain resilient in the face of no answers. No one knows your body like you do.

Until next time.

🌎E

Endometriosis is, at its core, a condition of shit growing where it shouldn’t in the human body. Tissue that’s supposed to only be in the uterine lining shows up elsewhere, makes itself at home, and wreaks havoc to anything near it. Sometimes it goes undetected; so many folks don’t know they have it because it doesn’t impact their life at all. And sometimes it’s so debilitating it lands you in the hospital.

I clearly am not in the first camp. My endometriosis had me in the ER and out of work twice over the last year. The first time I had no clue what was going on. I knew I had pain, bad pain, and had some horrific stomach virus that had me sicker than I had ever been in my life. My husband made me go to the ER on the fourth day I couldn’t keep Pepto or water down, and we learned that I had an ovarian cyst rupture. I was in pain and had terrible GI symptoms because I had internal bleeding. And because I was experiencing an endometriosis flare up, though they didn’t put that label on it.

At the time I was given anti-nausea pills, an IV, and told to rest for the remainder of the week for everything to calm down. I was told to follow up with my gyno in a few days to make sure all was well. I wasn’t to do anything strenuous, like walking up and down a bunch of stairs, climbing a ladder, or lifting something more than five pounds. I was basically on bed rest since I couldn’t leave my third-floor apartment or do my very physical job. I did what any rational person would do and spent the three days between my ER visit and follow up appointment trying to understand what the hell happened and why the hell it happened.

I had had cysts before, but none that had ever ruptured and caused a significant amount of pain. I was diagnosed with Polycystic Ovary Syndrome (PCOS) in 2020 after a three-month long investigation to figure out why Lexapro was causing constant vaginal bleeding when I had the Nexplanon birth control implant. I was told this nonstop bleeding is a side effect that only happens if you have PCOS. Not wanting to go against my doctors, or question them too much, I had my first transvaginal ultrasound and a CT scan to confirm cysts. I swapped the arm implant for an IUD and the Lexapro for Zoloft and went on with my life.

Fast forward five years to the ER visit that changed it all. While it’d been a long time since I’d dealt with cysts, I at least wasn’t a stranger to them. Fibroids, however, were a new term to me and one that was on my discharge paperwork but not mentioned at all by my ER doctors. In Googling, I absolutely freaked myself out, especially when the C word came up alongside it. To think that I could potentially have cancer at 27 felt like I was zooming in on an image at the end of a really dark tunnel. My vision blurred around the word and I grew more anxious. And then I saw the term endometriosis in the WebMD article.

While certainly less grave, the only person I knew who had endometriosis was my grandmother. (Technically, my step grandmother.) I knew that she had painful periods that were so severe she hemorrhaged. That the first time she hemorrhaged at fourteen she thought her liver was falling out. That she was never able to have a child of her own because of said endometriosis. And while I’d been dealing with painful, irregular, heavy periods since I was 11, it was the last bit that scared me the most.

This whole process of learning I have endometriosis started just over a year ago. I wanted to see how much time I have left, biologically, to have children. If I can have children. Because at some point early in my life, I was told I couldn’t and that thought had stuck with me. I accepted that I wasn’t going to be a mother. And I was content with that, because I didn’t want to be. I didn’t want to continue the cycle of abuse and manipulation that I had experienced. But then, when I met my now husband, my tune began to change. Because I had finally met the person with whom I could parent and see a larger life with. It therefore felt particularly brutal to learn the same OBGYN who bullied me into a pregnancy test at 14 and caused me to break down by saying I was lying about being a virgin if I wasn’t getting my periods was potentially telling the truth about my inability to carry a child. There was something in me that didn’t want to believe it, and I needed to have more information.

I had fertility testing done in October, which was inconclusive. Meaning my fertility levels were low but it was hard to tell if that’s how the cookie crumbled or a result of my IUD. I was told to get a more accurate picture, I needed to be off birth control for three months. My IUD had to be replaced this year anyway, so I figured it was perfect timing. I had my IUD removed in January with a plan to repeat the fertility testing in April. And two weeks later I had my first bout in the ER with pelvic pain (see above).

The second time I went to the ER for what I thought was a cyst rupture was much calmer. I had had a sharp, stabbing pain that woke me up at 1am and that persisted the rest of that day. The next morning, I woke up, put on soft clothes, packed a bag with my Switch and Kindle, and waited for my husband to wake up to drive me to the Home Depot Emergency Room in Brooklyn. I was in significant pain and cried when the women at the front desk asked me what was going on. I responded that I thought I had a cyst rupture, that I had this happen back in February and was experiencing the same symptoms, and that I didn’t want to just suffer the way I had before. I was brought in, given a bed, and made very comfortable by the nurse, PA, and attending. I was given morphine, had multiple ultrasounds, blood work, and a CT scan. And everything came back clear. There were no cysts, no evidence of a rupture. Except it was also clear that I was in incredible pain, that when the PA pressed on my abdomen my pain level skyrocketed to an 8/10, even with pain killers. And it was clear to them that I was having an endometriosis flare up, that I needed to get into a specialist ASAP, and that my pain was real.

How validating that ER visit was. To have pain so significant that I was prescribed morphine because the most aggressive NSAIDs didn’t do shit. To be taken seriously and to have been listened to about my pain. To finally be on the path to getting answers. I was able to get an appointment with one of the top endometriosis doctors in the world two weeks later who confirmed within ten minutes of listening to my symptoms and completing a physical exam that I have endometriosis.

One month later, I had a hysteroscopy, laparoscopy, cystectomy, and appendectomy to remove the endometriosis that was in my abdomen.

I had read about another woman’s journey with endometriosis in February when the word popped up for the first time. A book titled Ask Me About My Uterus by Abby Norman. It was informative and led me to look at my symptoms in a new light. In the same way, I’m hoping this Substack series can do the same. That my candid explanations of what I’ve gone through, how I got there, and how I’m living with and managing my endometriosis can lead other women and people with uteruses to seek care, help, and relief that is so desperately needed from the condition.

I’m aiming to be thoroughly vulnerable, honest, and transparent in these accounts. There will be some kinda gross things I talk about and some that are potentially triggering. I’ll do my best to note these at the top of each entry, but I hope you’ll follow through and read these parts regardless. Because there’s really no way to proceed without confronting the pieces that make us turn away, and the parts that made me shudder are the same ones that made the disease become so much clearer.

I’m also stating here and now that this is my experience. I am by no means a medical professional, and while I will be recounting what my care team has given me, that doesn’t mean it’ll work for everyone or even anyone. Each case of endometriosis is different, and that’s a huge part of why it’s challenging to diagnose and care for. I hope that this will act as a guide more than anything, along with solace that there is hope, community, and care if you look for it in the right places.

Until next time.

🌎 E

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I yearn for a snow day as an adult. Where I wake up early to my alarm and race to check the scrolling alphabetical list of delays and closures and celebrate when I see my work listed. I rush into the kitchen to make coffee and hot cocoa so I can start the day as cozy as possible. I watch the snow fall easily and elegantly from the windows, the edges collecting frost while the trees grow heavy. I call my friends to coordinate playing in the snow: sledding, making snowmen and snow angels, having snowball fights. I come inside after playing, cheeks rosy and snowflakes in my hair and dusting my eyelashes. I put my socks, snow pants, hats, mittens, and coats in the hallway and above the radiator to dry out. I change back into my pjs, preparing for a state of rest once again, wearing my fuzzy socks that are reserved for such days. I put on a movie in the background and sip tea while I prep soup to simmer, a nourishing stock that will continue to warm me from the inside out. I don’t pay attention to the time, only turning on lamps when the light through the windows fades. I take a nap, wrapped in blankets with soft music playing, the cats snuggled up. And when I wake up, I stretch, refresh my tea, and take a deep breath. I needed the break and the rest, the quiet. The same way the earth did. I have been able to embrace the quiet, to hibernate, to slow and protect myself to re-emerge and thaw in time with my surroundings.

And instead, when it snows, I put on layer after layer of cotton and wool, the natural fabrics keeping me warm as I trudge through the slush and flakes on the sidewalk, braced against the wind. I step carefully in my boots, unsure where the ice and puddles are hiding beneath the fresh layers of white. I reach out with my right hand, preparing to grasp the railing adjacent to the subway steps should my boots slip and I need the support. I hold onto the hot latte in my left, hoping the liquid stays insulated against the cold, cursing myself for forgetting my reusable mug again. I shed my gloves, hood, and scarf and unbutton my coat while waiting for the subway. I brush off the snow from my bag so it can sit on my lap without dripping. I check my phone to see how many actors will be late, if there are complications for others entering the city. I prepare for fewer audience members, less screams at the top of the show and after The Rumble. I think about how those who are seeing the show have traversed through the snow. And in another way, it is restorative, engaging with my chosen artform and sharing it with others. There is rest and celebration in doing the familiar and being swaddled by a community of artists and patrons. And when I leave for the day, I take additional time to walk through the lights of an almost-empty Times Square. I marvel at the LEDs reflecting in the snow, the bright against the quiet, the lack of pedestrians and bicycles whizzing by. I take a moment to breathe in, letting my cheeks get rosy and the snow to dust my glasses and eyelashes. I listen to the squish and crunch of the slush and snow beneath my boots as I walk to the subway, thoughts of blankets and tea warming me until I get home.

The concept of the 75 Hard Style Challenge (originated by ) is simple: You get dressed every day for 75 days straight. You don’t purchase any new clothing or accessories, using only what you already have in your closet. The creative side of it is rooted in the idea that you can create or hone your personal style using what exists in your repertoire; that you don’t need to add anything to have it be “better”. It also requires that you document each outfit. This doesn’t necessarily mean that you share them on social media or do anything more than have photos in some capacity.

I came across the challenge on Instagram last year, in 2024, and felt that it was something interesting and that I could never do. To not buy clothes for 75 whole days felt impossible. I was prepping for my wedding in September, so I was, in fact, buying many clothing items. For the wedding day, the rehearsal, the afterparty, the days leading up to it, the bachelorette party. I was also in rehearsals for my first Broadway show, on track to achieve a goal I had been working towards for ten years. Which meant I was also buying clothes and shoes to wear for commuting, being on my feet, running around the rehearsal room, blacks for tech, and then show blacks. Not to mention what I’d wear for opening night, press events, and eventually the Tony Awards, both the ceremony where I worked and the after party where we celebrated our wins. In all of that, I felt like I was starting to develop a closet I was proud of, that I felt comfortable in, that I was excited about. I was creating looks that were true to my identity and self-expression.

And at the same time, I was consuming more than I ever had before. I ran out of hangers, I took over more of our closet (because my now-husband and I share a closet in our sweet one-bedroom Brooklyn apartment), and I found that I was also becoming overwhelmed when I would get ready in the mornings. I was comparing myself to my Instagram feed. To people whose style I admired and wanted to emulate. To those who had much more wealth and are gifted items from companies in exchange for posting. I felt that I wasn’t doing enough, that if I just had the right shirt, pants, socks, shoes, jacket, vest, etc. that I would finally achieve a look I felt comfortable in.

When the excitement of my wedding and The Outsiders calmed down, I took a step back. I had spent thousands on my wardrobe, partly again because of the wedding, but also on clothing rentals, several pairs of pricey shoes, and individual items from brands that while they are on the higher end of quality, they’re also on the higher end of price. I had spent without tracking, without realizing how much was really going in and out of my accounts because I was also making more than I ever had. I didn’t necessarily need to track my accounts in the same way I had when I was freelancing and would go weeks without work.

I recognized at the same time that my spending increased, my other hobbies fell to the wayside. I wasn’t creating, whether in the form of writing, crocheting, knitting, or painting. I wasn’t reading, playing Animal Crossing, hanging out with friends. My weekends consisted of shopping trips to get something new for my closet or our home. I was relying on the newness of items, the short-term satisfaction and the temporary dopamine hits of styling something for the first time to get me through what was one of the most stressful and exciting years of my life. I had developed a shopping addiction, even though I wouldn’t have characterized it as that when I was in it. The same way I wouldn’t have admitted you were right if you had asked me my senior year of college if I was an alcoholic. Because addicts don’t, or rather sometimes can’t, admit that they are addicts. At least I couldn’t.

When I moved to California in 2019 for grad school, I had to stop drinking. Because I couldn’t afford a $15 cocktail or beer when I went out anymore. I was living off credit cards, what I made as a part time barista, and the very small salary I got from UCSD that covered most of my rent and required over 40 hours of work each week. Being thrown into a personal economic crisis meant I had to cut back, and I only drank when I wasn’t the one paying for it. Having that distance from my drinking, which prior to moving was regularly 5-6 beers a night, made me realize that my consumption was unhealthy and was acting as a balm.

In the same way, doing the 75 hard style challenge required that I distance myself from shopping. And allowed the clarity to confront the hard truth that I was doing the same thing with clothes that I had done with alcohol. And I realized that while gambling, cigarettes, weed, and alcohol were addictions I grew up around in my family, shopping was the one passed down. How deeply I was affected by the women in my family soothing themselves through small, frivolous purchases, because it was something they could control and something they could choose for themselves. That stopping by Wild Bill’s on the way home from the grocery store to pick up a silly toy or a new pair of off-brand Crocs had fostered a connection between consumption and autonomy. That we didn’t need to tell my dad or grandpa about what we had bought, unless we were shopping for Back to School in which case a fashion show was absolutely required.

I’ve taken a lot of pride in leaving the negative aspects of my childhood behind. How I was able to work through some of the situations that I faced, the uncertainty of growing up without financial security and reaching peak adolescence when my parents were separating. How I got out of that life through education, finding community, and working towards a dream. How I have gone to therapy to forgive the things I cannot forget and to unearth the reasons behind my emotions in ways that I wished my parents and siblings would. So it was jarring to realize that something was still lurking under the surface, something that was actually affecting me. And something that felt not only accepted by social media, but encouraged. Because consumption means sales, and social media no longer feels about community, but about marketing.

The places I, and so many others, had turned to for connection have turned into platforms for advertisements and product placements to influence people to buy the next thing. Which I had allowed myself to get fully sucked into. So many brands I now enjoy I found on Instagram. And while some trends and silhouettes I’ve grown to love from seeing them in person on the street, most of them I’ve seen from brands and influencers trying to sell me on them. It feels so complicated to try to form a sense of personal style when it’s built on comparisons and consumption. Yet we also need to compare and consume to build identity. We build ourselves by pulling in information and experiences throughout our lives, crafting them into something new. So, it makes sense to do the same with our sense of style and self-expression. And the 75 Hard Style Challenge has also made me interrogate how I can continue to flesh out my own style without continuing to spend, consume, and take in more literal things.

All that said, I technically failed the challenge 35 days in. And when I did, I asked myself, at the suggestion of my husband, how I would feel failing it by buying the items I wanted. And when I reflected, I felt at peace with the decisions. Because they would be purchases that were intentional and made in an effort to get items that I’m excited about and able to get sustainably. They were not impulse purchases or to reward or soothe myself. They were to genuinely add items to my closet that I feel are missing and have been interested in for longer than just a day. Just like going out for a drink intentionally with friends has become a healthy way to engage with something that was once the source of great pain for me, adding to my closet in a slow and intentional way allows me to do the same. I’m excited to see what more the Challenge teaches me in the remaining 38 days, how lowering my consumption can change more than just the footprint of my closet, but also my life as a whole. How it can allow me to reconnect with my values of sustainability, intention, creativity, and community. And how the community of people who engage in the challenge have already been supportive and welcoming.