When thirty-four-year-old Andrea Baines was asked to design a special effects shoot as a part of her course at a makeup academy, she decided to use it as an opportunity to explain to others the pain that she and millions of other women go through on a monthly basis.
The goal of the project was to show people who don’t know anything about the condition that just because you can’t see it, doesn’t mean it’s not there or that it’s not real .
She said: “I wanted to make an invisible illness visible and get people talking.”
What is Endometriosis?
Endometriosis is a condition wherein the tissue that makes up the lining of the uterus, called the endometrium, grows in other places, such as the fallopian tubes, the ovaries, or even along the pelvis .
Every month your endometrium breaks down and causes your period to start. In the case of endometriosis, however, things don’t go quite so smoothly. When endometrial tissue growing on places other than the uterus breaks down, it has nowhere to go. This causes cysts, heavy periods, terrible cramps, and possible infertility . Very little is known about endometriosis, but it is estimated to impact up to one in every ten women. It is the third leading cause of gynecologic hospitalizations in the United States, and the leading cause of hysterectomy .
What are the Signs and Symptoms of Endometriosis?
Endometriosis is characterized by two main symptoms: dysmenorrhea, and deep dyspareunia .
Dysmenorrhea is the medical term for the pain and discomfort associated with menstruation, of which there are two types. Primary dysmenorrhea are the cramps that come back every time you have a period and usually last for twelve to seventy-two hours. They can also be accompanied by other symptoms such as nausea and vomiting, fatigue, and diarrhea .
Secondary dysmenorrhea is similar to primary, however, the pain usually begins earlier and lasts longer. This type of dysmenorrhea is caused by a disorder in your reproductive organs, such as endometriosis .
Dysmenorrhea happens when natural chemicals in your uterus called prostaglandins cause your uterus to contract. During your period, your uterus contracts more heavily, which can sometimes cause it to press on nearby blood vessels. When this happens, the oxygen supply to the muscles of the uterus gets briefly cut off, resulting in pain . Dyspareunia is the medical term for pain that occurs just before, during, or after intercourse . This can happen for a number of reasons, but deep dyspareunia, which occurs during deep penetration, is very common for sufferers of endometriosis .
The Impact of Endometriosis
As if the physical pain wasn’t enough, endometriosis can have financial, mental, and emotional implications as well. One study found that women who are affected by the condition lost on average 10.8 hours of work weekly, mainly due to reduced effectiveness while working . This equates to between $16 970 and $20 898 per year .
Baines, who was diagnosed with endometriosis at eighteen years old, has now had three surgeries. The scar tissue from these procedures has created even more pain.
“Sometimes the pain leaves me bed bound,” she said.
The debilitating condition can have a profound emotional impact on women as well. Women with endometriosis report high levels of anxiety, depression, and other psychiatric disorders. This emotional pain has been shown to exacerbate the physical pain even further, trapping women in a vicious cycle .
Baines is all-too-familiar with the emotional pain of her condition.
“Emotionally it’s affected me because I feel guilty when I’m so tired and it’s also embarrassing to bleed so heavily. The fact it’s invisible can be really hard to deal with as people assume you’re well.” 
Diagnosis and Treatment for Endometriosis
There are multiple ways to go about diagnosing endometriosis. Your doctor may perform a pelvic exam, which involves palpating (feeling) areas in your pelvis for abnormalities. This is usually the first step, but it is often not possible to feel small areas of endometriosis .
Other tests include an ultrasound, an MRI, or a laparoscopy. A laparoscopy is a procedure that involves being put under general anesthesia while a surgeon inserts a tiny viewing instrument through an incision near your navel to look for tissue outside the uterus .
Unfortunately, there is no cure for endometriosis. Treatment primarily focuses on pain relief and management, and your doctor may recommend an over-the-counter pain reliever such as Advil or Aleve .
Hormonal therapy, such as birth control, maybe an effective solution if you are not trying to become pregnant. Hormone medication may slow the growth of endometrial tissue and prevent new growth, which can mitigate pain .
Surgery to remove endometriosis implants while preserving your uterus and ovaries might be a solution if you are trying to become pregnant. This is known as conservative surgery and is usually performed laparoscopically .
Many women who suffer from endometriosis and who do not plan on having children eventually opt to have a hysterectomy, removal of the uterus. This, however, is a major surgery and will bring about early menopause without the hormones produced by the ovaries, and many doctors are moving away from this approach .
For a condition that affects so many women, it is shocking how little we know about it. Creating awareness and starting a conversation is incredibly important for people like Andrea, as they can often feel very alone in their struggle.
“I wanted the image to be quite shocking to gain interest and really connect with women who also suffer.” 
As more people like her begin to speak up, we can only hope that more resources will be allocated to researching this debilitating condition so that women like Andrea can one day experience relief.
- ‘Graphic Pictures Show The Reality Of Endometriosis’ Tyla Lauren Bell. Published December 16, 2019
- ‘Endometriosis: Causes, Symptoms & Treatments’ Live Science Amanda Chan.
- ‘Epidemiology of Endometriosis’ Science Direct Brenda Eskenazi PhD, Marcella L. Warner PhD
- ‘Pain symptoms associated with endometriosis’ Europe PMC Fedele L, Bianchi S, Bocciolone L, Di Nola G, Parazzini F. Published May 1, 1999.
- ‘Dysmenorrhea’ Cleveland Clinic
- ‘Painful intercourse (dyspareunia)’ Mayo Clinic
- ‘Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries’ Science Direct Kelechi E. Nnoaham M.D
- ‘The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey’ PLOS Mike Armour. Published October 10, 2019
- ‘Patients’ report on how endometriosis affects health, work, and daily life’ Pubmed Jessica Fourquet.
- ‘Anxiety and depression in patients with endometriosis: impact and management challenges’ PubMed Antonio Simone Laganà
- ‘Endometriosis’ Mayo Clinic