A Black Woman's Guide to Endometriosis
By: Ashley Williams
Endometriosis ‘endo’ is a chronic disease in which endometrial tissue (the lining of your uterus) grows outside of the uterus. It affects 190 million women and girls of reproductive age across the globe and 1 in 10 women in the United States.
Though seen as the white woman’s disease, KIMBRITIVE Advisor Tesiah Coleman, MSN, AGPCNP-BC, WHNP-BC, CLC shares the facts that prove endometriosis is very real to the Black women who suffer from it.
Here’s everything you need to know— and then some:
The average diagnosis of endometriosis takes 8 to 12 years, but for Black women it can take even longer. For us, endo is often underdiagnosed, undertreated, and ignored—not because it’s less common for Black women, but because the medical system, like most systems in this country, wasn't built to see or serve us.
Black women are 50% less likely to be diagnosed with endometriosis than white women, even though we experience similar—if not worse—symptoms.
The most common symptoms that women experience include:
- Chronic pelvic pain
- Painful periods (dysmenorrhea)
- Pain during or after sex (dyspareunia)
- Heavy menstrual bleeding
- Bowel and urinary issues, like painful bowel movements or urination
- Fatigue and inflammation-related symptoms
- Infertility or difficulty conceiving
Research suggests Black women with endometriosis may experience more severe and widespread pain. However, we are more likely to be misdiagnosed with other conditions, as pelvic inflammatory disease (PID) or fibroids. Black women also report higher levels of fatigue, bowel dysfunction, and severe cramping, potentially due to delays in diagnosis and inadequate treatment.
Unfortunately, by the time Black women are diagnosed, the disease has progressed, making treatment more difficult. From lack of insurance coverage to fewer Black-centered clinics, systemic inequities make it even harder for Black women to get the care we need. Additionally, endometriosis care requires highly skilled gynecologic surgeons—but Black women are less likely to be referred to these specialists, making it harder to access proper treatment.
What does proper endo treatment even look like?
Managing endometriosis isn’t just about taking a pill—it’s about finding real relief, reclaiming your body, and treating the root causes of pain. Treatment depends on the severity of symptoms and personal health goals. Options include:
Hormonal therapies – Hormones, especially estrogen, fuel endometriosis growth. Birth control can help by regulating hormones and reducing pain and bleeding. Birth control pills, progestin-only methods, or GnRH agonists help regulate estrogen and slow endo growth.
Pain relief – NSAIDs (like ibuprofen) and prescription medications for chronic pain and inflammation.
Pelvic floor therapy – Helps relieve muscle tension caused by chronic pain and inflammation.
Laparoscopic excision surgery – The gold standard for removing endometriosis, though access to skilled surgeons is a major barrier for many Black women.
Alternative surgical interventions – Myomectomy (for those with both fibroids and endo) or hysterectomy in severe cases—but only if all options have been explored.
Anti-inflammatory diets – Reducing processed foods, increasing omega-3s, and balancing gut health can help manage flare-ups.
Acupuncture & physical therapy – Shown to improve pain levels and overall function.
Mental health & stress reduction – Chronic pain and medical neglect take an emotional toll. Therapy, mindfulness, and strong support systems are critical for healing.
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How can lifestyle changes ease your symptoms?
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There are many lifestyle adjustments and alternative therapies that can help manage endometriosis symptoms:
Anti-inflammatory diet: Focus on whole foods, omega-3 fatty acids, and reducing dairy and processed foods
Exercise: Gentle movement, such as yoga or low-impact strength training, can help with pain and inflammation
Pelvic floor therapy: Helps relieve muscle tension caused by chronic pain
Acupuncture: Some women find relief through acupuncture, which may help with pain regulation
Stress reduction: Meditation, therapy, and prioritizing mental health can help manage the stress-related aspects of chronic illness
Let’s talk about sex.
What does sex, intimacy, fertility and reproductive health look like with endo?
Here’s the tea:
Sex & Intimacy
- Endometriosis can cause deep, stabbing pain during or after sex due to inflammation, scarring, and pelvic muscle tension. Many Black women are told to “just relax” or that pain is normal— don’t let anyone gaslight you, it’s not.
- Reduced libido – Constant pain, fatigue, and hormone imbalances can make intimacy feel like a chore instead of a source of connection and pleasure.
- Emotional toll – The fear of pain during sex can create anxiety, frustration, and relationship strain, especially when partners don’t understand the condition.
Treatment options includes pelvic floor therapy, lubricants, exploring pain-reducing positions, and open communication with partners.
Fertility & Reproductive Health
- Infertility – Endometriosis is a leading cause of infertility, affecting up to 50% of those with the condition. Scarring, inflammation, and hormone imbalances can make conception more difficult.
- Increased pregnancy risks – Those who do conceive may face higher rates of miscarriage, preterm birth, and pregnancy complications.
- Limited access to fertility treatments – Black women already face disparities in IVF success rates, insurance coverage, and access to reproductive specialists, making an already challenging journey even harder.
Treatment options inlcude early diagnosis, excision surgery, hormone regulation, and fertility treatments like IUI or IVF—but too many Black women aren’t even given the option before being told hysterectomy is their only path.
What does the historical treatment of endo for Black women show us?
The care Black women receive when diagnosed with endometriosis is a stark reminder of the importance of race-concordant providers and comprehensive and compassionate treatment plans. Seeing a doctor who looks like you and understands your experiences leads to better care and outcomes. Receiving care that centers patient autonomy, education, and multiple treatment options, rather than the quickest or cheapest fix allows women to live the lives they deserve.
We know traditional healthcare has failed Black women with endometriosis—delaying diagnosis, dismissing their pain, and limiting treatment options. Kyndred, changes that.
Through Kyndred, we’re reclaiming the narrative on endometriosis care, offering culturally competent, patient-led, and holistic support designed for Black women.
Kyndred offers:
On-demand virtual visits with expert clinicians who actually listen
Personalized treatment plans including hormonal therapy, pain management, and referrals for excision surgery
Sexual wellness and intimacy support, because endo shouldn’t steal your pleasure
Holistic healing options, from nutrition and anti-inflammatory diet guidance to stress management and pelvic floor therapy
Community-centered care through Sugar, our digital platform for expert-led education, support, and advocacy
Black women deserve better care—and we refuse to wait for the system to catch up. Kyndred puts power back in our hands, ensuring that women with endo don’t just survive, but thrive.
Disclaimer: This blog post is not medical advice, and does not assume patient-provider relationship. If you think you may have endometriosis please consult your provider.
Ashley Williams is a Brooklyn-based writer and editor. Her interests include exploring health, wellness and beauty through the lens of Black women. In the last nine years she has gathered a wealth of experience in communications and social media management in the nonprofit sector, academia and most recently healthtech. Ashley earned a Bachelor's degree in Health & Exercise Science from Syracuse University and a Master’s degree in Publishing from Pace University.