After the Surgery, the Silence Begins

No one really talks about what happens after endometriosis excision surgery.

There’s so much emphasis on getting there—the years of being dismissed, the gaslighting, the appointments that go nowhere, the quiet self-doubt that creeps in when you’re told “your scans are normal.” By the time surgery finally happens, it feels like a finish line. Like relief is supposed to arrive all at once.

B

ut for many of us, it doesn’t.

After excision surgery, the pain may change—but it doesn’t always disappear. The body feels unfamiliar. Nerves wake up in strange ways. The pelvis doesn’t trust itself yet. There’s fatigue that doesn’t match the calendar, brain fog that makes simple tasks feel heavy, and an emotional fragility that catches you off guard. You survived something invasive—physically and psychologically—but the world seems to expect you to be “better” now.

Mentally, there’s often a strange grief that surfaces. Grief for the years lost. Grief for the version of yourself that learned how to push through pain so well that resting now feels unsafe. Many endometriosis patients are high-functioning, capable, type-A women who learned early how to perform through discomfort. Surgery doesn’t automatically undo that conditioning. If anything, it can expose how deeply ingrained it is.

There’s also fear—quiet, constant, and rarely voiced. Fear that the pain will return. Fear that every twinge means something was missed. Fear of trusting your body again when it’s let you down before. Even when surgery is successful, the nervous system doesn’t immediately get the message. It’s been on high alert for years.

Physically, recovery is rarely linear. Some days you feel strong, hopeful, almost normal. Other days, you’re exhausted, inflamed, bloated, emotional, and unsure why. Hormones shift. Inflammation takes time to settle. The gut reacts. Sleep is disrupted. And when you try to explain this to others, it can sound confusing—even to yourself.

“You had surgery already, right?”

Yes. And healing is still happening.

What many patients don’t realize—and what the system often fails to explain—is that excision surgery treats the disease burden, but it doesn’t automatically restore or normalize your entire life and body systems.  Endometriosis existed your entire adult life affecting your immune system, your nervous system, your gut, hormones, your psychological and emotional well-being and even how the brain processes pain.

After your surgery, those systems need care too, but they’re rarely addressed in a coordinated way.

To bridge that gap, you must take control of your health and well-being.

After surgery, patients are often handed back to the world with minimal guidance—left to figure out what lingering symptoms are normal, what needs attention, and how to support a body that’s trying to recalibrate. It is not because surgeons don’t care. It is not because other doctors aren’t trying.  Endometriosis doesn’t live neatly in one medicine specialty or sub-specialty.

After surgical intervention, so many women feel alone again.

Realizing you still need help after excision surgery doesn’t mean something went wrong. It doesn’t mean you failed surgery. It doesn’t mean you’re “still sick.” It means you’re listening to what your body is asking for now—which is integration, not just intervention.

Support can look different for everyone. Sometimes it’s having someone help you understand why your energy hasn’t returned yet. Sometimes it’s addressing inflammation, hormone shifts, or nutrient depletion. Sometimes it’s learning how to feel safe in your body again after years of pain. Sometimes the years of psychological trauma don’t simply go away. Often, it’s simply being believed when you say, “I’m better—but I’m not fully okay yet.”

You’re not weak for needing continued care. You’re not dramatic for noticing subtle changes. And you’re not broken because healing isn’t instant.

Excision surgery can be life-changing—but it’s often the beginning of a new chapter, not the final page. The goal isn’t just being pain-free, but feeling whole again. It is about being understood, supported and guided forward instead of left behind.

If you’re in that in-between space—post-surgery, post-diagnosis, but still searching for steadiness—know this: you’re not imagining it, and you’re not alone. Healing after endometriosis is not just about what was removed.

There is still so much that you need to recount and control.