Excellent resource, structured in a helpful, easy-to-understand way. I think the book will be a guide for many suffering. I identified with so many of the stories highlighted. Thanks to NetGalley for the advanced copy.

This book is incredibly informative. I’ve recently been diagnosed with Endometriosis and I’ve felt at a loss, o left my GP more confused than I was when I went in! There’s so much information online but it is hard to find it all and deciding which bits are relevant to me, this book helped me with this.

I particularly liked how this broke down the symptoms and other conditions associated with Endometriosis, it made it easier to understand and to learn. I will definitely be purchasing this and telling as many other women I know that suffer!

I found this to be extremely informative. I really appreciated the opportunity to read it early, as a sufferer of endometriosis. I love that it sheds light on a major issue for women.

Endometriosis: From Harm to Hope is an incredibly insightful, compassionate, and empowering read that I believe is essential for anyone living with endometriosis—or supporting someone who is.

This book does an excellent job of explaining what endometriosis truly is and how deeply it can affect the entire body, not just the reproductive system. The author’s background as a mental health provider, combined with her own lived experience of endometriosis, gives this guide a rare balance of medical clarity and emotional understanding. Nothing is sugar-coated, especially when it comes to the mental toll of living with a chronic, often misunderstood condition, but that honesty is exactly what makes this book so powerful.

This is a book that reminds readers that endometriosis may take a lot, but it does not take away our value. We are still worthy of love, dignity, and joy. For anyone suffering from severe period pain (endometriosis often goes undiagnosed for far too long), feeling dismissed by medical professionals, or searching for understanding and support, this book is truly invaluable.

Thank you NetGalley and John Murray Press US for this ARC.

This book is true to its description: Casey helps the reader feel seen, even when her team of medical professionals doesn’t know how to support her with endometriosis.

The author goes in-depth into the symptoms, some prescribed remedies and options, and the mental toll it takes on someone with this health challenge. She explains how endo shares similar symptoms to other health-related complications, and how it can impact pregnancy.

As someone who has done hours of research and has seen multiple professionals (many of whom do not provide adequate support or believe me), I appreciate Casey’s honest perspective and way of addressing the many challenges that come with endo.

This book is a great way to learn more about endo. I would also recommend the reader look into cycle syncing and natural supplements to help symptoms.

Endometriosis from harm to hope - a chronic illness guide by Casey Berna LCSW (‘Licensed Clinical Social Worker’) published by Sheldon Press, an imprint of John Murray Press this February (2026). Berna has endometriosis too and she describes her personal experience alongwith that of others in this book.

‘This book is dedicated to my brave and resilient daughter. May disease or illness never make you doubt your self-worth. May you never mistake your lack of capacity for a lack of competence. May you always believe your lived experiences. May you never suffer fools who invalidate you. May you always feel loved.’ Casey Berna [2%]

ENDOMETRIOSIS & PAKISTANI WOMEN:
“In Pakistan, the estimated prevalence of endometriosis is 16.8%” According to an article published in Journal of Gynecology Obstetrics and Human Reproduction (Volume 50, issue number 9, November 2021, co-authored by Mohammad Hasan Raza Raja, Nida Farooqui, Dr Nadeem Zuberi, Mussarrat Ashraf, Dr Arfa Azhar, Rozeena Baig, Bisma Badar, and Dr Rehana Rehman). - this of course is as per reported data - because most of endometrial patients are silent sufferers. [Raja, M. S. M. H. R., Farooqui, R. A. N., Zuberi, A. P. D. N., Ashraf, S. T. M., Azhar, S. I. D. A., Baig, R. A. R., Badar, M. S. B., & Rehman, A. P. D. R. (2021). Endometriosis, infertility and MicroRNA's: A review. Journal of Gynecology Obstetrics and Human Reproduction, 50(9), Article 102157].

For e.g. a symposium “Endometriosis: a conversation to accelerate action on helping women who are suffering in silence” was held at Capital Hospital Islamabad in March last year (2025) A news report on it was published in Dawn March 10, 2025. It quoted Capital Hospital’s Executive Director Dr Mohammad Naeem Taj as saying that: “About one in four women undergoing laparoscopic procedures is diagnosed with endometriosis.” Dr Taj, a leading laparoscopic surgeon of Pakistan, underscored the significant yet often overlooked prevalence of endometriosis in Pakistan. He also pointed out that the disease remained poorly understood and inadequately addressed due to a number of factors including insufficient medical knowledge, limited public awareness, inadequate research funding and societal taboos surrounding women’s reproductive health.
In her keynote address, Prof Dr Syeda Batool Mazhar stressed the importance of early diagnosis and personalized management tailored to individual fertility desires and pain severity. She also stressed the positive impact of lifestyle modifications and advocated for accelerated programs focused on women’s rights and empowerment, particularly in health-related matters, to ensure informed decision-making in disease management. Dr Sheeba Noreen, head of the Department of Obstetrics and Gynaecology at Capital Hospital, addressed the diagnostic delays caused by societal stigma surrounding menstruation. Dr Hadia Aziz, Associate Gynaecologist, highlighted the societal invisibility of endometriosis sufferers which denied them adequate healthcare and recognition of their pain. She emphasised the state’s moral and political obligation to acknowledge their suffering and provide essential resources.”

GLOBAL / U.S. STATISTICS ON ENDOMETRIOSIS:
So the experience of Pakistani women is not that different from those in rest of the world. According to the non-profit Endometriosis Foundation of America, Endometriosis affects an estimated 200 million women worldwide and approximately one in 10 women in the U.S. (that would be 6.5 to 9 million women btw in America alone) Office on Women’s health, part of U..S Department o9f Health & Human Services, quotes a study to give statistics on how prevalent this chronic disease is: ‘It may affect more than 11% of American women between 15 and 44.1’ [’Incidence of endometriosis by study population and diagnostic method: the ENDO study’.] World Health Organization quotes similar stats: that it ‘affects an estimated 10% (190 million) of reproductive age women worldwide.’ [15 Oct. 2025]

DELAY IN DIAGNOSIS:
What is important to remember is that on average, there is a 7-10-year delay in diagnosis [as per EndoFund website.] That’s a hell of a long time to be unwell and unsure and scared. And there are plenty of books in the market on this subject in all kinds of languages. It’s always good to consult your local health care worker, General Physician, gynaecologist, reproductive endocrinologist, functional medicine expert or nutritionist, too. I’m sure plenty of listeners are interested in finding as much info about it as possible and in this regard, the book by Casey Berna will comfort an affectee and enhance the possibilities of cure or manage the symptoms.

NOT A GYNECOLOGICAL SUBSPECIALTY:
She makes it a point to mention that ‘endometriosis is not a gynecological subspecialty’ [pg.25] and how ‘most of the health care providers do not learn much about it in medical school’ [page 24] - now this is something that is very important in relation to Pakistan, where the only recourse available to women is a gynaecologist referral, no specialist or general physician is recommended or answers your questions. You’ll have to go to a gynaecologist and get yourself tested and they will give whatever medication they think is good for you to reduce or eliminate the endometrial cyst. So even if you are single, unmarried, virgin or non-sexually active, you still have to sit in a labor room / waiting area with married women who are either in some month of pregnancy or are trying to get pregnant. The gynecologist surgeon whose speciality is maternal and fetal / baby care before and after pregnancy, not endometriosis, will have 5 minutes to do an ultrasound on your ovaries / pelvic region basically or abdomen or breasts to check for endometrial tissue - and you are only getting it checked on the advisement / direction of a general physician, since the GP has no such expertise or facility. Some gynaecologists have their own fertility centres or IVF treatment facilities and they are laser focussed on profits off the baby-making machine. The clinic will be extremely crowded with no privacy and the doctor will simply have no time to discuss your ‘symptoms’ or anxieties or queries. They have scores of clients waiting. Fee for consultation 3-5K. Ultrasound: 4-7K per area. Blood tests: 500 rupees - 20K (if hormone indicators are also tested). Medicines: 3K-plus per month, which may or may not reduce pain, make you bloated, depressed or fat. The OB/GYN surgery on ovaries to remove cyst or endometrial tissue may render you infertile completely - a risky gamble of a surgery.
Now Berna in this book differentiates between a general OB/GYN doctor (who monitors pregnancies and deliver babies) and a gynacological oncologist who screens and treats cancer patients. However, there is no multidisciplinary specialist for endometriosis.

She says that American doctors usually rely on the Management of Endometriosis Practice Bulletin by American College of Obstetricians & Gynecologists (ACOG) to diagnose and treat it. [page 26] Btw, the ACOG recommends that if pain is severe and does not go away even after treatment, then a hysterectomy i.e. removal of ovaries may be done. [https://www.acog.org/womens-health/faqs/endometriosis ] In fact, Berna says that “so much of the research surrounding endometriosis and treatment for the disease are based on stopping menstruation, or dramatically reducing estrogen levels inducing menopause-like symptoms, or surgically removing our ovaries and/or uterus to treat the disease. We are told time and again that if we can make it to menopause we will feel better. Some of us are even encouraged to go through surgically induced menopause to be able to find relief from all of our endometriosis symptoms. Some people do feel better once they are in menopause. I often wonder how many of these people also had adenomyosis or other uterine-based conditions that did get better after menstruation stopped. We know that endometriosis, adhesions, fibrosis and inflammation exist in menopausal patients.” [pg. 60]

INFERTILITY:
There are a lot of myths around this disease. The most important thing to remember is that not everyone with endometriosis is infertile, as Casey Berna notes on pg. 43. The American Society of Reproductive Medicine estimates that 30-50% of women with endometriosis suffer from infertility and 25-50% of women with infertility have endometriosis….but there are multiple factors that contribute to infertility in endometriosis patients and she goes on to describe all of them [pages 43-44]

DEFINITION:
Even though endometriosis is normally discussed in relation to reduced fertility, Casey Berna defines it as “a systemic inflammatory disease that can impact nearly every organ in the body. By definition, endometriosis is the presence of endometriotic lesions (or tissues) found in various locations outside of the uterus. These lesions are similar in nature to the tissue that lines the uterus, except endometriotic lesions create their own estrogen and stimulate the release of excess prostaglandins [which are hormone-like lipid/fatty compounds], often inciting an inflammatory response from our own body’s immune system. The inflammatory response is our body’s way of trying to heal, yet the body is not able to eradicate the lesions. Pain, inflammation, organ dysfuntions, fibrosis, and adhesions commonly develop wherever endometriosis exists and also contributes to systemic inflammation throughout the body.” [pgs 1-2]

She calls it ‘an unwelcome intruder in the body,’ ‘an excruciating and invasive disease that impacts 1 in 10 individuals assigned female at birth, and loess commonly has been found in cisgender males.’ [pg. 2]

Page 4: “While endometriosis can impact fertility and sexual health, it is far from the only thing. It can impact the ten other systems in the body including _____” [she lists down the other body organs]

She says it’s not simply a hormone imbalance, that it’s not a curable disease, that it’s not just a white woman’s disease or caused by sexual trauma, but most importantly she writes, endometriosis is not just ‘in the patients head’ as women sufferers are so often brushed aside on this pretext. [pages 4-5]

SYMPTOMS:
Right at the beginning [page 1], Casey Berna quotes a 26 year old woman’s symptoms as following - you’ll find real case studies and views of actual sufferers in this book: And another one aged 16 who is quoted on page 8, etc.

She goes on to lay out the all-encompassing and diverse set of things a person feels when they have endometriosis on pages 7-8]. And says on page 10 that “in our thirties and forties, (health care) providers more readily recognize endometriosis if we are white and struggling with infertility. But by then, the disease has been thriving in our bodies for decades.” [pg. 10]

MULTIDISCIPLINARY TREATMENT:
On pages 17-31 she gives multidisciplinary options available to affectees. She starts by naming the types and side effects or drawbacks of all medications that may be prescribed to an affectee: for e.g. the NSAIDS (nonsteroidal anti-inflammatory drugs), the combined hormonal contraceptives, progesterone and progestins, GnRH agonists (which put you in a menopause-like state) and GnRH antagonists (drugs with significant side effects to the individual and their fetus), surgical treatment options available (for removal / excision of endometriosis) which according to Berna, may include a team of a general surgeon, a colorectal surgeon, a urologist and sometimes a cardiothoracic surgeon, while majority of OB/Gyns cauterize or burn the surface of the endometriotic lesions, called the ablation technique. [pages 21-22]. Even after doing all this, there is no guarantee that these options will reduce the symptoms and or reduce the chance of the disease progression to other parts of the body. But she recommends pelvic floor therapists and mental health practitioners, pain management specialists, acupuncturists, nutritionists and functional medicine practitioners for a truly multidisciplinary care for endometriosis. [pg.23]

On pages 65- 90 she discusses the possibility of other chronic health issues simultaneously with endometriosis and challenges in their proper diagnosis and treatment such as adenomyosis, uterine fibroids, interstilial cystitis female bladder pain syndrome, polycystic ovary syndrome, fibromyalgia syndrome, myalgic encephalomyelitis / chronic fatigue syndrome, hypermobile Ehlers-Danlos Syndrome, postural orthostatic tachycardia syndrome, mast cell activation syndrome, even long COVID. Autoimmune disorders like lupus, rheumatoid arthritis, celiac disease, Multiple sclerosis, inflammatory bowel disease, addison’s disease, sjorgens disease, hashimotos thyroiditis etc. can also co-exist at the same time as and overlapping endometriosis. You’ll see that the symptoms of these syndromes and disorders mirror those of endometriosis with fatigue, pain, and gastrointestinal issues recurring theme. From pages 91-183, she goes on to talk about the toll all of this takes on mental health. A huge range of medical trauma is discussed. The needs of such an individual on a personal, familial, societal and advocacy level are pointed out.

SUPPORT PROTOCOL FOR ALL PROVIDERS:
Health care professionals can review the support protocol she wants them to follow given as Appendix A on page 185- 188.

So all in all, this book provides a summary of the multitude of issues surrounding the subject of endometriosis and it will be helpful to anyone who wants quick, easy to read info on all basic aspects of the disease to better prepare on what to expect from one’s own self and others.

Thanks to the publisher for the ARC. All the best to the author in her health journey.

This was a great book with all kinds of information. I had heard a good bit of the things the author covered but it was at all different times, from all different sources, so it was nice to have everything in one place. This was a book that made me feel seen and was therapeutic and inspirational. Thank you for the reading opportunity.

An impressively informative and empathetic overview of the condition, the book is particularly strong in the way it validates patients’ experiences and breaks down the systemic barriers that so often delay diagnosis and care. The only limitation is that it leans heavily on the structure, policies, and advocacy landscape of the U.S. healthcare system, which means some sections feel less directly applicable elsewhere, though the core insights about pain, latest research, dismissal and the need for patient‑centred support remain universally valuable.

Easy-to-follow compendium of helpful endometriosis facts, stories, and information. Great resource for those with endometriosis and/or those in their lives that support them.

An in-depth examination of endometriosis and the huge number of ways it can impact your life.

At once both wonderfully educational and completely infuriating, this book breaks down the physical, mental, and social ways that endometriosis can affect someone. As well as examining how the process of getting a diagnosis and treating the disease can be completely overwhelming with medical racism, doctors dismissing or diminishing your experience.

Thanks to NetGalley and John Murray Press for this arc.