Stromal endometriosis, characterized by fibrous tissue with nerve endings and lacking glandular lesions, can cause increased bloating, inflammation, and deeper pain.

“The problem is a small subgroup of patients have stromal endometriosis who's actually, you know, this stromal endometriosis is not as rare as what you read. It's actually very common in almost every end endometriosis surgery that I do. My path report shows at some stroal endometriosis implants. So stromal endometriosis, imagine those cells in the uterus, they have the gland, but they also have the stroma, the connective tissue around it. Stromal endometriosis doesn't have the glandular uh lesions with it. It's just these fibers that have nerve endings and the the nerves get squeezed and actually patients with stromal endometriosis tend to have more bloating, more inflammation and more deeper pain.”