My endo notes · 6 min read

Why My Endo Pain Starts on Day 14 (And What an ER Nurse Told Me to Do About It)

KBy Kayla M. · Tulsa, OK
Updated November 4, 2026

If you got here from my post, you already know how I ended up on my son's floor at 3:12 AM. What you don't know yet is the one question that would have kept me off it. So many of you messaged me with the same three questions: what exactly Renee told me, why the DIM I bought made everything worse, and what I take now. So I'm putting all of it in one place, the way I wish someone had put it for me twenty-three years ago.

Here's the short version if you didn't see the post. I'm 38, I've had endo since I was fifteen, and four months after I came off the pill I ended up on my son's bedroom floor at 3:12 in the morning with a 5.2 centimeter chocolate cyst. In the ER, around 4 AM, a night nurse named Renee pulled up a stool and asked me one question that changed how I see my whole cycle.

“Not the day it hurts most. The first day you feel anything at all. What day of your cycle is that?”

Answer Renee's question before you read anything else

Open your period app, or just think back over your last three cycles, and be honest with yourself.

• Do you get a sharp little twinge low on one side somewhere around day 11 to 14?
• Does your belly go from flat to “are you pregnant?” in the middle of your cycle, not just on your period?
• Do your cramps come with diarrhea, or does your gut go weird the week before?

If you said yes to even one, your bad week probably doesn't start on day one either. Mine started somewhere between day 11 and day 14, every single cycle, and it was sitting in my own app the whole time. I'd been budgeting for one bad week a month. I was living two and a half.

It was never too much estrogen. It was estrogen with nowhere to go.

I always thought “estrogen dominance” meant my body made too much of it. That's what half the endo videos say and what half the supplement bottles say. Renee said it's not that simple, and when she drew it on the back of my discharge papers, it was the first explanation of my endo that actually made sense to me.

Your estrogen is supposed to make a one-way trip. It peaks right before you ovulate, around days 12 to 14, does its job, and then your liver packs up the used estrogen so your body can throw it out. The package goes down to your gut and leaves.

With endo, that trip breaks in two places.

The first is the peak. Endo spots feed on estrogen, so days 12 to 14 are when they get their biggest meal. That's the twinge. That's the belly that blows up in ten minutes. The spots even make some estrogen of their own, which is why the pill can turn your ovaries down while the endo keeps growing anyway.

The second is the back door. In your gut there's an enzyme called beta-glucuronidase that unpacks the estrogen your liver just packed and lets it back into your blood. Renee said in some women up to a third of it comes back that way. So the endo gets a second helping every single day, and it lands right on top of the next peak.

“It was never too much estrogen. It was estrogen with nowhere to go.”

That one sentence explained twenty-three years for me. It explained the diarrhea with every cramp, because my gut was working on what my liver sent down. It explained why my cramps were back by my second cycle off the pill, and why my lap at 29 bought me about a year before everything slowly came back.

Why my Amazon DIM made my period ten days late (and why this time it didn't)

This is the part most of you asked about, so I'm going to be honest. After I came off the pill, I bought a bottle of 300 mg DIM from Amazon because everybody in the endo groups talks about it. My period came ten days late and I had a headache for four days straight. I quit, and I decided DIM was dangerous for women like me.

If that happened to you, you're not crazy and it wasn't in your head. Half the women in my endo group have a DIM horror story, and some brands now put “No DIM” right on the front of the bottle.

Here's what Renee told me, and it's the only reason I was willing to try again.

DIM does one job. It changes what your estrogen turns into, toward the gentler kind and away from the kind that feeds endo. That part is real. Researchers took endo tissue out during surgery, put DIM on it, and the estrogen coming off the endo dropped by almost half while the healthy tissue right next to it didn't change. Women who added DIM to their endo pill had less pelvic pain and better bleeding than women on the pill alone.

But DIM on its own does nothing about the road out. It changes the estrogen and then leaves it sitting there with the back door wide open. And 300 mg all at once, on a body that had just come off hormones, was way too much, way too fast, with nowhere for it to go. That's your late period. That's your four-day headache.

So it was never that DIM is bad. It was DIM on its own, with the back door wide open and nowhere for the estrogen to go. And taking the DIM out, like those “No DIM” bottles do, doesn't fix that. It just leaves your estrogen the kind that feeds the spots, and works on the gut alone, which is the last stop, not the whole road.

Everything I'd already tried, and why it kept coming back

That night I typed what Renee said into the notes on my phone. I'm pasting it here because I think every woman with endo should have this list.

Every one of them works on one stop. None of them closes the whole road.

What Renee texted me two days later: the whole road out, in one softgel

Renee had written her cell on my discharge papers. Two days after the ER, she sent me that photo with one line under it: “This is what I'd take if I still had my ovaries.” When I called her, she said the thing I still repeat to everyone.

“It's not just DIM, and it's not a gut pill. It's the whole road out, with the back door shut.”

The pouch was FemSwitch. Renee calls the way it works “change it, pack it, keep it packed,” and when I read the label I finally understood why it wasn't the same thing as my Amazon bottle.

1. 1
   Change itDIM 200 mg

   It changes what your estrogen turns into, toward the kind that doesn't feed the spots. It's 200 mg, not 300, and you start with half of that.

2. 2
   Pack itBroccoli seed 300 mg + white mustard seed 30 mg

   The mustard seed switches the broccoli seed on, so your liver can pack the used estrogen up for the trip out.

3. 3
   Keep it packedCalcium D-glucarate 200 mg

   It blocks beta-glucuronidase, the gut enzyme that unpacks your estrogen. That's the back door, and it's the piece my DIM never had.

For your period and the week before, there's saffron at 30 mg, which has been studied for painful periods, plus vitex at 40 mg, B6 at 20 mg and vitamin E. DIM only dissolves in fat, so it all comes in a softgel with 900 mg of evening primrose oil, with rosemary and black pepper to help it absorb.

There are no hormones, no soy and no plant estrogens in it. It doesn't add estrogen and it doesn't shut anything off, so you can take it on or off the pill.

How Renee told me to start: one softgel with your biggest meal, two from day 5, and don't judge it on cycle one.

Cycle by cycle: from 14 ibuprofen to 4, and a cyst from 5.2 to 3.1 cm

1. Days 1–5

   On day 3 I had a mild headache for one afternoon, not the four-day kind. On day 5 I went to two softgels.

2. Cycle 1

   My period came on time and it still hurt. But I took 9 ibuprofen instead of my usual 14, and I didn't throw up.

3. Cycle 2

   Day 14 came and the twinge didn't. I only noticed because I was waiting for it, standing at Eli's soccer practice with my stomach flat under my T-shirt.

4. Cycle 3

   My period lasted 4 days instead of 7. I took 4 ibuprofen the whole time, I was at my desk on day one, and I texted Renee, “Day one. I'm at work.”

5. Month 4

   When I told my OB-GYN I wasn't going back on hormones, she booked an ultrasound. The cyst that was 5.2 centimeters in the ER measured 3.1. She said, “Whatever you're doing, don't stop.”

It isn't gone, and I still know my period is coming. But it doesn't run my month anymore, and Eli stopped asking if mommy's tummy hurts again.

What other women wrote to me after my post

My inbox blew up after that post. I asked a few women if I could share what they told me, and I'm leaving their last names out.

Where to get it, and the 90 days that made me brave enough to try

They sell it on their own site, and that's where my link goes. If you're nervous like I was, this is the part that made me feel safe enough to try.

Three full cycles, or every dollar back. They give you 90 days from the day your first order arrives, which is three full cycles. If it doesn't help, you email them and they refund every dollar, even if the pouch is empty. No return label, no photo, no phone call. That's on your first order, and nothing else I tried ever came with that.

My one night in the ER cost us $2,840 after the deductible, plus two unpaid days. Four months of this costs less than seventy cents a day, and if it doesn't help, it costs nothing.

Right now it's in pre-sale. When I ordered mine, the November batch was already gone, and the December 1 batch is filling up. You reserve today, it ships December 1 and gets to you between December 8 and 15, and your 90 days don't start until it's in your hands.

See if the December 1 batch is still open →