The Endo Letters

The Endo Letters

Written by Holly Sanneman

Illustrated by Matt Shembari

(Original story and characters created for The American End of Endo Project. Please feel free to share, but we kindly ask that you keep the attributions.)

@americanendoefendoproject @hollysanneman #TheEndoLetters

In the first episode of The Endo Letters, we meet Endo Metriosis as seen on his preferred “match, chat, and meet new people app” that is called “Torture”. 

Episode 1- Endometriosis’ Dating Profile

Hi All,

My name is EndoMetriosis but you can call me Endo for short. I live wherever the heck I want to and take form however I want to. I don’t like labels or “sameness” so I do whatever I want mostly.

I have a weakness, an addiction almost: I love estrogen and cannot get enough of it. Makes me feel alive. It makes me really angry too, but I get off on being angry. I don’t know where I was born, but I know I have relatives that live in uteruses. I’m embarrassed to call them relatives- I am NOT the same as them, FYI. They’re just afraid to explore and blow things up. They seem more into “babies” and “normal periods” and stuff.

That life is too boring for me, so for my Patient, I don’t let those boring Endometrium give her “normal” anything. I’m a drifter and a rebel and love seeing how much I can burn to the ground. One of my favorite things is knowing how so few people know how to deal with me. I feel invincible, as if I could torture people forever. You can help me.

First, in order to help me, deny that I exist or at least how “bad” I am. As long as people think excruciating pain is normal, I am free to wreck people’s lives. As soon as you start pointing fingers at me and standing up for “normal periods”, I am endangered. So please, keep denying me and keep denying women’s pain. Thank you in advance, dear friends.

(read more below)

Next, deny periods in general. It’s easier to deny my presence and deny women’s pain when we all just make it a rule to not discuss gross organs like uteruses and ovaries and focus on what they consider not-gross organs like stomachs and kidneys. Shame keeps them quiet.

If we can make it a rule to leave “impolite” conversation out of the equation and focus on easy topics and anything superficial, I can get my destructive work done in peace. If these pesky women could just keep me a secret at the doctor’s office, I wouldn’t have to deal with haters. If doctors could keep rolling their eyes and ignoring the patients who do squawk, I could get a lot more done. Seriously people, I have lives to ruin here, and I am a damn good torture artist.

I really love seeing how big I can get, how many ways I can look, and where I can hide. My favorite thing to do? Hard to choose. One thing I love is showing up in bizarre places no one would expect. The other thing I love to do is leave scars that cause even more damage. It’s my “calling card”.

I’d call myself “resilient” because even when doctors try to zap me out or treat me with medications, I keep growing. I’d consider myself creative, anarchist, temperamental, and goal-oriented: the more places I can “level” and prevent from thriving, the better I’m doing. I aspire to freeze organs and obliterate entire systems, but I do what I can when I can.

So that’s it, rant over. That’s me, Endo, all summed up. If you’re into destroying women’s lives and building an empire of misery, you and I can be best friends along with my squad that includes Adenomyosis, Interstitial Cystitis, and Fibroids. If you bring pain, destruction, depression, hopelessness, or any other form of torture to girls and women, let’s hang out some time. 

Episode 2: A Body in Chaos – Heart’s Correspondence with Brain

Hello Brain Dear,

How are you? I wanted to see if you have any information that could help me with something. I am really struggling because I feel like I have to be really strong all the time but everyone seems to think I am weak. I want to help the Patient but I feel like I am falling apart. Do you have any idea what is going on in the body?

With Love, Heart

Hello my Sweetheart,

I know, I’m concerned, too. Every day the nerves run up here and deliver bad messages but I cannot tell what to make of it. The Patient wants answers but I don’t really know what to tell her. What kind of Brain am I, that I cannot think?

Kind Thoughts, Brain

Oh Brain, I know the feeling. I feel like a poor heart for being down so often but I feel like I am under attack nonstop. Whatever shall we do?


I don’t know Darling. I will think harder and remain vigilant for clues as to what could be happening. -Brain

The Endo Letters- Episode 3 Edit

By Endo Project Squad | January 24, 2019 | 0

Episode 3- Brain’s Briefing with Eyes & Ears

The next day at Headquarters…

Brain: Eyes, Ears, thank you for seeing and hearing me this afternoon.

Eyes and Ears: Absolutely, sir. What seems to be the problem?

Brain: We have a problem within the Patient’s body and it is affecting each of us in some way. I can’t seem to think of what could be wrong. We need you all to remain vigilant and look for clues as to what could be happening. Can you do that for us?

Eyes and Ears: Yes, of course.

Brain: Information is power, so pay attention. Read intelligent books and articles and talk to a variety of people. Collect what you can for me and I will evaluate it critically.

Eyes and Ears: Yes, sir.

The Endo Letters- Episode 4 Edit

By Endo Project Squad | January 26, 2019 | 0

Episode 4- Intestinal Property Manager’s Encounter with Endo

Intestinal Property Manager: Endo, Fella. You gotta go.

Endo: No way man, squatter’s rights. I live here and there’s nothing you can do about it.

Intestinal Property Manager: No, no. I’m sorry. We’ve have had lots of complaints that you are causing problems here. When you moved in you said you were training to be a uterus and we believed you. You said you weren’t taking up any room and we believed you. Now, 20 years later you are not a uterus and your kids and friends are taking over the place and leaving their junk everywhere. Not to mention there are some criminals in the group…

Endo: CRIMINALS? Really, you’re gonna go there? These aren’t criminals!

Intestinal Property Manager: Oh really? Than why are they gluing those tissues together as we speak?? I am watching them do it right now!

Endo: Ah, no man. Those aren’t from my guys. Those tissues are being glued together by uh… the Uterus. It’s her fault.

Intestinal Property Manager: Okay well are THOSE your kids who are burrowing over there? Yes, those are your kids. Those are endo kids. Why are they IN the walls? “Get out of the walls!”

Endo: Nah they ain’t gonna listen to you. They’re just kids anyway not criminals. And we ain’t leavin’.

Intestinal Property Manager: I realize that this is hard for you and that our last attempts at removing you were unsuccessful, but you really need to go. We have alerted the Patient’s Brain that you could be the problem.

Endo: Me and the Brain are close. We met at a party last year… well, I mean, we didn’t really meet. I did something funny and he thought it was stupid but I’m pretty sure that once we talk we will be buddies and then there’s really nothing you can do about me or my guys. Our Patient will never suspect that I am being anything but a perfect tenant. Just wait and see.

The Endo Letters- Episode 5 Edit

By Endo Project Squad | January 28, 2019 | 0

Episode 5- Endo texts Brain

That afternoon…


Endometriosis here. I know we got off on the wrong foot when you first learned my name, but I thought we could start over. I’m just a few little tissues and I like to play pranks. I’m not so bad. I’m sure we can get along once we get to know each other. You’re funny right? You got a good sense of humor?

Anyway, you haven’t heard from me in a while because I been dealing with the landlord at one of my places- he wants me out even though I’m doing nothing wrong. You see, I decided to branch out to the bowels so we are getting settled in there. It’s super funny what I want to do.

So, labor-like sensations had almost driven our Patient to insanity, but she got more pain medicine and changed her diet or something. I don’t know.

She’s always trying to avoid these strong sensations (which she refers to as “pain” but she’s clearly misled), but I know how to mess with her still. Well this time, she will have to deal with more than just the usual feelings she mistakenly calls “pain”.

If all goes according to plan, we will have increasing bowel symptoms including constipation and diarrhea (I like to keep her on her toes!), nausea, and a lack of appetite. I’d like to see her keep to her new diet with all of that being thrown at her- ha!

It’s a juggling act for sure and the punchline is hilarious I assure you. This is where I need your help. She cannot suspect that I have hidden her bowels. I don’t want her to know about me in general but seriously, you need to keep this a secret from her.

It will make the surprise that make funnier. If you do me this one favor, it might shut up that intestinal landlord and then you and I can be friends forever.



The bowels? Seriously? You know I don’t approve of what you are doing to this girl.

I cannot condone this.

I have alerted her that you may be up to something in her guts. Count me out.

An organ in my position cannot be playing such horrific “pranks”. Surprising as it may seem to you, I am not seeing this as “humorous”.

I am reassessing the signals I was sent to see if these “sensations” are not pain… but they really seem like they are.

They are really intense, too. I must advise you to lay off on the jokes right away.


The Endo Letters- Episode 6 Edit

By Endo Project Squad | January 31, 2019 | 0

Episode 6- Brain’s Dinner Talk with Heart

That night at dinner

Brain: Oh my Darling, I got the strangest message today from a fellow named Endo… He’s apparently a little guy who wants to be a comedian.

Heart: Well what did he want, Dear?

Brain: Well of all things he wanted me to let him play jokes on the poor intestines. You know that whole area is going through a lot right now though. It would be a horrid prank to play-with all the crime they’ve been seeing there. I feel terrible for the intestinal landlord. He says it’s a mess down there.

Heart: Crime!? Oh my!

Brain: Yes yes… They’re really struggling right now and I cannot figure out why. Between that and the pain messages from all over… I really am perplexed. Endo said he was joking around with “sensations” and that the Patient is mistaken for thinking they are “pain”. Besides, he lives in the south and the Patient keeps sending out pain signals from all over.

Heart: Well, do you think that Endo fellow is involved? I mean really involved?

Brain: Oh nonsense, Heart. He’s tiny really. You can hardly see the guy. He talks like he’s going to do big crazy things but it’s all talk… I think it’s all talk anyway. I just don’t see how anyone that invisible and generally quiet could be so bad.

Heart: Well alright if you say so. I still think it seems suspicious. Our Patient was made for so much more than this. She should not be miserable every day, so if I were you, I’d do my best to get to the bottom of this.

The Endo Letters- Episode 7 Edit

By Endo Project Squad | February 1, 2019 | 0

Episode 7- Endo’s Secret Encounter with Uterus


Endo: Hey… shh. Don’t look too suspicious.

Uterus: Wait, what? Me?

Endo: SHHHH I said. I’m here to warn you.

Uterus: Warn me? About what?

Endo: About your impending eviction.

Uterus: Oh no! Why?? What happened?

Endo: The Patient is tired of pain, plain and simple. You’ve really done it this time. She’s miserable.

Uterus: Oh dear! I had no idea. The ovaries and I have just been doing our jobs… honest. I never meant to hurt the Patient! I’m innocent I promise.

Endo: SHHHHHH! Everybody knows pelvic pain equals a criminal uterus. EVERYBODY knows that.

Uterus: Oh no no no. That is horrible. Sir, if I broke the law it was entirely unintentional. I feel so bad about this. All I ever do is try to keep to my schedule and stay ready in case it’s time for the Patient to have a baby. This is just awful!

Endo: No need to get hysterical. I was just warning you that people are talking. Just a warning, period.

Uterus: *sniff sniff*okay, thank you for the warning, kind sir. I will pack my things. Before you go Dear, what is your name?

Endo: Let’s just say, you probably can’t pronounce it.

The Endo Letters- Episode 8 Edit

By Endo Project Squad | February 3, 2019 | 0

Episode 8: Endo’s Correspondence With Brain Part II

The next day…

Texts from Endo:

Brain Brain Brain,Dear old Brain,

You can’t think that I actually meant what I said! It was a joke. I was joking. Of course I’m not involved with the bowels. It’s probably just irritable bowel syndrome she’s dealing with. A coincidence. You know how Big and Small Intestines get for no reason: irritable and overreacting.

No no, I was kidding and there is no reason to suspect me. I’m not a gut problem. If you really want her to feel better you should just imply to the patient that if she would just get a hysterectomy, pain will be gone and we can live together in peace.

I want you to note that the Patient’s people did numerous tests recently on the property down here and never once did anyone even notice I was here, so if anything comes up and people want to blame me, you just show them the results of the tests to set them straight.

Imaging: clear. Bloodwork: clear. Pelvic exam: clear. It’s pretty obvious that I’m not the issue.

Texts from Brain:


Thank you for clarifying your intentions. I don’t know what to think anymore. The Patient is not totally comfortable with the idea of a hysterectomy but wants to feel better. The thing with the bowels is making her feel crazy now. The doctor she just visited made her feel crazy, too.

I’m feeling like it’s all my fault, you know? I should be able to sort this out for her. Am I sick? Am I broken?

Maybe I should just tell her to give up looking for answers since I am clearly no good at sorting information. It’s a lot to take in. Heart is complaining to me also and I don’t know what to tell her. This is probably way too much information to give to a relative stranger, but I guess I don’t know who to talk to. Everyone in this body seems so sad and confused nowadays.

On another note, the Patient is concerned about the pain she has not just during her period, but also around ovulation and other random times, too. Since you’re related to the Endometrium family, do you have any idea what that could be?

Texts from Endo:


Yes, I hate to break it to you, but the Patient does sound a little coocoo. Maybe you should take a break and encourage the Eyes to stop reading so much. Like I always say, too much information is dangerous. If the doctor doesn’t know what is wrong with her, that means it is probably all your fault.

Maybe you should look into some medications to help you relax. You don’t want her to go completely insane all because of you, do you?

As far as the pain that seems to be so frequent, no, I don’t have a clue. I’m minding my own business over here, just some little tissues, just chillin’. I mean, if she has pain that often, do you think maybe she’s just depressed? Maybe she needs to exercise more. I strongly urge you to let it go or look into medication. I mean, at the end of the day, are health and sanity really that important? You should focus on getting her to accept her reality and find a way of getting her to calm down. 

Hope this helps. 

The Endo Letters- Episode 9 Edit

By Endo Project Squad | February 7, 2019 | 0

Episode 9: Uterus’ Meeting with Brain

Later that week

Uterus: Hello, Sir. I am here to turn myself in. *sniff sniff*

Brain: Thank you for stepping forward, Uterus.

Uterus: It was the right thing to do. I feel terrible about everything.

Brain: So, what is it about you that causes pain? Is there something wrong with you? Is there anything malfunctioning in you? You seem like a nice enough organ, don’t seem like you’d do it on purpose…

Uterus: Oh heavens no I would never hurt anyone on purpose.

Brain: So you’re saying you are not aggravating the nerves or sending them with bad messages?

Uterus: Of course not! The ovaries and I have just been keeping to our schedule as best as we can and I have been cleaning, preparing and decorating the nursery in case a fetus needs somewhere safe to stay for several months. I just heard I was in trouble for doing something wrong and let me tell you sir, I had no intentions of-

Brain: Wait, WHO told you you were in trouble?

Uterus: A stranger, very smooth-talking and quick. He looked familiar… like maybe we could be related… but I’ve never seen him at any holidays…

Brain: Interesting. Very interesting. Uterus, you are not in trouble. You seem innocent, for now. Go back to redecorating for your possible embryonic guest. What color is the nursery this month?

Uterus: I’m going with reds and pinks.

The Endo Letters- Episode 10 Edit

By Endo Project Squad | February 10, 2019 | 0

Episode 10: Endo’s Text with Brain Part III

Two weeks later…


Hello? I never heard back from you after the last message. Is everything okay?

Another week later…


HELLO! Where are you? Are you getting these messages? I hope you’re not mad at me for something. The whole “traveling to the chest” thing was a joke.

Oh wait, did I even send that? I don’t remember. Never mind.

Anyway, I miss you!

Three days later…


You detestable, miserable, slimy rat. You lying, dirty scoundrel from the depths of hell. I just spent the last few weeks doing the opposite of what you told me to do because something seemed OFF.

When you said that information is dangerous, there was a major red flag. Information is not dangerous, it is empowering. Information is my industry: I am a BRAIN, and our Patient is an intelligent young woman. She and I banded together and learned all we could this week, and what we learned is that YOU are the problem.

YOU are the reason she hurts all the time.

YOU are the one stealing her life.

YOU are the one that infiltrated her bowels.

YOU are the one traveling into her chest.

You think you’re so clever and that you will never get caught. Well guess what, sucker, our Patient has an appointment with an endo specialist who is going to do a wide excision. You can’t hide from this doctor. You’re getting sent to the pathology lab so you can be officially sentenced, and you are being vanquished.

We’re on to you all, and you are going down. No more hurting her. NO. She deserves far better than this. She will not let you steal another moment of her life. I never want to hear from you again.



I am crushed that you think I am the problem. I’m just little tissues, like I said. Am I cancer? No. Am I killing this girl? No. Do I cause pain? Does anyone really know? It’s all hearsay. I think you’re just looking for someone to blame here. Maybe you should just get me a soy latte as an apology and cancel that excision surgery. Aren’t all surgeries the same? I lived through the last one so even if I was guilty, this one wouldn’t work anyway.

The Endo Letters- Episode 11 Edit

By Endo Project Squad | February 11, 2019 | 0

Episode 11: Endo gets what endo deserves

One month later…


I’m writing you from the big house. It’s literally a petri dish. That surgeon got every last one of us. I’ve never seen such thorough removal. Literally all of my buddies are here. I’m honestly impressed that you and the Patient  figured this out- we’ve stumped people for millennia. Bravo.

The thing I hate most about this though is that all the other chronic illnesses get to keep playing while I’m in the slammer. So here’s the deal: Now that I’m locked up I can give you some pointers from a disease’s perspective to help with future run-ins. A consultant, if you will.

They said good behavior won’t let me out any sooner, but I guess I can at least snitch on the other conditions now that the game is over for me. I wouldn’t want other expert diseases to outlast my reign. That would be just embarrassing.

We chronic conditions, we hate specialists.

If you want to defeat a condition, work with the Eyes and Ears to find a competent specialist. Also we love hostile, inflammatory environments and are highly opportunistic, so work with the other organs to help them realize what is inflammatory to our Patient and work with the Immune System to see what puts her body in the best condition.

We inflammatory guys HATE when the Patient is in good overall condition because it makes our jobs harder. Lastly, we THRIVE on hopelessness. If you want to help the Patient to be “optimistic” and keep “trying” and taking “healthful steps”, work hand in hand with the Heart and remind her of hope. That will make any disease squirm in its seat.



Can’t say that I’m sorry for turning you in. The Patient seems to be doing much better now. I’ve gotten about 90% fewer pain messages since you guys went away. That said, I do thank you for your pointers. I’ll be sure to promote hope. Do you think if you were to get out, you’d be reformed?


Hey B,

Oh hell no. Absolutely not. Once Endometriosis, always Endometriosis. Destruction is in our DNA. I can teach lessons here, but I’d definitely go back to sticking organs together and poking at nerves if given the chance. Even thinking about it gets me riled up. I’m inflammatory and my friends are, too. We compete with each other. We love bonding, both with each other and bonding together organs and tissues.

I don’t know what day I’ll get out of here (if ever), but if I do get out, I’ll go back to torturing. It’s what I do and it’s who I am. Besides, no one would think I could come back, so no one would suspect me. Our friends on the outside have done a tremendous job of spreading all kinds of fake news so that most people don’t really understand who I am or what I am capable of.

No, if I ever have the chance to screw up the Patient again, everyone will say “you can’t be sick, you had surgery” and I will laugh and laugh and laugh. Have fun on the outside, Nerd.


The Endo Letters- Episode 12 Edit

By Endo Project Squad | February 12, 2019 | 0

Episode 12: Recap

CS Lewis’ book The Screwtape Letters was the inspiration for this story series. I have found it particularly effective to hear stories from sides that are dissimilar to the usual stories. In this case, a classic case of endometriosis in a person’s body is narrated through the perspective of the person’s body itself, including endometriosis. The person these body parts inhabit is called their Patient and she represents the 176 million or so people who suffer from and fight against endometriosis.

If you find yourself in a role that is similar to the Patient in this story, please take Brain’s advice and learn from Endo’s “consultant” notes. Knowledge truly IS power, but learn critically. Not everything that comes from a “medical source” is accurate, so compare and contrast information from a variety of reliable sources. Keep the hope: it’s more difficult yet more important than almost anything, so keep trying. Find an actual endometriosis specialist who removes endo instead of just burning it. Make sure they are obsessed with thoroughness because thoroughness is everything.

I hope that you enjoyed this story series! Feel free to share it as much as you like, but please always attribute it correctly: @AmericanEndofEndoProject, Story by Holly Sanneman, Illustrations by Matt Shembari


  1. Pamela on June 16, 2020 at 5:28 pm

    If I was not already hurting from endo I would be hurting from the humor and understanding of this!

    • AEEP on June 17, 2020 at 12:40 am

      Sometimes we gotta laugh to keep from crying :-p Glad you enjoyed it!

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