I’m 19 and I’ve had really rough periods since I was about 13. I’ve been on birth control to regulate my otherwise unpredictable cycle since I was 14, but this month specifically I’ve been bleeding randomly every week.

I often have cramps, even when I’m not on my period, and intense lower back pain. When I’m in the first couple days of my cycle, my cramping is so bad that I just have to curl into a ball and apply heat for hours at a time. At random times in the month, I get slightly less intense cramping and pretty severe nausea. I alternate frequently between constipation and diarrhea. My periods are always very heavy.

I have sex frequently without pain, but sometimes certain positions make me cramp in my lower abdomen area. My partner and I have figured out what works, so this isn’t a huge problem. Sometimes I have mild soreness like cramps after I orgasm, especially if I orgasm multiple times in a short period. I get frequent bloating.

I tend to attribute a lot of these symptoms to stress, but I’m starting to wonder if I should get checked for endometriosis. Thoughts?