Carys Thurlby first experienced the pain as a teenager.
During high school exams, she recalls “chewing on” Tylenol as searing pain tore through her pelvis and radiated into her legs.
In the beginning, the episodes appeared only around her period. Gradually, however, the pain became a constant presence.
At 19, Carys was diagnosed with endometriosis — a chronic condition in which tissue resembling the uterine lining grows elsewhere in the body, most often in the pelvis, causing severe pain.
More than 6.5 million women in the US are affected by endometriosis. The condition can bring painful periods, pain during sex, exhaustion and difficulties conceiving.
Its causes remain unclear (see panel), and there is currently no cure.
It took another two decades for Carys, now 43, to find relief: a total hysterectomy.
Today, she says the invasive, irreversible and controversial procedure transformed both her life and her body for the better.
Before the surgery, Carys — a trainee educational psychologist from Worcester, England — says endometriosis dominated every part of her existence.
“Every day was about scraping through to survive,” Carys says.
“I didn’t have any hobbies and barely a social life.”
The pain forced her to take a year away from college. When she returned, the agony had intensified, disrupting her ambition to become a teacher.
“It would have been too much to be standing up teaching all day,” she says.
Endometriosis also made it difficult for Carys and her husband, David, to start a family.
After 12 years of trying, the couple eventually had two children through IVF: Laurence, now nine, and Merryn, now seven. The treatment cost the family around $60,000.
Alongside the pain and fertility struggles, the condition affected Carys’s weight by restricting her ability to exercise and shaping her eating habits.
It took two decades for Carys Thurlby, now 43, to find a treatment that eased her pain. She is pictured at her heaviest, when she weighed 20st.
At her heaviest, Carys, who is 5ft 6in, weighed 280lbs.
“I barely moved,” she says. “After a full day’s work, I was exhausted by the evening. I’d snack on sugary food because it made me feel better for a few minutes.
“Then I’d feel worse. It’s a cliche, but it was comfort eating — a vicious cycle. I hated my weight, but I was in too much pain to do anything about it.”
Over the years, Carys tried a series of endometriosis treatments. This included the birth control pill, which suppresses the female sex hormone estrogen.
Studies show that the painful lesions triggered by endometriosis feed off estrogen, so reducing the amount in the body can ease symptoms.
When this failed, Carys had multiple rounds of surgery to remove the lesions. However, after several years the pain would return, which is a common experience for endometriosis patients.
According to the charity Endometriosis UK, around half will find symptoms return within five years, as abnormal tissue grows back.
However, everything changed for Carys when, five years ago, her specialist asked if she would consider a hysterectomy.
The operation, which involves removing the uterus and sometimes also the cervix, fallopian tubes or ovaries, is most commonly offered to treat fibroids – noncancerous growths in the uterus – or cancer.
However, it is also used to treat severe endometriosis, as evidence suggests it can significantly ease painful symptoms. This is largely because a hysterectomy stops periods permanently, which are often a major trigger for endometriosis pain.
Surgery is generally considered a last resort. In part, this is because a hysterectomy is major and irreversible surgery.
As with other major operations, there are also risks including bleeding, infection and, more rarely, damage to surrounding organs.
However, another reason hysterectomy is not routinely offered is because experts still debate how effective it is at relieving the pain of endometriosis. While some patients experience a dramatic improvement, others continue to suffer symptoms.
One factor may be whether the patient also has a closely linked condition called adenomyosis.
This is where tissue similar to the lining of the uterus grows into its muscular wall, causing inflammation and often severe pain during periods.
Unlike endometriosis elsewhere in the body, adenomyosis is effectively cured by removing the uterus. This means women suffering from both conditions may be particularly likely to see their period-related pain improve after a hysterectomy.
Carys now weighs 9.5st, meaning she has more than halved her body weight since she had her hysterectomy, and says she never thought she would be so healthy – or pain-free
Studies suggest that about 40 percent of endometriosis patients also have adenomyosis.
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American actress Gabrielle Union has also spoken publicly about suffering from adenomyosis, which she discovered after years of fertility problems and failed IVF treatments.
Union, best known for starring in Bring It On and Bad Boys II, has said she was repeatedly made to feel that her difficulties conceiving were the result of waiting too long to have children, before learning that she had adenomyosis.
While removing the uterus will typically ease the pain caused by adenomyosis, it may not provide a long-term fix for endometriosis.
A major research review in 2021 concluded that, for endometriosis patients who have their uterus removed, the risk of symptoms returning was about 50 percent.
‘A hysterectomy can be helpful for managing pain triggered by adenomyosis, but it’s not a cure,’ says Dr Lucky Saraswat of the University of Aberdeen in Scotland.
‘Endometriosis is, by definition, where this tissue grows outside of the uterus. So removing the organ won’t remove all the symptoms. Patients will often experience temporary relief but then the tissue will grow elsewhere and the pain will return.’
Instead, experts say removing the uterus and the ovaries offers a more definitive solution. This is because endometriosis lesions feed off estrogen, which is produced in the ovaries.
‘Removing the ovaries is crucial,’ says Dr Saraswat. ‘Do this and the endometriosis can go dormant and the risk of it returning is limited.’
However, the procedure triggers early menopause and infertility.
‘We wouldn’t ordinarily offer this to women in their 20s,’ says Dr Saraswat. ‘It’s not for anyone looking to have a family. And early menopause triggers a number of tough symptoms that most women want to avoid.’
However, for Carys, things were more complicated.
In her 30s, in a bid to end her pain, she opted to have her ovaries removed but not her uterus, a procedure known as an oophorectomy. It had not been a success and her painful symptoms had continued.
This meant that, while research suggests that removing the ovaries is more effective than removing the uterus, a hysterectomy was, as her specialist explained, Carys’s only remaining option.
‘It was pretty terrifying,’ she says. ‘I knew that this was it – if this didn’t work, I might be in pain for the rest of my life.’
The procedure was not easy for Carys either. She was in the hospital for five days, where she caught Covid, leaving her unwell.
But within four to six weeks, she began to notice something: she was no longer in pain all the time.
‘For the first time in my adult life, I could simply stand up,’ she says. ‘Before, the moment I walked into a room, I’d look for somewhere to sit. I couldn’t stand for too long.
‘Now I found myself on my feet more and more, without even thinking about it. People even told me they could see in my face that I wasn’t in as much discomfort.
‘Sometimes I do feel the occasional stabbing pain. But I can go days without noticing it. For the first time in years, the condition isn’t dictating everything.’
It was at this point that Carys began to think about her weight.
She had been well aware that she was obese. However, dealing with her pain had always been her main priority. And exercise had always seemed out of reach.
She considered weight-loss surgery – where a balloon is inserted into the stomach, restricting appetite. However, she decided against it, largely because she had been through so many operations by then.
‘I nearly let myself be talked into it,’ she says. ‘Then I thought, what am I doing?’
In September 2024, Carys began counting her calories, which helped her lose a small but noticeable amount of weight.
Buoyed by this success – and reveling in her lack of pain – Carys began doing dance exercise classes at her local gym.
Slowly, the exercise fueled the weight loss. And the weight loss fueled the exercise.
By August 2025, Carys was down to 196lbs. Then, out of nowhere, her dance classes were canceled.
On a whim, she downloaded Couch to 5K – a beginner running program designed to gradually build up to running three miles. At first, she could not run for more than a minute.
‘It was horrible,’ she says. ‘But when I finished I was so proud of myself that I did it again the next day. And the next.’
She finished the program in six weeks and continued to run.
In November, Carys completed her first 10K race and, in May, she completed a 34-mile ultramarathon over the Malvern Hills in England.
She is now training for the London Marathon next year.
Her target is to raise about $5,400 for Caudwell Children – a British charity that supports disabled and neurodivergent children.
Carys now weighs 133lbs, meaning she has more than halved her body weight since she had her hysterectomy, and says she never thought she would be so healthy – or pain-free.
‘I never imagined I would be able to walk long distances, never mind run,’ she says. ‘For so long, this pain dominated my life. It goes to show just how much you can achieve when you are pain-free.’