Like a Fire in My Womb

What pain metaphors reveal about invisible illnesses like endometriosis — a bilingual article by Dr. Stella Bullo.

Dr. Stella Bullo

How do you put your pain into words? For some, it feels like blades cutting from the inside; for others, monsters lurking or an internal fire burning. Research shows that such metaphors can hold important clues to chronic conditions like endometriosis.

“It’s like something is stabbing me from the inside.”
“It feels like an animal is clawing at my belly from within.”
“It’s fire. It’s pressure. It’s something that won’t let me live.”

These are just some of the phrases I’ve heard over the years from other women living with endometriosis.

And in my case, the one I repeated most often was: “It feels like someone is strangling my uterus.” I would scream it out, curled on the floor in the fetal position, while my cat purred and kneaded my head and my husband panicked looking for the morphine. His hand trembled as he gave it to me; minutes later, my body softened and my gaze drifted into the fog of the opioid.

By the time I was finally diagnosed with endometriosis, the disease was advanced. My quality of life was in ruins. I had spent more than a decade being told it was “normal.”

Descriptions like these are metaphors loaded with imagery, intense bodily sensations, and overwhelming emotions — desperate attempts to voice what hurts in silence.

Yet in the clinic, those words often shrink to “it hurts a lot,” and then into a 1–10 scale — useful, yes, but often inadequate for the complexity of pain.

That’s when many of us hear, “you have a low pain threshold,” “women are built to withstand pain in the reproductive area,” or “it’ll go away once you have a child” (a child that, in my case, never came because aggressive endometriosis had already caused infertility).

Between morphine, metaphors, and myths about womanhood, pain becomes invisible — or worse, normalised.

Why does language matter so much?

I say this not only from lived experience but from years of research. I hold a PhD in Linguistics (Lancaster University, UK) and founded The Language of Endometriosis, a project at Manchester Metropolitan University exploring how we talk about menstrual pain — and how that language can shape, or hinder, diagnosis.

For years I listened to, transcribed, and analysed accounts from people living with endometriosis: testimonies dense with imagery, metaphor, silences, gesture, and repetition — the struggle to say the unsayable.

Findings appeared in journals across linguistics, health communication, and psychology, and reached broader audiences via outlets like The New York Times, BBC Radio, and Glamour.

What emerged is as evident as it is worrying: clinicians and patients often don’t speak the same language. They may share English or Spanish, but not meanings.

There is a gap between what is felt, what is expressed, and what is understood in clinical settings. That gap is not trivial; it may be one reason endometriosis remains slow or uncertain to diagnose.

What words can reveal

People living with chronic pain — especially endometriosis — rarely rely solely on clinical terms.

We reach for knives, fire, pressure, internal monsters. It isn’t melodrama. It’s translating the unnameable.

In story after story, metaphors recur. Far from confusing, they can sharpen communication about a profoundly physical, emotional, often traumatic experience — if we take time to listen.

These are attempts to make the invisible visible — to turn pain into something shareable.

Of course, metaphors aren’t always understood. In some settings they seem vague or “too subjective.” That’s not a reason to dismiss them; it’s a reason to attend more closely.

When someone says “it feels like something is crushing me from the inside,” that phrase — absent from diagnostic manuals — can still be a vital clue, a red flag, an opening that changes a medical history.

This isn’t about turning patients into doctors or doctors into poets; it’s about meeting in the middle, where pain is neither silenced nor distorted.

Teaching how to name pain

Naming pain doesn’t cure it, but it can be the first step toward it being seen.

Teaching girls, teens, and anyone who menstruates to speak about pain in their own words is not trivial or “literary.” It can be a public-health tool.

We need to validate metaphors — not dismiss them — and learn to unpack them; to listen without rushing; to notice when something sounds unusual. That, too, is care.

Pain lives in the body, but it needs language to be heard. When pain has words — even imprecise or strange ones — it can begin to make sense, and begin to meet a response.

It took me over fifteen years to be diagnosed. If I’d known I could say “it feels like someone is strangling my uterus” without being labelled exaggerated or overly emotional, perhaps things would have been different.

Let’s make sure others don’t wait that long — as professionals, as parents and friends, as a society. Every story heard in time can change a life.

And you — how do you put your pain into words?

Glossary

  • Endometriosis: A chronic inflammatory condition in which tissue similar to the uterine lining grows outside the uterus, causing pain, infertility, and other symptoms.
  • Metaphor: Describing something in terms of something else (e.g., “a fire inside” for pain).
  • Pain scale (1–10): A subjective tool for rating pain intensity.

Learn more in The Language of Endometriosis.