At Ayla Rising, we believe it’s important to look beyond endometriosis alone.

A growing body of research and clinical observation suggests that many people living with endometriosis also experience a pattern of commonly overlapping conditions, including hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD), postural orthostatic tachycardia syndrome (POTS) and other forms of dysautonomia, mast cell activation syndrome (MCAS), and neurodivergence.

This emerging pattern has become known by some clinicians and researchers as the Pentad.

While research is still evolving, these conditions appear to occur together more often than would be expected by chance. We still have much to learn about why they overlap, but many researchers believe there may be shared genetic, developmental, immune, connective tissue, and nervous system factors that contribute to this pattern.

Each condition can affect the others.

Chronic pain, autonomic dysfunction, connective tissue disorders, mast cell activation, sensory differences, and neurodivergence can create a cascade of challenges that place significant demands on the body and nervous system. When one condition worsens, it can influence the others, creating what many people describe as a “domino effect.”

Because of this, we believe each condition deserves thoughtful evaluation and appropriate treatment. Addressing only one diagnosis while overlooking the others may leave people without the comprehensive care they need.

Understanding the whole picture allows people to make more informed decisions, advocate for themselves more effectively, and build healthcare teams that recognize the complexity of these interconnected conditions.

Just as importantly, we believe community matters. Living with complex chronic illness can be isolating, and connecting with others who share similar experiences can be an essential part of healing and living well.

We also believe these differences are not defined solely by struggle. Many people discover strengths, creativity, deep empathy, unique ways of thinking, and remarkable resilience through these experiences. With the right support, education, healthcare, and community, it is possible not only to manage these conditions but to build a meaningful and fulfilling life.