Women all over the world are now opening up, speaking up, and demystifying endometriosis. According to the American College of Obstetricians and Gynecologists, one in 10 women has endometriosis—a condition in which the tissue that lines the uterus is found outside the uterus, and causes symptoms like excruciating cramps, heavy bleeding, nausea, infertility, and pain during sexual activities. Actress and dancer Julianne Hough revealed her endometriosis diagnosis two years ago and most recently opened up to Women’s Health about her 15-year struggle with it, why she kept her diagnosis a secret, how she manages her symptoms now, and how it has affected her sex life.

Hough said she had “no idea” that so many women had endometriosis and that the one time she went to the emergency room for it, “nobody could tell me what was wrong with me.” Even after she received a proper diagnosis, she continued to keep it a secret, fearful that endo would affect her career and her relationships.

Now that she’s married to a supportive partner, Brooks Laich, she is open about her pain, especially when it comes to their sex life. According to the Endometriosis Foundation of America, penetrative sex can be especially painful for women with endo.

However, penetration is only one way to have sex. Hough says that she and Laich have found that foreplay is their best friend now.

Now that she’s been living with this pain for half her life, Hough has found some mental coping strategies to deal. “Instead of getting frustrated, I acknowledge it, honor what it is, and move on,” she explained. “It’s all about connecting to your body, loving it unconditionally, and trusting how you feel.”

Have endo and need more resources and support? Head here for more information on endometriosis symptoms.