When Julianne Hough sashays across the stage on ABC’s “Dancing with the Stars,” you’d never be able to tell that she lives with crippling chronic pain. But she does.

In 2008, the Emmy-nominated dancer and actress was rushed to the hospital with severe pains and given emergency surgery. Through the ordeal, it was revealed that she has endometriosis — a diagnosis which put an end to the years of wondering and confusion about what was causing her chronic pain.

Endometriosis affects an estimated 5 million women in the United States alone. It can cause abdominal and back pain, severe cramping during your period, and even infertility. But many women who have it either don’t know about it or have had difficulty getting it diagnosed — which affects what treatments they can receive.

That’s why Hough has teamed up with the Get in the Know About ME in EndoMEtriosis campaign to raise awareness and help get women the treatment they need.

We caught up with Hough to find out more about her journey, and how she’s empowered herself to take control of her endometriosis.

Q&A with Julianne Hough

You have endometriosis, which you made public in 2008. What led you to open up about your diagnosis?

I think for me it was that I felt it wasn’t an okay thing to talk about. I’m a woman, and so I should just be strong, not complain, and stuff like that. Then I realized, the more I spoke about it, the more my friends and family found out that they had endometriosis. I realized this was an opportunity for me to use my voice for others, and not just myself.

So, when Get in the Know About ME and Endometriosis came about, I felt like I had to be involved in this, because I am the “ME.” You don’t have to live through debilitating pain and feel like you’re completely alone. There’s other people out there. It’s about starting a conversation so people are heard and understood.

What was the most challenging aspect of hearing the diagnosis?

Oddly, it was just finding a doctor that really could diagnose me. For a long time, I had to figure out what was going on [myself] because I wasn’t quite sure. So it’s just the time that it probably took to know. It was almost a relief, because then I felt like I could put a name to the pain and it wasn’t just like the normal, everyday cramps. It was something more.

Did you feel like there were resources for you once you were diagnosed, or were you a bit confused about what it was, or what it was supposed to be like?

Oh, definitely. For years I was like, “What is it again, and why does it hurt?” The great thing is the website and being able to go there is that it’s like a checklist of things. You can see if you have some of the symptoms and be educated about the questions that you want to ask your doctor eventually.

It’s been almost 10 years since that happened for me. So if I can do anything to help other young girls and young women figure that out, feel safe, and feel like they’re at a great place to find information, that’s amazing.

Over the years, what’s been the most helpful form of emotional support for you? What helps you in your everyday life?

Oh my gosh. Without my husband, my friends, and my family, who all obviously know, I would just be… I would be silent. I would just go about my day and try not to make a big deal out of things. But I think because now I feel comfortable and open, and they know about everything, they can immediately tell when I’m having one of my episodes. Or, I just tell them.

The other day, for instance, we were at the beach, and I was not in the best state of mind. I was hurting pretty bad, and that can be mistaken for, “Oh, she’s in a bad mood,” or something like that. But then, because they knew, it was like, “Oh, well of course. She’s not feeling great right now. I’m not going to make her feel bad about that.”

What would your advice be to others living with endometriosis, as well as the people who are supporting those who suffer from it?

I think that at the end of the day, people just want to be understood and to feel like they can speak openly and be safe. If you are somebody who knows somebody who has it, just be there to support and understand them as best as you can. And, of course, if you are the one who has it, be vocal about it and let others know that they’re not alone.

As a dancer, you live a very active and healthy lifestyle. Do you feel that this constant physical activity helps with your endometriosis?

I don’t know if there’s a direct medical correlation, but I feel that there is. Being active for me, in general, is good for my mental health, my physical health, my spiritual health, everything.

I know for me — just my own diagnosis of my own head — I’m thinking, yes, there’s blood flow. There’s releasing toxins, and stuff like that. Being active for me means you’re producing heat. I know that having heat applied to the area obviously feels better.

Being active is such a big part of my life. Not just part of my day, but a part of my life. I have to be active. Otherwise, I don’t feel free. I feel restricted.

You also mentioned mental health. What lifestyle rituals or mental health practices help you when it comes to handling your endometriosis?

In general for my everyday state of mind, I try to wake up and think about the things that I’m grateful for. Usually it’s something that is present in my life. Maybe something that I want to achieve in the near future that I would be grateful for.

I’m the one that’s able to choose my state of mind. You can’t always control circumstances that happen to you, but you can choose how you handle them. That is a huge part of the beginning of my day. I choose the kind of day that I’m going to have. And that goes from, “Oh, I’m too tired to work out,” or “You know what? Yes, I do need a break. I’m not going to work out today.” But I get to choose, and then I get to give the meaning to that.

I think it’s more just being really aware of what you need and what your body needs, and allowing yourself to have that. And then, throughout the day and throughout your life, just recognizing that and just being self-aware.

This interview has been edited for length and clarity.