Top tips for managing endometriosis

One in ten people assigned female at birth or of reproductive age, live with endometriosis in the UK.¹ With no current cure for this disease, treatment usually focuses on symptom management² and the reduction of the endometrial tissue, through surgical or hormonal treatment.

In this article, Nikki Porges, registered nurse in our 24/7 health support line, for members, explores some ways to help alleviate the symptoms of the condition, although it’s worth noting that what works for one person might not work for another.

What is endometriosis?

In endometriosis, cells like those of the womb lining grow in other areas of the body, mainly the pelvic area such as the ovaries or fallopian tubes but can also grow elsewhere in the body such as the bowel and bladder, most commonly.

As these cells behave in exactly the same way as the cells lining the uterus, they will enlarge then bleed as if having a period. However, as there is nowhere for the blood to go when these cells bleed (during menstruation) this can lead to inflammation, and the formation of what is known as chocolate cysts, scarring, and pain.³

For more information about how endometriosis is diagnosed and what treatments are sometimes offered, visit our article: Endometriosis symptoms, diagnosis and treatment.

Living with endometriosis

Due to the symptoms, which can include:

• chronic pain,
• bloating,
• nausea,
• fatigue,
• painful bowel movements or urination,
• depression or/and anxiety,
• infertility,
• or a general feeling of being unwell and weakness,

endometriosis can severely impact someone’s life and the ability to function day-to-day, physically and emotionally.

The precise cause of endometriosis-associated pain is not well understood, and the severity of the pain does not seem to correlate with the size or location of endometrial lesions.⁴ It’s thought, however, that when patches of endometriosis develop directly on a nerve or its pathway this can cause significant and acute pain, regardless of the size of the endometriosis lesions.

For some the pain could be caused by lesions containing nerve cells, or scar tissue pulling on internal organs. For some women, it’s during the menstrual cycle that the pain intensifies which is thought to be caused by changes in the hormone levels.

Currently, there’s no cure but there are some ways to help lessen the impact and severity of the symptoms.

Top tips for managing symptoms

1) Heat

Use heat to help reduce pain such as a hot water bottle, bath, or electric heat pad as this will help to promote blood flow, helping your muscles to relax.

2) Keeping active

Try to get moving and stay active. Any movement or exercise can help by increasing circulation and feel-good hormones that help boost mood and reduce pain.

You may want to adapt what you do depending on your symptoms, for example, higher intensity activities such as cycling or running may be better on days symptoms are less impactful.

Low impact activities such as walking, or light stretching could be better suited when pain is higher. Activities like Pilates and yoga can also help manage pelvic pain.

3) Looking after your mental wellbeing

Look after your psychological wellbeing through stress management techniques and by doing things that bring you joy. If our mental health isn’t good, it can make our physical pain feel worse.

Sometimes because there are no visible signs of illness, endometriosis symptoms are not taken seriously by friends and family members. Fatigue is confused with tiredness, and many people do not understand that the pain women with endometriosis experience is not comparable to the usual menstrual pain that most women know.

The feeling of being misunderstood also may contribute to the development of psychologic problems such as anxiety and depression.⁵

4) Sleep

Try to get good sleep to help reduce fatigue, as well as reduce stress. You could try incorporating some muscle relation techniques into your bedtime routine, such as: 

• light stretching,
• a bath with Epsom salts,
• or relaxation with aromatherapy oils.

>Read more about the health benefits of sleep.

5) Diet

A healthy balanced diet including fruits, vegetables, and wholegrains will always best support our body and mind, and whilst there is limited research that says specific foods can make endometriosis better or worse, limiting processed foods, meat, dairy, and even gluten have been suggested to improve symptoms for some.

Endometriosis can’t be prevented but according to the Office on Women’s Health, a woman might be able to reduce their risk of developing it by avoiding foods and chemicals that increase their oestrogen levels. These substances include caffeine and alcohol.⁶

6) Keeping a symptom diary

Track your pain and other symptoms throughout the month. This way you may be able to see trends which could help you adjust your day/week accordingly, as well as provide important information when discussing management or treatment with your doctor.

7) It’s good to talk

Talk about how you are feeling, especially if those around you don’t have the lived experience. Speaking openly can help them to better understand and can help avoid stressful or negative conversations.

Talk to your doctor as over the counter medications may not always be enough to manage your pain. There may also be hormonal therapy or surgical options that you may want to discuss.

Find support groups and share experiences with others in the same position as you. Endometriosis UK for example, has a directory, a helpline, a webchat, and an online community.⁷

If endometriosis is affecting you, don’t suffer in silence. Speak to your doctor if you need more support.

References

1. Endometriosis Facts and Figures – Endometriosis UK
2. Endometriosis – World Health Organisation
3. Endometrioma: Chocolate Cyst – The Endometriosis Foundation
4. Endometriosis Symptoms – Endometriosis News
5. Anxiety and Depression – Endometriosis News
6. How can I prevent endometriosis? – Office on Women’s Health
7. Get support – Endometriosis UK