Does Endometriosis Cause Weight Gain? What to Know

By OBGYN Dr. Kenosha Gleaton

Endometriosis is a condition characterized by the spread of uterine tissue outside of the uterus. This tissue can be found on the fallopian tubes, bladder, ovaries, and other places in the abdomen. [1] There are a few common symptoms of endometriosis including long or heavy periods, irregular bleeding, and pelvic pain or discomfort. There are a wide range of other symptoms that someone with endometriosis may experience including weight gain, bloating, fatigue, diarrhea, and more. [1] 

Exploring the connection between endometriosis and weight gain

Some people with endometriosis may experience weight gain, bloating, or difficulty losing weight. Let’s take a look at the links between endometriosis and weight. 

Hormonal imbalance and its impact on weight

Having abnormal or fluctuating hormone levels can cause many different symptoms, including weight gain and weight loss. [2] Research suggests there is a link between endometriosis and high levels of estrogen. [3] Estrogen is a hormone that plays an important role in the menstrual cycle, reproductive development, fat distribution, and more. Having a high amount of estrogen in the body can lead to a number of symptoms, including breast tenderness, bloating, irregular periods, heavy periods, and more. Some data even suggests that high levels of estrogen are associated with a higher body mass index (BMI). [4] 

Additionally, using hormonal contraceptives is a common way to treat or manage endometriosis. [1]  Regulating the menstrual cycle may help reduce symptoms in some people, causing them to seek out hormonal IUDs, oral contraceptive pills, or other hormone therapies. While not proven to be correlated, many claim that use of hormonal contraceptives has caused weight fluctuations. [5]  

To summarize, abnormal hormone levels caused by endometriosis or hormone therapy may be causing weight gain. [2,5] 

Inflammation and its role in weight gain

Have you heard the term “endo belly?” It refers to the painful, bloated stomach many with endometriosis experience during or around menstruation. [6] This bloating is caused by a buildup of gas and inflammation in the body and is sometimes accompanied by diarrhea, constipation, and nausea. [6] Bloating can be fairly severe in some people and may feel or look like weight gain. While this may not be the case for everyone, constipation, fluid retention, and bloating may be the cause of your weight fluctuations. 

Pain, fatigue, and other factors influencing weight

Other symptoms caused by endometriosis may play a role in weight gain. Pain is one of the most common symptoms of endometriosis and may lead to decreased activity and motivation, contributing to weight gain. [1,7] We also know that chronic pain may lead to depression over time, another potential cause of weight fluctuations. [7] Endometriosis has also been associated with poor sleep quality. [8] Lack of sleep has been linked to decreased metabolism, obesity, and some chronic conditions. [9-10]  Read What Does Endometriosis Feel Like? for more information. 

Is it harder to lose weight with endometriosis?

It’s possible that losing weight may be more difficult for people with endometriosis. There are numerous symptoms and difficulties tied to endometriosis that can influence weight and metabolism. [4-8] These can often be difficult to treat or manage and may even feel impossible to get a handle on. The good news is that there are many ways to support your overall wellbeing, even when it seems hopeless. 

There are many factors that can play a role in weight fluctuations, some may not even be tied to endometriosis. It’s important that you always speak to a healthcare provider about any of your concerns to determine the root of the issue.    

Practical tips for managing weight with endometriosis

Many of us know that the primary methods for weight loss are exercising and eating healthier. When attempting to lose weight with endometriosis or any other chronic conditions, there are some additional factors that you may need to consider. It’s also important to set goals focused on improving your mental wellbeing and overall health, rather than just losing or gaining weight. Feeling happy and healthy is often more important than reaching a goal weight or dress size. As always, you should always speak to a healthcare provider about your health conditions, concerns, and weight management goals. 

Implementing a healthy diet

A healthy and balanced diet not only helps with weight management, but may be able to influence endometriosis symptoms. Inflammation is the primary cause of bloating and pelvic pain experienced by those with endometriosis. [1] Consuming anti-inflammatory foods and beverages may help decrease bloating, improve digestion, and aid in weight management. [11-12] This includes a diet high in fruits, vegetables, whole grains, nuts, legumes, and fish, and low in refined grains, red meat, processed foods, high fat dairy products, and salt. [12] 

Embracing regular exercise

Exercising regularly can do wonders for chronic conditions, mood, weight management, and more. [13] It’s no secret that endometriosis pain may make exercise feel impossible, but even going for a short walk, swimming, or doing yoga can help you move your body and positively influence your health. Getting into a routine can be difficult, so challenge yourself to exercise at least one more day than usual for a few weeks, and slowly build your way up to exercising multiple times a week. If you feel you’re unable to participate in any exercise due to your pain or discomfort, you should speak to a healthcare provider about your options. 

Managing stress and prioritizing self-care 

As mentioned already, depression and poor sleep can both contribute to weight fluctuations and worsening endometriosis symptoms. [7-10] Finding healthy ways to manage stress and promote rest may help with your overall health, including maintaining a healthy weight. This may include improving your nighttime routine or incorporating new routines to manage your stress. Some examples include drinking plenty of water before bed, avoiding caffeine or alcohol, avoiding screens before bed, journaling, reading, taking a bath, or drinking some herbal tea. Learn more self-care tips for endometriosis. 

Seeking professional help and support

Remember that endometriosis is a chronic condition that can impact people in many ways. Whether or not your weight fluctuations are caused by endometriosis, it’s important to prioritize your overall health and wellbeing over losing weight. A healthcare provider can give you more detailed information on healthy ways to manage your weight and what a healthy weight range may look like. It’s always best to reach out to a professional for support if you have any concerns or questions about your health. 

How Natalist can help you navigate endometriosis

There is no known cause or cure for endometriosis, but there are ways to manage symptoms and support your overall health. Whether you’re hoping to fight inflammation with supplements, stay hydrated with tasty electrolyte drinks, or support your fertility with prenatal vitamins, Natalist has products that can help. Keep reading about endometriosis and more on the Natalist blog. 

References:

1. Endometriosis. Mayo Clinic. July 24 2018. URL. Accessed May 2023. 
2. Ylli D, Sidhu S, Parikh T, et al. Endocrine Changes in Obesity. [Updated 2022 Sep 6]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279053/
3. Chantalat E, Valera MC, Vaysse C, et al. Estrogen Receptors and Endometriosis. Int J Mol Sci. 2020;21(8):2815. Published 2020 Apr 17. doi:10.3390/ijms21082815
4. Mair KM, Gaw R, MacLean MR. Obesity, estrogens and adipose tissue dysfunction - implications for pulmonary arterial hypertension. Pulm Circ. 2020;10(3):2045894020952019. Published 2020 Sep 18. doi:10.1177/2045894020952023
5. Gallo MF, Lopez LM, Grimes DA, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database Syst Rev. 2011;(9):CD003987. Published 2011 Sep 7. doi:10.1002/14651858.CD003987.pub4
6. Endo Belly: What It Is and How To Get Rid of It. Cleveland Clinic. January 4 2023. URL. Accessed May 2023. 
7. Ghusn W, Bouchard C, Frye M, Acosta A. Weight-centric treatment of depression and chronic pain. Obesity Pillars Volume 3. https://doi.org/10.1016/j.obpill.2022.100025
8. Youseflu, S., Jahanian Sadatmahalleh, S., Roshanzadeh, G. et al. Effects of endometriosis on sleep quality of women: does life style factor make a difference?. BMC Women's Health 20, 168 (2020). https://doi.org/10.1186/s12905-020-01036-z
9. Aldabal L, Bahammam AS. Metabolic, endocrine, and immune consequences of sleep deprivation. Open Respir Med J. 2011;5:31-43. doi:10.2174/1874306401105010031
10. What Are Sleep Deprivation and Deficiency? National Heart, Lung, and Blood Institute. March 24 2022. URL. Accessed May 2023
11. Nap A, de Roos N. Endometriosis and the effects of dietary interventions: what are we looking for?. Reprod Fertil. 2022;3(2):C14-C22. Published 2022 May 30. doi:10.1530/RAF-21-0110
12. Stromsnes K, Correas AG, Lehmann J, Gambini J, Olaso-Gonzalez G. Anti-Inflammatory Properties of Diet: Role in Healthy Aging. Biomedicines. 2021;9(8):922. Published 2021 Jul 30. doi:10.3390/biomedicines9080922
13. Benefits of Physical Activity. CDC. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. June 16 2022. URL. Accessed May 2023.