Self-Care for Endometriosis: Tips for Relief

By Dr. Kenosha Gleaton, OBGYN

If you’re battling endometriosis, it may be helpful to know what causes flare-ups as well as what you can do to find relief. Here are some tips for managing endometriosis pain and discomfort. 

Endometriosis pain and flare-ups

Endometriosis is a condition that involves uterine tissue growing outside of the uterus. This can often lead to pain, infertility, excessive bleeding, and other uncomfortable symptoms. [1] Endometriosis can cause cyclical or chronic pain and discomfort. Some also experience endometriosis flare-ups, AKA periods of time when symptoms seem to be worse than usual. Some painful symptoms associated with endometriosis include pelvic pain, painful urination, painful bowel movements, heavy bleeding, painful sex, constipation, diarrhea, depression, and fatigue. [1]  Read more about what endometriosis feels like. 

What triggers endometriosis flare-ups?

Knowing what triggers flare-ups may help you manage and avoid them. While there isn’t an exact cause of endometriosis or the painful symptoms associated, there are some factors that may contribute to endometriosis pain that you can plan for or avoid. [1] 

Hormonal changes and menstruation

The hormone fluctuations responsible for menstruation are also going to impact the endometrium that isn’t found in the uterus. This means that hormonal fluctuations can still cause tissue to thicken, break down, and bleed even if the tissue is found in your abdomen, rectum, or around the ovaries. [2] This can cause inflammation and severe pain in the body. 

Stress and emotional factors

There is a bit of a vicious cycle happening in regards to stress and endometriosis. Chronic pain tends to increase cortisol (stress) levels over time, and high cortisol levels may actually worsen the severity and duration of pain. [3-4] If you are under a lot of stress unrelated to your endometriosis, it could still be worsening your discomfort. Additionally, having endometriosis puts you at a higher risk of developing other inflammatory or immune related conditions. [4] Is endometriosis an autoimmune disease? Find out → 

Lack of sleep

Disrupted sleep has been found to weaken the immune system, which may increase inflammation in the body. [5] This can result in increased discomfort for those with endometriosis. This can also be a vicious cycle as many have difficulty sleeping as a result of their pain and discomfort. [5] If you are experiencing insomnia or aren’t getting restful sleep, speak to a healthcare provider about your options. 

Diet and lifestyle choices

Some foods create an inflammatory response in the body, which can worsen pain and discomfort. This includes foods such as refined carbohydrates, fried foods, soda, processed foods, red meat, and processed meat. [6] Other lifestyle choices can also impact endometriosis pain. Some studies have found links between alcohol and caffeine with worsened endometriosis pain and inflammation. [7] 

Managing endometriosis pain

Now that you know what could be causing pain and discomfort, let’s talk about what you can do to manage endometriosis pain. 

Over the counter pain relief options

There are many over-the-counter medications that may be useful for pain relief. You should speak to a healthcare provider about what the best option is for you. Some common options include nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, aspirin, and naproxen. [8] 

Prescription medications

In some cases, prescription medications may be more helpful than over the counter. If you’re interested in stopping your menstrual cycle altogether, some of the cyclical pain associated with menstruation may be resolved using hormone therapy. [8] Your healthcare provider may also be able to prescribe extra strength pain medications if necessary. 

Diet and nutrition for endometriosis relief

Adjusting your diet and supplement routine may provide some pain relief or improve symptoms. 

Anti-inflammatory foods 

Some great anti-inflammatory foods include nuts, plant oils, fruits, green leafy vegetables, and fatty fish. [6] Additionally, fiber can help flush out excess estrogen in the body that could be contributing to cramping and pain. [9] High-fiber foods include vegetables, fruits, legumes, and whole grains. 

Supplements

Some supplements may be useful for supporting pain relief and balancing hormones. Research suggests that vitamin D, magnesium, and calcium can be used for menstrual cramp relief. [10-12] There is also data that supports zinc for cramp relief and the regulation of some hormones. [13] Lastly, omega-3 fatty acids and vitamin C have anti-inflammatory effects and are also shown to improve endometriosis pain and lesions. [10] 

Emotional support and mental health

Endometriosis is considered a chronic disease with no known cure. [1] This can be upsetting for many, especially if you feel as though you’re alone. Finding support groups or communities that can relate to your pain and discomfort is a great way to prioritize your mental health and self care. You should also speak to a healthcare provider if you do have concerns about your mental health. 

Prioritizing Rest and Sleep

We know that poor sleep and chronic stress cause difficult cycles when it comes to endometriosis symptoms. [3-5] It can be hard to relax and get restful sleep when dealing with pain and discomfort. Do what you can to manage your stress and find ways to help yourself relax at night. Physical activity during the day can be a great way to relieve stress and improve sleep. Some other options for relaxing include journaling, taking a bath, reading, or getting a massage. Try to avoid drinking alcohol or caffeine, and put away any electronics before going to sleep to help you relax. 

Complementary and Alternative Therapies

If you feel like you’ve tried all the supplements, lifestyle changes, and medications and still haven’t found relief, or if you’re just interested in alternative therapies, there are some other options available. Some data suggests that acupuncture may be helpful for relieving symptoms and improving quality of life in some patients. [8] Another alternative therapy option is electrotherapy, which uses electrical currents to block pain signals along the nerves. [8] A study found that TENS helped reduce pelvic pain, menstrual pain, and improved quality of life. [8] These methods may not be for everyone, and remember that you should always talk to a healthcare provider before trying any new therapies. 

Discussing Fertility and Pregnancy Concerns

It can be confusing trying to get information about endometriosis and its effect on fertility and pregnancy. Everyone’s body and circumstances are different, but it is possible to conceive and have a healthy pregnancy with endometriosis. [14] If you are interested in learning more about your fertility and pregnancy options, speak to a healthcare provider. Some supplements and lifestyle changes may increase your chances of conceiving, such as taking vitamin E, zinc, tracking your cycles, and more.  [10] 

How Natalist Can Help

Endometriosis can be a painful and uncomfortable condition. Fortunately, there are some things you can do to avoid flare-ups and prioritize your health and wellbeing. If you’re interested in managing cramps, hormone balance, or inflammation, you may benefit from taking supplements such as fiber, vitamin D, magnesium, calcium, and zinc. Natalist also has options for cycle regularity support and fertility support if you’re thinking about conceiving soon. You should also speak to your healthcare provider for tailored recommendations and treatment options. No matter where you are in your reproductive journey, we’re rooting for you! 

References:

1. Endometriosis. World Health Organization. March 24 2023. URL. Accessed May 2023. 
2. Saunders PTK, Horne AW. Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell. 2021;184(11):2807-2824. doi:10.1016/j.cell.2021.04.041
3. Lima AP, Moura MD, Rosa e Silva AA. Prolactin and cortisol levels in women with endometriosis. Braz J Med Biol Res. 2006;39(8):1121-1127. doi:10.1590/s0100-879x2006000800015
4. Reis FM, Coutinho LM, Vannuccini S, Luisi S, Petraglia F. Is Stress a Cause or a Consequence of Endometriosis?. Reprod Sci. 2020;27(1):39-45. doi:10.1007/s43032-019-00053-0
5. Ishikura IA, Hachul H, Pires GN, Tufik S, Andersen ML. The relationship between insomnia and endometriosis. J Clin Sleep Med. 2020;16(8):1387–1388.
6. Foods that fight inflammation. Harvard Health Publishing. November 16 2021. URL. Accessed May 2023.  
7. Li Piani L, Chiaffarino F, Cipriani S, Viganò P, Somigliana E, Parazzini F. A systematic review and meta-analysis on alcohol consumption and risk of endometriosis: an update from 2012. Sci Rep. 2022;12(1):19122. Published 2022 Nov 9. doi:10.1038/s41598-022-21173-9
8. Kalaitzopoulos DR, Samartzis N, Kolovos GN, et al. Treatment of endometriosis: a review with comparison of 8 guidelines. BMC Womens Health. 2021;21(1):397. Published 2021 Nov 29. doi:10.1186/s12905-021-01545-5
9. Barnard ND, Holtz DN, Schmidt N, et al. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023;10:1089891. Published 2023 Feb 17. doi:10.3389/fnut.2023.1089891
10. Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022;93(1):e2022159. Published 2022 Mar 14. doi:10.23750/abm.v93i1.11237
11. Abdi F, Amjadi MA, Zaheri F, Rahnemaei FA. Role of vitamin D and calcium in the relief of primary dysmenorrhea: a systematic review. Obstet Gynecol Sci. 2021;64(1):13-26. doi:10.5468/ogs.20205
12. Parazzini F, Di Martino M, Pellegrino P. Magnesium in the gynecological practice: a literature review. Magnesium in the gynecological practice: a literature review. Magnes Res. 2017;30(1):1-7. doi:10.1684/mrh.2017.0419
13. Nasiadek M, Stragierowicz J, Klimczak M, Kilanowicz A. The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients. 2020;12(8):2464. Published 2020 Aug 16. doi:10.3390/nu12082464
14. Fadhlaoui A, Bouquet de la Jolinière J, Feki A. Endometriosis and infertility: how and when to treat?. Front Surg. 2014;1:24. Published 2014 Jul 2. doi:10.3389/fsurg.2014.00024