Endometriosis occurs when tissue similar to the lining of the uterus begins to grow outside the uterus, causing symptoms such as pain, bleeding, and irritation, and eventually scar tissue can develop in affected areas. Some women experience these symptoms from the time of ovulation until the start of their period – which means that about half of each month they experience endometriosis-related pain. Others may experience mostly menstrual pain, or symptoms such as painful sex, excessive bleeding, or infertility.
The effects of endometriosis can affect women in several ways. “However, it is difficult to diagnose because symptoms can occur in different areas of the body,” says Carly Goldstein, MD, a gynecological surgeon at the Seckin Endometriosis Center in New York City and a consulting surgeon with the Endometriosis Foundation of America (EFA). “Some women may not experience painful periods, or experience seemingly unrelated symptoms that may delay diagnosis.” These can include chronic lower back and leg pain, nerve pain, painful bowel movements, and digestive problems.
Quality of life challenges associated with endometriosis
Endometriosis affects a woman most often during her childbearing years, around age 25 to 35, though symptoms can start as soon as her period starts — as early as 11, according to the EFA. This is often the time when a woman is busy trying to build her life. “Endometriosis may cause a woman to miss work or school, or she may have trouble keeping a job or completing school in severe cases,” says Dr. Goldstein, who has endometriosis.
To add to the frustration of living in pain, there can be a long delay between the onset of endometriosis symptoms and a diagnosis. “At least one in 10 women will have endometriosis, but it will probably go underdiagnosed. It can take up to 10 years for a diagnosis, especially if symptoms are atypical,” says Goldstein, and as explained by Yale University Medicine .
Endometriosis self-care strategies
Getting a proper diagnosis and treatment plan for endometriosis is important, but in addition, taking care of yourself can help you feel your best. “You may need to eat more healthily and focus more on the wellness of those around you, but it will be worth it in the long run—not just for endometriosis, but for your overall health as well,” says Goldstein.
In addition to working with a gynecologist to manage endometriosis, try these self-care strategies to make your daily life easier:
- Eat a healthy diet A diet low in fat and high in fiber and antioxidants has been shown to reduce symptoms of endometriosis, and some women with endometriosis have found that additional supplementation with vitamins D, C, and E also has benefits, according to research published in February 2023. Also include Foods rich in omega-3 fatty acids in your diet, such as avocados, nuts, olive oil, and wild fish are low in mercury, as it has been linked to reduced inflammation — and so are processed foods and soft drinks.
- Stay active You may not want to exercise when you’re in pain, but when you feel up to it, try to get at least 30 minutes of movement each day. A study from 2022 showed that women with endometriosis who exercised three days a week reported lower levels of pain in the days following exercise.
- Try acupuncture “Acupuncture may be helpful in combating pain associated with endometriosis or in helping to regulate cycles,” says Goldstein. In this form of Chinese medicine, the practitioner places tiny needles on parts of the body to help correct imbalances by increasing blood flow to those areas. For women with endometriosis, this often means getting acupuncture needles into the pelvic area and lower abdomen to help relieve symptoms such as cramps.
- Find ways to get a good night’s sleep Research shows that women with endometriosis are twice as likely to experience fatigue as those without the condition. This fatigue was also associated with a sevenfold increase in insomnia. To get better sleep, start with the basics, advises the Centers for Disease Control and Prevention: Aim for a consistent bedtime, make sure your bedroom is dark and quiet, eliminate devices and distractions, and avoid large meals, caffeine and alcohol close to bedtime. Cognitive behavioral therapy (CBT) is also recommended to treat insomnia before trying alternative options, such as pills or supplements, according to the Mayo Clinic. And if none of these methods help, Goldstein is a proponent of relaxing nighttime rituals to help get a good night’s sleep: “Try bathing with lavender and chamomile oils, which help relax muscles.” An Epsom salts bath can also help soothe pelvic and abdominal pain. Goldstein adds that you can also try herbal teas that can help you sleep better, such as those containing valerian root.
- Be kind to yourself If you keep track of your menstrual cycle and symptoms of endometriosis on a monthly basis, you can get an idea of when you might be experiencing the most pain. Try to clear your calendar during these times so you don’t have to rush between social and work commitments and can instead focus more on taking things easy.
- Explore the connection between mind and body Living with pain is emotionally draining as well as physically – and calming your mind with techniques such as meditation and deep breathing may help your body feel better. A study showed that mindfulness meditation can improve symptoms of pain and depression in people with chronic pain.
- Get support According to the EFA, more than 200 million people worldwide suffer from endometriosis. You can join online support resources like My Endometriosis Team and Facebook groups to connect with others with endometriosis, or you might ask your gynecologist about local groups that can provide in-person opportunities to share stories and strategies.