Medically reviewed by: Melissa A. Delgado, MD, FACOG
Melissa A. Delgado, MD, FACOG is the founder and owner of The Chronic Pelvic Pain Center of Northern Virginia. Dr. Delgado is an experienced, board-certified OB/GYN and has spent the past 10 years dedicating her time to understanding complex and persistent pelvic pain.
Endometriosis is a chronic condition that affects millions of women worldwide. Living with endometriosis (“endo” for short) can be challenging. But by better understanding the condition and following easy self-care strategies, anyone can better manage their endo symptoms and improve their quality of life.
In this article, we'll go over the various considerations that go into endometriosis self care, from understanding what causes flare-ups and how to best manage your mental health, to relieving chronic endo-related pain (like lower back pain and pelvic pain) and making beneficial lifestyle changes.
Endometriosis Flare-Ups: Causes & Triggers
Flare-ups in endometriosis are usually short periods of elevated pain and/or discomfort caused by the growth of excess endometrial tissue outside of the uterus. The exact causes of endo flare-ups can and do vary from person to person, so identifying what causes your endometriosis flare-ups can help you manage them far more effectively.
Some common endometriosis flare-up triggers include:
Hormonal changes: Fluctuations in normal hormone levels, particularly your estrogen, can cause endometrial tissue to grow where it shouldn’t, leading to increased pain and inflammation, too.
Menstruation: Whenever it’s that time of month you may notice that your endo symptoms are more intense. That’s because endometrial tissue outside the uterus also responds to hormonal changes, like increased estrogen.
Too much stress: High levels of stress can and often do trigger endo-related inflammation and can also increase your pain sensitivity, worsening endo symptoms.
Problematic diet: Certain foods—like red meat, processed foods, and caffeine—can cause aggravated inflammation and exacerbate your endometriosis symptoms (more on this later).
Extreme physical activity: While regular exercise is often recommended as a cure-all for all sorts of conditions, overdoing it or engaging in high-impact activities, like kickboxing, can sometimes cause endo flare-ups.
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The importance of self-care for endometriosis
Knowledge is power, which is why self-care is a crucial aspect of managing endo flare-ups and regular, recurring endo-related symptoms. Proper self-care can help you take control of your health and well-being by:
Improving your physical and emotional health
Reducing stress and anxiety
Minimizing the impact of endometriosis on your daily life
Increasing your resilience and ability to cope with challenges
Developing a better understanding of your body and its needs
Let’s dive right into it. Here are five essential self-care strategies for anyone living with endometriosis.
1. Daily Living: Coping Strategies & Support
Living with endometriosis can be very challenging, which is why adopting effective coping strategies and seeking support can help you manage the condition much more effectively.
Some tips for coping with endometriosis include:
Arm yourself with knowledge: Learn everything you can about endometriosis and stay informed on new research, developments, and potential treatments. The goal is to always make informed decisions about your care.
Create a pain management plan: Work with your healthcare provider and perhaps even pain management specialists to create a personalized plan for managing your endo-related pain. This plan could include natural remedies, a medication regimen, alternative therapies, and even diet and lifestyle changes.
Avoid triggering foods and activities: A key part of every pain management plan is knowing what activities or foods to avoid (and at what times of the month). By being aware of what causes your symptoms to get worse and simply avoiding those triggers, you’re well on your way to taking ownership of your quality of life.
Prioritize self-care routines: At the end of the day, don’t forget to take care of yourself. Make (or schedule) time for activities that help you to relax and decompress, as stress can also worsen endo symptoms. Indulge in hobbies, spend time with friends, exercise regularly, etc.
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2. Mental Health: Managing Anxiety & Depression
Self-care routines are especially important because endometriosis can and often does take a toll on your mental health. It can even lead to anxiety and depression for some.
To better manage these emotional challenges, consider the following strategies:
Seek professional guidance: A mental health professional, like a therapist or a counselor, can help provide support when addressing the non-physical symptoms of endometriosis, such as anxiety and depression.
Adopt healthy coping mechanisms: Learning to recognize and challenge negative thought patterns that can easily present themselves in the face of recurring pain or uncertainty is easier said than done. But habits that help you reflect on your journey, like journaling, can often be an excellent supplement to professional help.
Practice mindful meditation: Meditation techniques like deep breathing and progressive muscle relaxation have been shown to help reduce anxiety and improve your overall mental well-being. Even without endo symptoms, we would recommend this!
Build up a support network: Connect with friends, family, and peer support groups (like MyEndometriosisTeam) that understand what you're going through. Sharing your experiences and learning from others who are experiencing the same problems can provide much-needed emotional support and practical advice, too.
3. Relieving Pain: Natural Remedies & Medical Treatments
There are many potential ways to relieve endometriosis pain. They can range from natural remedies that work for you to prescription medications or, in serious cases, surgery.
Some endometriosis treatment options to consider include:
Over-the-counter (OTC) pain relievers: Medications you can buy at your local pharmacy like ibuprofen, naproxen, and acetaminophen can help manage mild to moderate pain, including endo-related pain, such as lower back pain and pelvic pain.
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Hormonal therapies: Hormone-based treatments, such as birth control pills or gonadotropin-releasing hormone (GnRH) agonists, can help manage your endometriosis symptoms by regulating your hormone levels and menstrual cycles at all times.
Read more:
Heat therapy: Applying heat to the pelvic area, such as using a heating pad or taking a warm bath, can help relax muscles and alleviate pain. This home-based pain relief practice is effective for many people living with endometriosis.
Alternative treatments: Some people have reported finding relief from endometriosis pain through alternative or homeopathic practices like acupuncture, deep-tissue massage, or specific herbal supplements.
Surgery: In very severe cases, laparoscopic or robotic surgery may be recommended to remove excess endometrial tissue. For some women suffering from debilitating endo pain, a hysterectomy might be the best solution.
4. Changing Diets: Foods to Eat and Foods to Avoid
A person’s diet can play a significant role in how they experience their endometriosis symptoms. Some studies have shown that adopting an anti-inflammatory diet (e.g., one low in foods that cause inflammation) can help alleviate endo flare-ups and endo-related pain.
Anti-inflammatory foods to consider including in your endometriosis diet include:
Fruits and vegetables: Fresh produce rich in antioxidants and high in fiber, can help reduce inflammation and promote overall gut health. Harvard Medical School recommends tomatoes and green leafy vegetables like spinach, kale, and collard greens and fruits like strawberries, blueberries, cherries, and oranges.
Whole grains: Opt for whole grains like quinoa, brown rice, and whole wheat over traditional white bread alternatives. The same applies to rice. Whole grains are high in fiber and can help regulate digestion.
Omega-3 fatty acids: Fatty fish like salmon, mackerel, tuna, and sardines and nuts like almonds, walnuts, and flaxseeds contain omega-3 fatty acids, which have powerful anti-inflammatory properties. Including more olive oil in your diet is also helpful.
Lean, white-meat proteins: Choosing leaner proteins like poultry, fish, and beans can help support muscle health and reduce inflammation, too.
At the same time, it’s important to avoid and limit pro-inflammatory foods that can exacerbate endometriosis symptoms, including:
Processed foods: Nearly all processed foods contain added sugars, unhealthy fats, and artificial additives, all of which can contribute to inflammation. Think French fries, fried fast food in general, soda, etc.
Processed carbs: A lot of people don’t realize that white bread and white rice are also processed foods. But refined carbohydrates are not only stripped of essential nutrients but they’re often treated with chemicals and have preservatives added, too.
Red meats: High consumption of any red meat, like beef or mutton, has been linked to increased levels of inflammation and worse endometriosis pain symptoms. Many red meats are processed too, like hot dogs and sausages.
Trans fats: These ‘bad fats’ are found in some fried and processed foods and can promote inflammation. If you’re not sure what is or isn’t a trans fat, check the “Nutrition Facts” label on any food item and look under “Total Fat” for “Trans Fat.”
Caffeine, sugar, and alcohol: Unfortunately, all three of these can contribute to increased inflammation in the body and should be consumed only in moderation if you are living with endometriosis.
5. Mind-Body Practices: Yoga, Meditation, and More
Incorporating well-established mind-body practices into your endometriosis self-care routine can help relieve pain, reduce stress, and improve your overall well-being. There’s a reason these practices have been popular in cultures around the world for thousands of years!
The key to nearly all of these practices? They help reduce acute stress. And lower stress levels have always been linked with better health.
Some beneficial mind-body practices to consider include:
Gentle yoga: Gentler yoga poses that anyone can do help stretch and strengthen your muscles, ease pelvic pain, and promote relaxation. If you’re not very flexible, consider avoiding the more difficult forms of yoga, as they could increase your stress levels if you find yourself really struggling with the poses.
Mindful meditation: Regular meditation can help calm the mind, reduce stress, and enhance your ability to cope with endometriosis symptoms. Meditating isn’t easy for everyone (especially anyone with ADD) but it can help anyone who makes it a habit.
Deep breathing exercises: Practicing deep, slow breaths is not just the first step to mindful meditation, but it can also automatically activate your body's natural relaxation response, which helps lower stress and alleviate pain, too.
Progressive muscle relaxation: This technique involves tensing and relaxing various muscle groups, promoting relaxation and pain relief. It’s a bit harder to master but has been shown to help some people living with endometriosis.
Take Charge of Your Endometriosis Self-Care Journey
Living with endometriosis can be challenging for anyone. At times, it might feel like nothing you’re doing is really helping. And during endometriosis flare-ups, you might even begin to believe that your symptoms are only getting worse, not better.
But by taking charge of your endometriosis self-care journey, you can better manage your symptoms and improve your quality of life for the long haul.
From understanding what causes your endo flare-ups, to adequately addressing your mental and emotional health, to implementing personalized pain relief strategies and adopting lifestyle changes, there are so many ways to empower yourself and take control of your well-being.
Remember, you don't have to face your endometriosis alone. Seek support from your loved ones, healthcare providers, and in-person or online support groups to help you navigate your personal journey to better health and happiness.
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