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.
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Endometriosis, or “endo,” is a condition where the lining of the uterus grows outside of it, causing pain and discomfort. While many women are familiar with the condition, not everyone has heard of endometriosis belly.
“Endo belly” is a term used to describe the bloating and discomfort that some people with endometriosis may experience. Endo belly is not necessarily caused by ovulation cycles or periods. In this article, let’s review what endo belly is, what triggers it, and how to manage it.
What Is Endo Belly?
Endo belly can be caused by inflamed and irritated endometriosis lesions growing outside of the uterus. These lesions can lead to persistent swelling and fluid retention in the abdomen. Women with endo belly report feeling an uncomfortable sense of fullness and even pain.
A study on abdominal bloating found that 96% of women with endometriosis experienced ‘belly bloating’ regularly, compared to 64% of women without endometriosis, who only experienced it occasionally.
In other words, endo belly is an extremely common experience for women living with endometriosis. But unlike endometriosis flares, which are usually caused by the same triggers for each person, endo belly can be challenging to deal with because it’s often unpredictable.
This can make it difficult for anyone living with endo belly to plan their day, as they just don’t know when endo belly could strike.
The Relationship Between Bloating and Endometriosis
General bloating is a very common symptom of endometriosis and can be caused by a number of factors.
In addition to endo belly, endometriosis can also cause bloating in the abdomen by interfering with the function of the digestive system and gastrointestinal (GI) tract. Endometriosis lesions can attach themselves to the intestines and other organs in the abdominal area, which can slow down digestion as well as cause constipation, excess gas, and bloating.
It's important to note that while bloating is a common symptom of endometriosis, not everyone with endometriosis will necessarily experience it.
Additionally, bloating can also be a symptom of other conditions, such as irritable bowel syndrome (IBS), so it's important to speak with your doctor if you're experiencing this symptom but aren’t sure why.
Symptoms of Endo Belly
As with endometriosis, endo belly can manifest in a variety of ways and often presents differently for different people. When endo belly strikes, the symptoms can range from mild discomfort to severe, crippling pain.
Some common symptoms of endo belly include:
A feeling of fullness or bloating in the abdominal area
Swelling or inflammation in the abdominal area
Pain or discomfort in the abdominal area
Nausea or vomiting
Constipation or diarrhea
Keep in mind that all of these symptoms can also happen to anyone for totally normal, harmless reasons (like eating too much or too quickly).
But if you feel as if any of these symptoms feel different or are more intense than usual, and aren’t sure why, it's important to speak with your doctor.
Endometriosis ovulation pain and endo belly
In addition to bloating and discomfort, some people with endometriosis also experience ovulation pain. This pain can occur when an egg is released from the ovary, but endometriosis lesions on the ovary or other reproductive organs get in the way.
Ovulation pain often accompanies endo belly, making that time of month particularly challenging.
If you're experiencing ovulation pain and endo belly, there are several safe and effective at-home strategies you can try to manage your symptoms. These include:
Taking over-the-counter pain relievers like ibuprofen or naproxen
Applying heat to your tummy, whether through a hot bath or hot water bottle
Resting and taking it easy whenever you know your period is on its way
What Triggers Endo Belly?
Endo belly can be triggered by a variety of factors, and its onset can be unpredictable. Some common triggers for endometriosis-related abdominal bloating include:
Inflammation triggered by excess endometrial tissue growing outside your uterus can cause swelling and water retention in your belly. This trigger is difficult to deal with because you can’t see it happening.
When excess endometrial tissue spreads over or into the ovaries themselves, it can trap blood that could turn into cysts if they don’t heal properly. This can also make your belly feel puffy and bloated.
Women with endo are at higher risk of small intestinal bacterial overgrowth (SIBO) and fibroids, both of which can make you feel bloated.
Digestive problems are also common with endometriosis, including issues like constipation and gas.
It’s important to remember that these are just common triggers of endo belly, but that your triggers might be slightly different. Staying attuned to your body's responses and identifying potential triggers for your endo belly is crucial.
How to Manage Endo Belly
Managing endo belly can be challenging, but there are several strategies that can help. These include:
Maintain a balanced diet: Eating fiber-rich foods, fruits, and vegetables in your diet can aid in reducing inflammation and enhancing digestion for anyone. A healthy diet is particularly helpful for women living with endometriosis.
Steer clear of known trigger foods: The endometriosis community is pretty much in agreement that there are some foods nearly always trigger bloating and inflammation for women with endometriosis (like red meat, processed foods, and caffeine).
Stay hydrated: This one’s a bit counterintuitive. Drinking ample amounts of water can actually help reduce fluid retention (which can cause bloating) and promote better digestion.
Keep a food journal: Monitoring your day-to-day endo symptoms can help you detect triggering foods and patterns more easily. This can put you in a better position to manage your endo belly so that it doesn’t sneak up when you least expect it.
Practice stress-management techniques: Common calming and stress-management practices like mindful meditation, yoga, or deep breathing exercises can all be useful in managing stress levels, which can help reduce pain and inflammation.
Engage in gentle physical activity: As much as exercise is a good thing for anyone, overdoing it isn’t encouraged for women with endo. Low-impact exercises like walking, swimming, and yoga can improve digestion and decrease inflammation.
It's also important to work with your doctor to develop a management plan that's tailored to your individual needs.
Does birth control help endometriosis and endo belly?
Speaking of that time of month, hormone therapy is a common treatment for many women living with endometriosis. Common hormone management therapies for endometriosis include:
Hormonal contraceptives: Birth control pills can help manage hormones that lead to endometrial tissue buildup. They can also shorten and lighten menstrual flow. Continuous-cycle regimens may even alleviate pain for some women with endo.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists: These helpful drugs can block ovarian hormones, reduce estrogen, and stop menstruation, which shrinks endometrial tissue. To offset artificial menopause side effects like hot flashes, supplementing with low-dose estrogen or progestin can help.
Progestin therapies: Levonorgestrel intrauterine devices (IUDs), contraceptive implants, contraceptive injections, and progestin pills can pause menstrual periods and endometrial growth, easing endometriosis and endo belly symptoms.
Aromatase inhibitors: Similar to Gn-RH agonists and antagonists, aromatase inhibitors are a type of medication that can lower your estrogen levels. They can be recommended alongside progestin or hormonal contraceptives for treating endometriosis.
It's important to speak with your doctor about the best hormone therapy options for you in particular.
Find Relief From Endo Symptoms
Endo belly can be a challenging and unpredictable part of living with endometriosis, but there are several effective ways that you can manage it. By eating a healthy diet, staying hydrated, managing your stress, and exercising regularly (but not too much), you can help reduce inflammation and bloating while improving digestion.
But if symptoms like endo belly are interfering with everyday life, it may be time to seek expert treatment.
Dr. Delgado specializes in treating endometriosis and its accompanying symptoms and conditions. She combines traditional treatments and holistic therapies to provide lasting relief from pain and discomfort. Get in touch today to take the first step toward your endo healing journey.