Endometriosis occurs when endometrial-like tissue starts to grow outside of the uterus, causing symptoms such as pain, bleeding, irritation, and eventually scar tissue can develop in the affected areas.

Some women experience these symptoms from the time they ovulate through the start of their period — meaning for half of each month they have endometriosis-related pain. Others may experience predominantly period pain, or symptoms like painful sex, excessive bleeding, or infertility.

The effects of endometriosis can impact women in many ways. “However, it’s hard to diagnose because the symptoms can occur in different areas of the body,” says Karli Goldstein, MD, a gynaecologic surgeon at Seckin Endometriosis Center in New York City and a consulting surgeon with the Endometriosis Foundation of America (EFA). “Some women may not have painful periods, or they experience seemingly unrelated symptoms that may lead to a delay in diagnosis.” These can include chronic lower back and leg pain, nerve pain, painful bowel movements, and digestive problems.

Quality-of-Life Challenges With Endometriosis

Endometriosis impacts a woman mostly during her reproductive years, around 25 to 35 years of age, although symptoms can begin as soon as she starts her period – as early as 11 years old, according to the EFA. This is often a time when a woman is busy trying to build her life. “Endometriosis may cause a woman to miss work or school, or she may even have trouble holding down a job or completing school in severe cases,” says Dr. Goldstein, who has endometriosis herself.

To add to the frustration of living in pain, there can be a long delay between the onset of endometriosis symptoms and diagnosis. “At least 1 in 10 women have endometriosis, but it’s probably underdiagnosed. It can take up to 10 years to diagnose, especially if symptoms are atypical,” says Goldstein, and as outlined by Yale Medicine.

Endometriosis Self-Care Strategies

It’s important to get a proper diagnosis and treatment plan for endometriosis, but in addition, taking care of yourself can help you feel your best. “You may need to eat healthier and focus more on wellness than those around you, but it’s worth it in the long run – not just for endometriosis, but for your overall health too,” says Goldstein. Try these self-care strategies to ease your day-to-day life:

Eat a Healthy Diet

A low-fat and primarily plant-based diet rich in fibre and antioxidants has been shown to decrease the symptoms of endometriosis, and some women with endometriosis have found that additional supplementation with vitamins D, C, and E has benefits as well, according to research published in February 2023. Also include foods high in omega-3 fatty acids in your diet, such as avocadoes, nuts, olive oil, and low-mercury wild fish, as these are linked to reduced inflammation – and remove processed foods and soda drinks from your diet.

Stay Active

You may not want to exercise when you’re in pain, but when you feel up to it, try to move at least 30 minutes a day. A study from 2022 showed that women with endometriosis who exercised three days a week reported lower pain levels in the days after exercise.

Try Acupuncture

“Acupuncture may be helpful in combatting pain related to endometriosis or in helping to regulate cycles,” says Goldstein.

In this form of Chinese medicine, a practitioner applies small needles to body parts to help correct imbalances by increasing blood flow to those areas.

For women with endometriosis, this often means getting acupuncture needles in the pelvic area and lower abdomen to help ease symptoms such as cramping.

Find Ways to Get a Good Night’s Sleep

Women with endometriosis are twice as likely to be affected by fatigue as those who don’t have the condition, according to research. This fatigue was also linked to a seven-fold increase in insomnia.To get better sleep, start with the basics, advises the Centers for Disease Control and Prevention: Aim for a consistent bedtime, ensure your bedroom is dark and quiet, remove devices and distractions, and avoid large meals, caffeine, and alcohol close to bedtime.Cognitive behavioural therapy (CBT) to treat insomnia is also recommended before trying alternative options, such as pills or supplements, according to the Mayo Clinic. And if none of those approaches helps, Goldstein is a proponent of relaxing night-time rituals to aid in getting some shut-eye: “Try taking a bath with lavender and chamomile oils, which help with muscle relaxation.” Bathing with Epsom salts can also help soothe pelvic and abdominal pain. You might also experiment with herbal teas that can help you sleep better, such as those with valerian root, Goldstein adds.

Be Kind to Yourself

If you keep track of your period and endometriosis symptoms on a monthly basis, you can get an idea of when you may experience the most pain. Try clearing your calendar during these times so you won’t have to rush between social and work obligations and can instead focus more on taking it easy.

Explore the Mind-Body Connection

Living with pain is draining emotionally as well as physically, so soothing your mind with approaches like meditation and deep breathing may help your body feel better. Mindfulness meditation can improve pain and depression symptoms in people who experience chronic pain, according to a study.

Get Support

According to the EFA, more than 200 million worldwide have endometriosis.

You can join online support resources such as My Endometriosis Team and Facebook groups to connect with others who have endometriosis, or you might ask your gynaecologist about local groups that can offer in-person opportunities to swap stories and strategies.

By prioritising taking care of your overall health, you can feel better, says Goldstein. “Endometriosis can be painful, but it doesn’t have to be. Stay open to different possibilities and work with your gynaecologist to see what helps.”