How To Deal With The Pain Of Endometriosis

Endometriosis is a chronic, hormone-dependent, inflammatory condition that affects approximately 10%¹ of women. The condition causes debilitating deep pelvic pain that you might feel during menstruation (dysmenorrhea), sex (dyspareunia), or when you go to the toilet (dysuria and dyschezia).

Pain and discomfort can greatly reduce your quality of life, and the condition may affect your fertility and increase your risk of cancer in the long term. Endometriosis is challenging to treat, but some readily available treatments and at-home remedies and techniques can effectively relieve pain, making the condition easier to live with.

How endometriosis develops

Endometriosis occurs when the inner lining of the uterus grows in another part of your body. Tissue is normally found in the pelvic cavity, abdomen lining, bladder, bowels, appendix, fallopian tubes, and ovaries.

You will typically feel endometriosis-related pain in your pelvis. It may be chronic, cyclic, and could get worse over time.²

The condition is thought to be caused by genetic and environmental factors, but almost all sources agree that it develops from the retrograde³ (backward) flow of menstruation that deposits endometrial cells into the abdominal cavity where they might grow.

What causes endometriosis pain?

There are three main causes of endometriosis pain.

The endometriosis tissue growing in other parts of your body works the same as the tissue in your uterus; it is stimulated by your monthly cycle, so it thickens, breaks down, and bleeds. The problem is that there is nowhere for the tissue to go once it has broken down. This process can result in painful swelling, inflammation, scarring, and lesions.

The adhesions that form as a result of endometriosis may also be causing your pain. Endometriosis can create thin bands of tissue between the surfaces of adjacent organs as a result of injury and inflammation, causing the organs to stick together. Organs can become immobile when aligned incorrectly, causing what’s known as “frozen pelvis.” This leads to a great deal of pain, particularly during or after sex.

Nerve hypersensitivity is the third cause of endometriosis pain. It is thought that continuous stimulation of pain receptors in the endometrial tissue increases pain sensitivity.

How to deal with endometriosis pain

There are three main methods for reducing endometriosis pain:

• Medication

• Surgery

• Alternative therapies

Your doctor might recommend medications to reduce your pain and make endometriosis symptoms more manageable. These include painkillers like analgesics or hormonal treatments such as combined oral contraceptives (COCs), implants, or other hormonal drugs.

Medication is not always successful, and some people are unable to take specific medications because they have an intolerance or are trying to get pregnant (some hormonal medications affect fertility).

Surgery is thought to be the only way to definitively reduce endometriosis pain and might be recommended when other treatment options have failed. It usually involves the removal of endometriosis tissue.

Alternative therapies may also be useful in reducing endometriosis symptoms. They are readily available and have few side effects.

At-home endometriosis treatments

The following at-home treatments and techniques may effectively reduce your endometriosis symptoms. The tools or ingredients you need are easy to obtain, and you might already have access to some of them.

Heat

Applying a heat pad to your abdomen can reduce pain. Heat helps loosen your cramping muscles and makes cramps less frequent and intense.

If you don’t have a heating pad, you can make one by simply filling a sock with rice and heating it in the microwave (take care not to make it so hot that it burns your skin). You might also find that a long soak in a warm bath helps to relax your muscles and ease tension and pain.

Transcutaneous electrical nerve stimulation machine (TENS)

A TENS machine is connected to your skin via electrodes and sends electrical pulses into your body. It offers endometriosis pain relief by relaxing your muscles and easing cramps.

TENS machines have been shown to effectively reduce period pain in 40–60%⁴ of women with dysmenorrhea unrelated to endometriosis. Its success in endometriosis patients has not yet been studied extensively, but some women do find it useful.

You can rent or buy a TENS machine if you don’t already have your own. They are easy to obtain and affordable. Be aware that TENS machines are not recommended⁵ if you are pregnant or have a heart condition.

Hydration

It’s important to stay hydrated when your endometriosis pain is severe as it can help to relieve symptoms. Dehydration can exacerbate bloating and cramping, which may increase discomfort.

Massage

Not only is daily pelvic massage a relaxing stimulus for cramping muscles, but it also forces you to be still and quiet for a few minutes. Massage can significantly reduce stress, which can exacerbate endometriosis symptoms. Consider using lavender or rosemary oil for their relaxing properties.

Herbal teas

Caffeine-free herbal teas have been shown to effectively reduce period pain, and they may also be useful for easing endometriosis-related pain.

Ginger tea

A 2016 review⁶ found that ginger was as effective as non-steroidal anti-inflammatory drugs (NSAIDs) in treating dysmenorrhea (period pain), and you may find that drinking ginger tea reduces your inflammation and nausea. It works by lowering the production of prostaglandins, lipids associated with cramping which may increase when estrogen is high.

Fennel tea

Fennel has been found to reduce uterine contractions, so you may find that fennel tea helps relieve your endometriosis pain and cramping. 80% of participants in one study⁷ examining the effects of fennel on dysmenorrhea reported that fennel completely reduced their pelvic pain.

Lemon balm

Lemon balm, which can be made into a tea, has antispasmodic and anti-inflammatory properties. A 2018 study⁸ found that lemon balm effectively reduced the symptoms of dysmenorrhea, including heavy bleeding and fatigue (both symptoms of endometriosis).

Turmeric

Ingesting turmeric (made into tea or a smoothie) could reduce your endometriosis pain. Turmeric has been used and studied for its anti-inflammatory properties, including on menstrual conditions like dysmenorrhea. The active ingredient curcumin⁹ has anti-inflammatory, antioxidant, and analgesic properties, which explains why it is so effective in treating pelvic pain.

Diet

Your diet can worsen endometriosis symptoms, including pain. This may be because some foods have an inflammatory effect and result in hormonal changes.For advice and recommendations suited to you, speak to your doctor or consult a dietician. Generally, endometriosis patients are advised to consume a diet⁵ consisting of omega-3 fatty acids and lots of fruits and vegetables. You should reduce your intake of sugar, fast foods, caffeine, and alcohol and consider switching to a low-FODMAP¹⁰ diet or limiting gluten.

Managing pain

Once you have found a method for reducing your pain, you can take steps to manage it going forward.

Track your symptoms

Track your pain and make a note of when it usually occurs. For example, at what point in your cycle do you experience pain? Does your pain get worse when you eat certain foods? This information will help you avoid pain triggers or adjust your lifestyle so that you can better manage your condition. It will also be helpful when speaking to your doctor as they will be able to prescribe effective treatments.

Adjust your diet

Your diet significantly affects your endometriosis symptoms. Identifying triggers for pain and sticking to a low-inflammatory diet (such as a low-FODMAP diet and reducing your consumption of processed food) can help you manage pain.

Plan ahead

Endometriosis symptoms can make day-to-day life challenging. Be kind to yourself and plan ahead, giving yourself time out of your work or social calendar when your symptoms are at their worst. Tracking your symptoms and triggers can make it easier to plan ahead.

Don’t overcrowd your calendar and leave no room for rest and self-care. Sometimes you just need to say “no” and identify commitments that actually matter.

Pelvic floor exercises

Chronic pain and inflammation can cause your pelvic floor muscles to tighten, resulting in further pain, especially during sex. You can do some pelvic floor exercises yourself at home, but seeing a physical therapist for advice and guidance could be helpful.

Reduce stress

Stress is thought to worsen endometriosis symptoms,¹¹ so you should consider ways to reduce your stress levels and make the condition more manageable.

Exercise is one way to reduce stress and alleviate your symptoms. Physical activity increases blood flow¹² to your muscles and produces endorphins, feel-good hormones that act as natural painkillers.

Spending some quiet, mindful time outdoors can also help to alleviate stress. Not only does it physically remove you from a stressful environment, but it also allows you to breathe deeply and process any thoughts you may be working through.

Relationships and communication

The everyday effects of endometriosis, including pain, heavy bleeding, fatigue, and fertility problems, can make relationships challenging. Be honest with others about your condition and ask for help when you need it.

The lowdown

Endometriosis is a common and painful condition with symptoms that make everyday life challenging. Medication (including painkillers and hormone therapies), surgery, and alternative therapies can effectively treat endometriosis symptoms. Some alternative therapies are inexpensive and easy to access — you might already have some in your kitchen cupboard!