What exactly are endometriosis flares? Basically, they are periods of time when pain and other symptoms worsen. These are the moments when it feels like your uterus is on fire or wrapped in barbed wire or like you are just going to explode from the inside out. Definitely no fun! Today we are going to spend some time exploring what triggers these endo flares, how we can best avoid them, and what to do when they happen.
How do I know when I’m having endometriosis flares?
When you are having endometriosis flares, the symptoms you experience will be your typical endometriosis symptoms, only much worse for a period of time. Oftentimes this involves an increase in pain levels, but can also show up as fatigue, heavy menstrual bleeding, bowel symptoms, and even mood changes like depression.
For many women, these flares occur during menstruation, but can happen anytime. They can last from hours to days or even weeks and can make life feel unbearable.
In other words, if you are having endometriosis flares, you probably know it! Listen to your body and read on to learn how to avoid triggers of these flares.
What triggers these endometriosis flares?
Endometriosis is an inflammatory condition. Reducing inflammation in your body is a huge part of healing and avoiding sources of inflammation can help you to avoid endometriosis flares.
Let’s explore some potential triggers of inflammation!
When we are thinking about inflammation, one of the key elements to look at is stress. We tend to think of stress as psychological, like stress from work or family or driving in traffic. This is absolutely something to look at!
But there are also internal, physical sources of stress that can heavily impact endometriosis. This includes inflammatory foods like vegetable oils, sugar, processed foods, and alcohol. It can also include lack of sleep, high intensity exercise, and even imbalances in your gut.
Trying to pinpoint exactly what may be triggering your endometriosis flares can be a bit frustrating, so my very best recommendation is to work on managing all potential forms of stress little by little.
This will be your best bet for long term healing!
Squash that stress!
Let’s start from square one here, from that psychological stress we talked about. Now avoiding stress in our lives altogether is probably not an option for any of us. But learning to manage stress levels is a huge part of the healing process.
I like to think of stress with the bathtub analogy. Imagine that the top level of the bathtub is the maximum stress level your body can handle. We all know what that feels like.
There are two ways you can address that full bathtub. One is to bale the water out and the other is to turn off (or at least turn down) the faucet.
Picture this: if you have a completely full bathtub with a faucet running on full blast, you will never be able to keep up with bailing it out before it fills back up. You have to find a way to also turn that faucet down in order to actually reduce the level of the water.
So step one, find ways to turn down the faucet. This will look different for everyone. Are there things you can say no to? Are there responsibilities at home or work you can delegate? For some this may be as drastic as changing jobs, relationships, or even the place you live. Listen to your instincts here. I’ll bet you know what is best for you.
Step two, find ways to manage your stress. Play around and find what works best for you. Helpful strategies can include meditation, journaling, deep breathing, walks in nature, yoga, or even spending time with a beloved pet, friend, or family member. Think about what helps you feel most calm and at ease in your body.
Look to your food
Food can be a huge source of inflammation that can lead to endometriosis flares. It can also be a huge source of reducing inflammation when you are very intentional about what you put on your plate.
Being in the nutrition world, I have many other posts on this site that are entirely dedicated to food and endo that I will link to at the end of this post. For now, let’s cover the basics.
Foods to avoid/limit: processed foods, vegetable oils, sugar, alcohol, and caffeine are the big ones. Other possibilities to look at are gluten, dairy, corn, soy, and of course your unique food sensitivities. This is where bio-individuality matters, so remember that which foods to avoid is not a one-size-fits-all answer.
Foods to focus on: a wide variety of fruits and veggies; whole food sources of protein like poultry, meat, seafood, and eggs; Omega-3 fats.
My best advice here starting out is to use the “crowding out” mentality. You don’t have to immediately cut out all of your favorite foods, but start by filling your plate with foods that do nourish your body and then take it one step at a time.
Sleep and movement
Sleep plays a huge role in your overall health, but particularly when it comes to reducing inflammation. Your body needs that sleep time in order to repair and restore and heal.
Aim for getting 7-9 hours of sleep per night. Yep, that may mean skipping that one last episode of Netflix and getting into bed earlier. Your body will thank you.
Help yourself get to sleep at night by turning off screens at least an hour before bed, dimming lighting in your home in the evening, getting sunlight exposure first thing in the morning, and even supplementing with magnesium. I recommend taking about 500mg of magnesium glycinate before bed.
So what about movement? This one is all about balance. Moving your body each day is important for blood flow, lymphatic flow, and digestive health. But exercise that is too intense can contribute to inflammation.
Focus on more gentle forms of exercise like yoga and walking. If you just love higher intensity exercise, try to focus on doing this during the first part of your cycle up to ovulation (the follicular phase) and then leaning into more gentle exercise after ovulation and up through menstruation.
How to put all this together to avoid endometriosis flares
At the end of the day, it is all about the little choices you make all throughout the day. You don’t have to be perfect to be healthy. Your goal here is consistency.
If it feels overwhelming to overhaul your life in one go, don’t! Take this information piece by piece and start incorporating it when you are ready.
After all, stressing about trying to be perfectly healthy will definitely be no help in reducing stress, will it?
You can also try keeping a journal of your symptoms. When slowly but surely you see improvement in your symptoms over time or a reduction in endometriosis flares, it can motivate you to want to keep going and make more positive changes.
What to do when you are having an endometriosis flare
Everything we have talked about so far has been related to avoiding future flares. But if you are reading this and are having a flare right now you probably want to know what to do about it.
I’m here for you!
Triage for endometriosis flares in the moment is all about reducing inflammation. My favorite tools for that include ginger, turmeric/curcumin, and magnesium. Ginger and turmeric or curcumin (curcumin is the active compound in turmeric) can be taken in capsule form or as a tea.
Magnesium can be taken in capsule form or topically to be absorbed through the skin. You can find topical magnesium lotions or gels in most health food stores or you can also take a hot bath with epsom salt. The heat from a hot bath can be soothing as well!
Other strategies include using a heating pad or even a TENS unit, acupuncture, and even deep breathing.
It can be easy to get worked up and stressed out when you are in a flare, so keeping yourself as calm as possible can help to avoid worsening the situation. Listen to some calming music, take deep breaths, and take refuge in the knowledge that it will be over soon.
Know when to seek further help
I am all about using food as medicine and supporting your body in natural ways as much as possible. But it is also important to recognize when you need to look beyond yourself for support.
This can still mean working from a holistic perspective. Sometimes just having a coach to guide you, be there for you, and help you when you get stuck is huge. Or maybe you need some support to dig deeper. For example, I use functional testing in my practice to get to the root of gut imbalances and food sensitivities alongside the nutrition and lifestyle work. If the needle isn’t moving enough for you doing this work on your own, that may be something to look into.
Then there is also the western medicine approach. If you are doing all the things and are still having intense pain, it may be time to talk to a skilled endometriosis excision surgeon. Nancy’s Nook is a great reference for connecting with one in your area. I will link to that in the resources section below!
Listen to your gut
As I always like to remind everyone, you know your body best. Listen to your instincts and keep on digging to find answers. Just remember that it is possible to heal, to feel good and thrive with endo. It’s just a matter of carving out your unique pathway towards that healing.
Remember too that you are not alone. There are so many other women out there just like you who are on this journey and we get it. Need to talk? I am always right here to listen.
Ready to go all in on your health, stop guessing, and follow a proven formula to help your body heal with endometriosis? Click here to learn more about how to work with me and apply for Thrive With Endo today!
Much love, my friend!
Gasnick, Kristen. (2023). Everything You Should Know About Endometriosis Flare-Ups. Retrieved from: https://www.verywellhealth.com/endometriosis-flare-up-7110454
Donnez, Jacques; Cacciottola, Luciana. (2022). Endometriosis: An Inflammatory Disease That Requires New Therapeutic Options. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836207/
National Institute of Health National Library of Medicine. (2018). What is an inflammation? Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279298/
UC San Diego Health News Room. (2012). Why Omega-3 Oils Help at the Cellular Level. Retrieved from: https://health.ucsd.edu/news/releases/pages/2012-05-15-omega-3-oils-help-at-cellular-level.aspx
Vallee, Alexandre; Lecarpentier, Yves. (2020). Curcumin and Endometriosis. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177778/
Simoupolos, Artemis P. (2002). Omega-3 fatty acids in inflammation and autoimmune diseases. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/12480795/
Wang, H Joe; Zakhari, Samir; Jung, Katherine M. (2010). Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842521/
Maier, J.A.; Castiglioni, S.; Locatelli, L.; Zocchi, M.; Mazur, A. (2021). Magnesium and inflammation: Advances and perspectives. Retrieved from: https://doi.org/10.1016/j.semcdb.2020.11.002
Nutritional Therapy Association (2021). Sleep, Stress, and Movement Module Materials [Video and PDF Documents].