Fatigue and endometriosis is NOT one of the first connections that I made when I started my endo journey. In fact, I truly didn’t even realize that I was fatigued until I wasn’t anymore. Fatigue is something that is so normalized in our culture that I didn’t even realize that it wasn’t normal. Everyone is just tired all the time, right?

Let’s rewind to 6 years ago before I started my journey towards healing with endometriosis. At the time, I was teaching classical ballet and yoga full time. I would teach my first class and be so exhausted that I wasn’t sure how I would make it through the rest of the day. If I had an early class and a later class, it was common for me to have to come home and nap in between.

Making plans on the weekends? Forget about it! That was my time to be able to rest and recoup and be ready to struggle through the week coming up.

I went into the work of healing my body with the intention of dealing with the pain, but I was so blown away by how much more energy I had. In doing my research, I discovered a 2020 study of 22 women with endo and all 22 of them reported experiencing fatigue. I was not alone! I just had to dig deeper.

How are fatigue and endometriosis connected?

Fatigue is a common symptom of inflammation. Think about when you have a virus, for example. Your body’s immune system is working full force to fight the infection. Oftentimes the very first symptom you experience is feeling tired. 

Why does this happen?

This is thought to be an imbalance of energy expenditure. Basically, your body is spending a lot of its energy reserves on your immune system and therefore doesn’t have enough energy to give to your cells. 

Now, in the case of a virus, that experience of inflammation is acute and short-lived. Your immune system fights the virus off and then settles down again.

In the case of a chronic disease like endometriosis, what happens is that your body constantly remains at a low-grade level of inflammation. This is what is known as chronic fatigue. 

How do I know if I have chronic fatigue and endometriosis?

Chronic fatigue is an incredibly common symptom of endometriosis, but of course endo is not the only disease that comes with a side serving of chronic fatigue. A diagnosis by a doctor is the only way to know for sure if you have endo.

Now, we are busy human beings so being tired is not an uncommon experience for most people. How do you differentiate being tired at the end of a long work day with true chronic fatigue?

It is a fine line of course, but the real difference is that with chronic fatigue it is often not proportional to the exertion that caused it and also may not be alleviated by rest. Then there is also the simple fact that you feel tired all the time. 

Please do yourself the biggest favor of your life and don’t assume that this is a normal state of being. Despite what well-meaning friends and relatives might say, you absolutely shouldn’t feel this way and you deserve better for your life!

So what can I do?

Given the connection between chronic inflammation and chronic fatigue, step one is to calm inflammation in your body.

How do we do this? 

Well, the answer of course is not super simple. It is one of the biggest projects that I work on with my clients. When we are talking about calming inflammation, what that really means is that we need to calm the immune system. 

That my friend comes right back to the health of your gut. A whopping 70% of your immune system lives in your gut, so it is always the best place to begin! I have a whole article about the endo-gut connection that I will link to below if you care to dig deeper on that.

Supporting your gut to support fatigue and endometriosis

Supporting your gut can become a bit complex, so if you have severe symptoms happening I highly recommend working with a practitioner trained in this area. I personally love using gut testing like the GI Map in my practice to give us a good picture of what is going on without using guesswork. It also allows us to take on an eradication protocol in the event of bacterial, parasitic, or fungal overgrowth (which I see in almost every one of my clients!). 

This of course is something you wouldn’t want to take on by yourself, but I have included some simple steps you can start with below so you can begin your healing journey today!

Simple steps you can take to start supporting the gut though include:

  • 1. Eating a wide range of fruits and veggies…think eat the rainbow (without the skittles of course)
  • 2. Include gut-healing nutrients in your diet, like bone broth, collagen powder, and slippery elm tea
  • 3. Include prebiotic and probiotic-rich foods in your diet, such as garlic, onions, green bananas, jerusalem artichoke, apples, and fermented foods like sauerkraut, kimchi, and yogurt, as well as kombucha and kefir.

Other ways to reduce inflammation

In addition to supporting gut health which helps us to address the root cause of inflammation, we can also address inflammation directly. 

While gut healing can take some time, you can see much quicker results (although not as lasting) by taking some simple steps with nutrition and supplementation.

Foods to avoid when working to reduce inflammation:

  • 1. Vegetable oils (including canola oil, soybean oil, sunflower and safflower oil, anything “hydrogenated” and of course plain old vegetable oil)
  • 2. Refined sugar
  • 3. Refined carbohydrates (think bread, pasta, pastries, etc.)
  • 4. Processed food
  • 5. Alcohol

Foods to focus on when working to reduce inflammation:

  • 1. Omega-3 rich foods (fatty fish like salmon, mackerel, and sardines as well as egg yolks from pasture-raised eggs, walnuts, flax seeds, chia seeds, hemp seeds, and pumpkin
  • 2. Antioxidant-rich foods from a wide variety of colored fruits and veggies like blueberries, strawberries, blackberries, apples, broccoli, carrots, sweet potato
  • 3. Ginger and turmeric–roots that have strong anti-inflammatory properties and can be used in whole-food form, as a tea, or in supplemental form

How else can you support fatigue and endometriosis?

Another place to look when supporting fatigue is to ensure you are getting enough nutrients in your body to support energy production. 

This includes plenty of protein. Animal sources of protein such as meat, poultry, seafood, eggs, and dairy are the most-bioavailable sources and will therefore give you much, much more bang for your buck.

Many of these foods are also very rich in B-vitamins which are essential for energy production.

All of this is a boost that is much more beneficial for the short term and long term than drinking cup after cup of coffee!

Final thoughts

I hope, my friend, that this all gives you a wonderful starting point when it comes to managing your fatigue and endometriosis. 

Truly it is my passion in life to help give women the tools to take their health into their own hands.

If you feel ready to take the next step in your journey, get to the root of your symptoms, and finally thrive your way through life again, I would love to see you inside of my Thrive With Endo program. Click here to learn more and apply today. 

Other articles you might enjoy:

Inflammation and Endometriosis
The Endo-Gut Connection
The 5 WORST Foods for Endometriosis
The 5 BEST Foods for Endometriosis


Lacourt, Tamara E.;  Vichaya, Elisabeth G.; Chiu, Gabriel S.; Dantzer, Robert; Heijnen, Cobi. (2018). The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure. Retrieved from:


Hab, Ulrike; Herpich, Catrin; Norman, Kristina. (2019). Anti-inflammatory Diets and Fatigue. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835556/

National Institute of Health National Library of Medicine. (2018). What is an inflammation? Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279298/

Pahwa, Roma; Goyal, Amandeep; Jialal, Ishwarlal. (2022). Chronic Inflammation. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK493173/

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/

Nutritional Therapy Association (2021). Immune Module Materials [Video and PDF Documents].

Alyssa Chavez endo belly girl




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