Endometriosis Flare Ups: What You Need To Know To Manage Symptoms

Around 10% of women globally are said to be affected by endometriosis; a chronic disease where scar tissue and inflammation build up in the pelvic region (1). There is limited understanding on the cause of endometriosis making it easy to be misdiagnosed or experience delays in diagnosis. But what exactly is a flare-up, and how can you manage the associated symptoms? If you want to know what could be causing your flare-ups and how you can possibly minimise the symptoms, then read on as this blog will cover effective ways to manage your endometriosis flare-ups.

What is an Endometriosis Flare Up ? 

An endometriosis flare up is a period of intense and increased severity of symptoms. It can last anywhere from a few days (usually during menstruation) to several weeks depending on the individual and cause of the flare-up. 

A woman experiencing an endometriosis flare up.

What are the symptoms of Endometriosis?

Endometriosis mainly affects the pelvic region; this is because tissue similar to that of the uterus lining grows elsewhere i.e. the ovaries or fallopian tubes, or even on the bowel or bladder. The symptoms are as follows (2)

  • Pelvic/ abdominal pain

  • ‘Debilitating’ pain that affects the individual's ability to carry out normal activities

  • Pain associated with sex

  • Heavy/ heavier periods

  • Possible mental health implications eg depression

  • Experiencing fertility issues

  • Tiredness and lack of energy

  • Painful bowel movement

What causes endometriosis flare ups?

Understanding the root of your flare-up is essential in helping you manage and take control. 

There are many factors that can influence the onset of a flare-up. Broadly speaking, these can  include hormonal changes and inflammation. But what do we mean by this?

  • Hormonal Changes: Oestrogen plays a key role in the onset of endometriosis. It promotes the shedding of tissue in the uterus lining which then builds up in other areas causing pain & other symptoms typically experienced during flare ups. 

  • Inflammation: When the body thinks it is under attack it stimulates an inflammatory response- these are usually temporary but due to the nature of endometriosis this can become chronic inflammation. This leads to a continuous and harsh cycle of  more scar tissue, more damage and more pain! 

Studies have also shown that several factors such as sleep deprivation, stress and the foods we eat can increase inflammation in the body. 

  • Sleep deprivation: Lack of sleep is associated with the production of inflammatory compounds and can lead to a ‘chronic inflammatory state’.  (3) 

  • Stress: Although an exact cause and effect relationship between stress and the onset of endometriosis hasn’t been established, a review in 2020 found greater stress was associated with intensified pain and symptoms. (4)

  • Diet: Your diet and the foods you consume can also lead to increased inflammation within the body. 

The following are all considered ‘inflammatory foods’

  • Alcohol 

  • Caffeine 

  • Red meat 

  • Trans fats 

Individuals with endometriosis should be mindful of their intake of inflammatory foods. 

So we have mentioned that hormonal changes and chronic inflammation can make the symptoms of endometriosis worse. But what can you now do with this information? Well, knowing these triggers can be extremely helpful in managing and possibly preventing the dreaded flare-ups. 

How to manage endometriosis flare ups?

Currently, there is no cure for endometriosis and so treatments aim to minimise symptoms and improve quality of life. A variety of treatment options are available which include; 


Hormone Treatments

These aim to lower oestrogen levels in the body or cause medical menopause.

  • They alleviate symptoms by preventing the growth of endometriosis 

  • Examples include; the ‘pill’, progestogens & GnRh analogues (5)

Pain Relief

These simply address the pain associated with symptoms, ie pelvic pain

  • NSAIDs (Ibuprofen,Valatrol etc) stop the body producing prostaglandins which can cause pain and inflammation. These are best taken a few days before the ‘flare-up’ would be expected. 

  • Heat is also a great option to alleviate the symptoms of a flare-up and ensure as much comfort as possible. Keeping a hot water bottle close by can be handy (5)!

 

Stress Management

As stress is both an associated trigger and symptom of endometriosis, managing stress levels is essential to gain control during intensified periods. 

  • Meditating and yoga are great ways to overcome stress. 

  • Creative tasks/ self-expression, another way to distract yourself

  • Practising mindfulness and remaining compassionate and kind to yourself. 

Symptom Monitoring

A great way to identify triggers and monitor pain levels throughout your cycle is by keeping a ‘symptom diary’. This can be in a notebook, on your phone via an app or using resources online (6). This is an extremely useful tool for both you and your doctor, as symptoms are easily recalled and it can be helpful in establishing patterns. Healthcare professionals can then use these patterns to create a personalised and individual treatment plan to help manage your endometriosis. 

 
Symptom monitoring can be benefical to track pacin and triggers through your menstrual cycle to establish patterns during endometriosis flare ups. .

Endometriosis flare ups are periods of intensified and severe symptoms that can affect the day to day lives of sufferers. Identifying your triggers and monitoring pain levels are extremely valuable in choosing the most suitable treatment option for you. This in turn will help manage your endometriosis and reduce the occurrence of flare-ups. 

If you would like 1-1 support in your endometriosis journey, get in touch to book a free discovery call.

References

  1. Endometriosis

  2. Endometriosis

  3. Role of sleep deprivation in immune-related disease risk and outcome

  4. Is Stress a Cause or a Consequence of Endometriosis?

  5. Treatment and Management | Endometriosis UK

  6. How to keep an endometriosis pain and symptom diary

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