How To: Manage Endometriosis

I’ve written about endometriosis before and I’ve written about being in pain recently so here’s a big ol’ disclaimer: I don’t have my health all figured out. There are some days where I’m in pain and I struggle to feel healthy and energized and there are other days where I feel like a normal twenty-something.

This photo, from August 2015, was taken during a hike up Mount Rainier. It’s what I turn to when my body feels weak and I’m in pain. My body is capable of doing quite a bit, even if it doesn’t feel like it.

Now that we’ve gotten that out of the way, I have learned so much over the years to help manage this disease and all of the symptoms that come along with it. Because this isn’t something that is talked about, that means that there’s a lot of misinformation out in the world about what endometriosis is, how to treat it, and what women who have it really go through. One in ten women in the United States has endometriosis and it takes an average of ten years (and plenty of misdiagnoses by multiple doctors) for a women to be diagnosed. This breaks my heart and sends me into a rage-induced tailspin and it’s a constant reminder that as a woman with endometriosis I have a responsibility to help other women. Because I have been let down by doctors I have done so much research over the years into ways to relieve my pain and make my body feel the very best it can. Hopefully some of the following tips can help you if you’re struggling to feel well and manage your endometriosis or suspected endometriosis. And if endometriosis isn’t a part of your life, thanks for reading this far. The more people who know about this disease the better!

Change #1: Diet

You had to know this was coming. This site is called Open Book Kitchen after all! Streamlining my diet has been one of the very best things I’ve done to reduce my pain and give my body a fighting chance. Endometriosis is a disease that results in full-body inflammation so one of the best things to do is to reduce the amount of inflammatory foods you consume. I work really hard to avoid processed sugar, fried foods, gluten, and artificial food additives, and it really pays off. You should also pay attention to how much dairy and alcohol you consume and how much conventionally raised meat and processed meat products you eat, but those weren’t an issue for me because I was already a freakish vegan who didn’t drink alcohol! But seriously – by taking the first step and paying attention to what you eat and drink, you are on the road towards better health. My diet is very focused on fruits and vegetables (organic whenever possible), nuts, seeds, beans, lentils, gluten-free grains, and anything else that is minimally processed, from the earth, and altogether good for you. I also drink mostly water but when I’m looking for something else I drink herbal tea, kombucha, and freshly made, unpasteurized juice. If you eat a standard american diet, this probably sounds insanely difficult to you, but hear me out: you don’t have to do everything at once. Follow Jessica Murnane’s advice – make the commitment to eat one plant-based meal a day. Your taste buds will start to adjust and you will slowly gain more confidence in the kitchen. You can do it! And if you have endometriosis this is one of the very best things you can do for yourself. But keep in mind – every body is different. Your body may be sensitive to certain foods that someone else’s body can easily tolerate. This is not a one size fits all approach! Pay attention to the signs your body gives you. You know yourself better than anyone else.

Change 2: Limit Environmental Toxins

Hormonal imbalances are a part of endometriosis – most women have low progesterone levels and high estrogen levels – and endometrial cells thrive on the estrogen in your body. When there’s already a perfect storm of hormones brewing in your body, it’s wise to steer clear of questionable chemicals and environmental pollutants. One of the easiest steps to take is to buy organic produce, as the pesticides on conventional produce haven’t been around long enough to really know how they affect your body. What they do to the plants they are sprayed on can be quite terrifying so it’s reasonable to believe that they wouldn’t necessarily do good things to your health. For women with endometriosis, the fact that chemicals in our food, the air, toiletries, and household cleaners can mimic estrogen can result in even more pain and inflammation.

As you can read in my last How To… post, I try to stay away from conventional beauty products and prefer to keep things simple with minimal ingredients. I attempt to do the same things with my household cleaners, using Dr. Bronner’s products whenever possible to wash my hands, dishes, and clean countertops. I’m not perfect – sometimes the most stubborn cleaning tasks have me reaching for conventional products. However, I think it’s wise for anyone, regardless of whether you have endometriosis, to limit the amount of strong chemicals at home.

Lastly, it would be foolish of me not to mention the chemicals in a product that most women with endometriosis use…tampons! If you’re going to buy tampons (or sanitary pads), make sure to buy those made from organic cotton. Most cotton grown in the United States is sprayed with glyphosate (also known as Round-Up) which the World Health Organization has said is “probably carcinogenic.” Ummm no thank you. Your body absorbs these chemicals from one of its most sensitive parts so that sounds like a disaster to me. So opt for organic (from brands like Seventh Generation, Natracare, and The Honest Co.) or embrace the world of menstrual cups. You’re probably freaking out at the thought of using a menstrual cup and that’s okay! It is pretty hippie/crunchy/granola! But coming from someone with endometriosis, know that it can really help.

Change 3: Exercise – but listen to your body

When I was 22 years old and experiencing horrific pelvic and abdominal pain for the first time, an ultrasound revealed two massive ovarian cysts. My doctor suspected they were chocolate cysts (filled with blood), which signaled endometriosis, but we wouldn’t know for sure until I had surgery to remove them. To make a long story short, I had to wait to have surgery until my semester of college was over, which meant that I had to live with these cysts (one was the size of a grapefruit!) for a few months. My doctor told me, unequivocally, that I could not exercise or else I ran the risk of a cyst bursting. Needless to say, I was terrified.

I think I still carry that fear with me now, even though to my knowledge I don’t currently have any ovarian cysts taking over my abdominal cavity. Exercising intensely brings with it a lot of anxiety for me now. It also doesn’t help that my body is frequently exhausted, my joints often hurt, and some days it takes all my energy to just be on my feet, accomplishing what I need to get done. Instead, I have found ways to challenge my body without exhausting it and making me useless for a day or two afterwards! I love doing yoga, and when I can’t make it to a formal class I do what I can at home, on my mat. I also like to keep active by going for long walks – I find that they help stretch out my sore hips without putting too much pressure on them and it gives me time to think, to breathe in some fresh air, and to listen to podcasts. What’s better than that?! I do need to find a way to exercise that gets my heart rate up a bit more, but some activity is better than no activity. I recently purchased a mini trampoline which is meant to increase lymph flow, boost your immune system, and drain toxins from your body. It is suspected that endometriosis is associated with a blocked lymphatic system, so I’m doing what I can to address this by rebounding and using a dry brush every day. The jury’s still out on whether these things are helping me feel a bit better, but I’ll report back with my findings!

One other thing that I try to do every single day is stretching and using my foam roller. I bought a very inexpensive foam roller from Amazon last year and it has changed my life! Using a foam roller is like giving your whole body a quick massage – it increases blood flow to your muscles and relieves tension when you feel like you have knots all over or are just feeling a bit stiff. I tend to get a lot of knots in my upper back, along my shoulder blades, and after rolling out for a few minutes before I go to sleep, my body is looser and more relaxed.

Lastly, keep in mind that you need to be doing what feels right for your body. I think it’s easy to see other people’s high intensity workouts on Instagram and think “wow, I need to be doing that to be healthy.” But when I’m experiencing fatigue or joint pain, I know that doing something that strenuous will take me out of commission for a couple days and I won’t be able to accomplish what I need to accomplish. It’s taken years to truly understand what my body needs, but now I’m in a position where I know when I can push a little bit harder and go to a really difficult hot yoga class and I know when I need to take it easy and maybe go for a walk instead. I can’t measure myself against any other woman, especially if they don’t have endometriosis or experience chronic pain. It is a whole other ballgame when your body is so sensitive, and you need to treat yourself with respect and with grace. Your version of “active” may not look like your friend’s version of being fit and that’s okay.

Change 4: Treating Pain & Discomfort

You can do all of the things I’ve talked about already in this post to attempt to keep your body healthy and feeling good, but endometriosis has a mind of its own. You never know when your body is going to flare up and put you in a ton of pain. It’s incredibly frustrating, especially when you’re putting so much effort into feeling good, but that’s the way it is and there’s no way around it. However, I’ve compiled a handy arsenal of pain relief methods over the years that I rely on every time my body flares up!

One of the biggest pieces of advice I can give women with endometriosis is to invest in a bag of epsom salts. It is inexpensive and never fails to make me feel noticeably better after a long soak in a tub. Epsom salts are actually made up of magnesium and sulfate and when you soak in a bath with them your body absorbs them and it can help treat joint pain, swelling, and sore muscles. Magnesium is a detoxifier and muscle relaxer and soaking in a warm tub ALWAYS feels good! Another great way to get magnesium is by spraying pure magnesium oil onto your abdomen when you have awful cramps – you just massage it into your skin. I’ve noticed a decreased amount of cramping pain when I’ve used magnesium oil so check it out and see how your body reacts to it.

Another great topical treatment for endometriosis pain is arnica gel – this anti-inflammatory substance helps relieve aches, pain, and swelling and can be easily applied to any part of the body that experiences pain. It’s a great option for natural pain relief, and when rubbed on my joints I definitely experience some relief. I’ve tried a couple brands but my favorite is Zim’s Max Freeze Gel because it also has menthol and aloe and has an amazing cooling quality when it’s put on the skin.

I’ve also relied extensively on my electric heating pad over the years as it always makes any sore body part feel a bit better. However, recently I read an article written by fellow endo sister Aubree Deimler that questions whether using continuous heat is bad for your fascia when you have adhesions and/or scar tissue from endometriosis. I’m still using my heating pad when I’m particularly inflamed but I’m a bit more hesitant about using it all the time.

Change 5: Do Your Research

This is a tough piece of advice, because endometriosis is misunderstood by so many people and there’s so much misinformation and contradicting information out there. Doctors have SO many theories about why endometriosis occurs, how to treat it, and whether women can be truly “cured” of the disease. The doctor who performed my first surgery believed that there was no way to get rid of the endometriosis in my body permanently. He was a big fan of major hormonal treatment methods like Lupron and didn’t really attempt to understand all of the work I was doing on my own to manage my symptoms. My current surgeon is completely different – he is trained in excision surgery, which is the gold standard for women with endometriosis. Endometriosis is surgically cut out of the body instead of being lasered away, which leaves the root of each endometriotic implant and allows it to grow back again after two or three years. This method of cutting out each implant is meant to get rid of the disease completely, so fingers crossed that ends of being true for me. If your surgeon is not trained in excision surgery, run in the opposite direction. I don’t say this to be dramatic or to be a fear monger but any traditional surgery is just a band aid – you will be back at square one within five years. Find a doctor who is skilled in excision – most typical OB/GYNs are not – and make sure you feel comfortable with him or her. When I speak with my current surgeon, I feel heard. He listens to what I have to say, he appreciates all the research I’ve done into the disease, and he takes it on himself to explain everything to me, oftentimes using pictures. He is constantly trying to learn more about the disease and that is incredibly comforting.

Other than finding a supportive doctor, you have a responsibility to yourself to do your own research. This sucks, I know, because it can end up feeling like a full-time job, but even when you have a doctor you trust, you shouldn’t just take what they have to say as the gospel. Once you take on the responsibility to learn everything you can about endometriosis, you begin to feel like you have more power. Feeling powerful and in control is a huge part of having endometriosis to me – my body attempts to deceive me any chance it gets, so I work hard to feel like I have some control over my body and my health. I do this through reading books, scouring the internet, listening to podcasts, and now through sharing all of this on Open Book Kitchen. You may not be able to control how your body feels, but you can absolutely control how you approach this disease. Don’t let it take your power away from you. The following resources have really helped me on my journey:

The Doctor Will See You Now by Tamer Seckin

From Pain To Peace With Endo by Aubree Deimler

Endometriosis: A Key To Healing Through Nutrition by Dian Shepperson Mills

There are so many more. If anyone reading this has any questions at all, please reach out to me. Like I said, I feel like it is my responsibility to share what I’ve learned with all of the women who are struggling alongside me with this disease. We’re all in this together, whether we want to be or not!

Love, Brenna




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