Endometriosis is an invisible illness that affects one in 10 women, including myself. Like most women with endometriosis, my diagnosis was severely delayed. The average delay in diagnosis for endometriosis is an alarming seven to 10 years; for me it came after 11 years, and by then I was in chronic and debilitating pain on a daily basis.
My story with endometriosis has been bittersweet. Even though I experienced severe pelvic pain throughout my teens and adulthood, my search for solutions means that I can now help women all over the world to live healthier, happier and thrive with endometriosis.
Based on my eight years experience in women’s health physiotherapy, functional nutrition, pain education and therapeutic exercise, I’ve put together my top 10 tips to help you manage endometriosis and pelvic pain.
1. Take deeper breaths
Research shows that people who have persistent pain tend to breath-hold or take shallow breaths into their upper chest. We also know that deep breathing helps to calm the nervous system, which is responsible for how much pain we feel. An added bonus of deep breathing is the stretch into the belly, ribs and pelvic floor, which can all get tight with endometriosis and pelvic pain.
2. Cut out gluten and sugar
75 percent of women with endometriosis who eliminate gluten and wheat from their diet will experience an improvement in their pain and abdominal symptoms. Gluten and sugar are known to cause more inflammation in the gut, and endometriosis symptoms worsen with inflammation. I have personally found eliminating gluten and sugar to reduce my period pain.
3. Eat more vegetables
Leafy green vegetables like kale, cruciferous vegetables like broccoli and Brussels sprouts, and eating colourful vegetables daily will help with lowering inflammation in the body, boosting immunity, enhancing detoxification, and overall improving gut and hormone health. Eating a largely plant-based whole foods diet will reduce abdominal and pelvic pain.
4. Find your flow
Yoga has been found to be very therapeutic for women with endometriosis. From the stretching that occurs in the pelvis, hips and abdomen, to the deep breathing and relaxation, the benefits of yoga are multitude. Yoga also allows the nerves to slide and glide through the tissue, which helps to calm the nervous system.
5. Relax your pelvic floor
At least 50 percent of women with endometriosis will experience painful sex. This is directly related to tension in the pelvic floor muscles. Women with endometriosis need to learn to relax their pelvic floor muscles down. They will also benefit from seeing a women’s health physiotherapist for some vaginal muscle release sessions.
6. Get stronger
Strength training is important for overall health and wellbeing. While stretching is important for releasing tension, it is equally important to build strength in surrounding muscles such as the buttock muscles, back muscles and upper body muscles. There are so many benefits to exercising, not just for physical health but also for mental health, as well as pain reduction.
7. Get regular massages
Massage can help release muscle tension and soothe the nervous system. Women with endometriosis can try gentle massage such as remedial massage and starting the massage away from the pelvis and hips to begin and slowly working towards the hips as the massage concludes. Having a foot massage can also ease tension in the back and pelvis.
8. Try acupuncture
If massage isn’t an options, acupuncture can be really helpful for easing tension in muscles and relaxing the nervous system. Acupuncture can be helpful for pain, as well as for regulating periods and for fertility.
9. Understanding pain reduces pain
The pain associated with endometriosis results in hypersensitivity of the nervous system - essentially the brain and nerves become extra sensitive and can have a lower threshold to setting off pain. Pain education and understanding the pain mechanism can help reduce the fear, anxiety and stress associated with endometriosis and pain.
10. Manage your stress
Stress is the biggest contributor to poor health in the 21st century, and the case is no different for women with endometriosis. Personally, when I am under excessive amounts of stress, my period pain is significantly worse. This is because of the excess stress hormone, cortisol, that courses through our bodies. When cortisol is being overproduced, it burns through progesterone, and when progesterone is low, periods become heavier and more painful.
Heba Shaheed is co-founder and CEO of The Pelvic Expert, a digital wellbeing platform specialising in maternal, menstrual and hormone health. Heba was inspired to work in the space following her own challenges with 15-year history of chronic pelvic pain and endometriosis. A qualified physiotherapist, nutritionist and exercise specialist, she has supported more than 2000 women to better health and wellbeing. The Pelvic Expert provides holistic and research-based, women-focussed, online wellbeing programs to corporates, private health insurers, workplaces and individuals.