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Menstruation is unpleasant for most women — but if you have endometriosis, periods can be straight up hellish. What can you do to fight your period-related endometriosis symptoms?

Periods are quite unpleasant and even debilitating for large numbers of women, accounting for more sick days than you may think at first glance. For women with endometriosis — the most characteristic symptom of which is pelvic pain — they're even worse, though. The symptoms of this condition, in which the tissues that normally line the uterus and which women shed during periods also proliferate in other areas of the reproductive system and beyond, tend to peak during menstruation and grow worse over time. Periods can be so bad that you're hardly able to get out of bed.

For women with endometriosis, periods may in short, be an absolute nightmare. 

Symptoms that could indicate that you have endometriosis include:

  • Dysmenorrhea — abnormally painful menstrual periods. Your incoming period may "announce" itself in advance by giving you pelvic pain and cramps, alongside lower back pain. 
  • Menorrhagia — abnormally long and heavy periods in which you lose 80 milliliters of blood or even more. 
  • Menometrorrhagia — vaginal bleeding between menstrual periods.
  • Pain during and sometimes after sexual intercourse.
  • Painful and often strained bowel movements, and pain while urinating, that is more likely to present itself while you are on your period.
  • Endometriosis leads to infertility in many cases, and it may first be diagnosed after you seek medical help because you have been trying to conceive unsuccessfully for a while.
  • Fatigue, abdominal bloating, nausea and sometimes vomiting, and diarrhea alternating with constipation are other frequent symptoms women from endometriosis suffer from.

Endometriosis and painful periods: Is there any way to find relief?

Yes! You can try a variety of endometriosis treatment options, some of which you'll use only during menstruation and others of which offer overall symptom relief.

Painkilers

While over the counter painkillers may not take all your pain away, they'll at least make it a bit more bearable. Non-steroidal anti-inflammatory medications (NSAIDs), ike ibuprofen (Advil, Motrin) or naproxen (Aleve) are often recommended to women with endometriosis, as they help fight pain and the inflammation also associated with the condition at the same time. 

Try a heating pad — or a warm bath

You can buy heating pads specifically designed to relieve menstrual pain at a pharmacy or on the internet — and because research has shown these to be as effective as ibuprofen in reducing your discomfort, they're very much worth looking into. If you don't have one, try a hot bath or shower instead, as they're likely to have the same effect.

The birth control pill

Oral hormonal contraceptives do more than prevent pregnancy, and also have many secondary benefits. If you're not trying to conceive, they can be an excellent way to reduce period pain as well as the duration or volume of your menstrual flow. Birth control pills can be combined, or progestin-only — and other hormonal contraceptives, like Depo Provera or the Mirena IUD, are also options. Discuss the best choice for you with your healthcare provider.

Get a TENS machine

Transcutaneous electronic nerve stimulation (TENS) machines are quite popular for (slight) relief from labor or Braxton Hicks contractions for pregnant women in the UK. They're believed to block pain signals in the nervous system. These TENS machines have also been researched in an endometriosis context, and it seems that they indeed have the potential to reduce pain — during and outside of periods — for endometriosis patients.

Acupuncture

No conclusive research exists to prove that acupuncture relieves endometriosis pain, but many chronic pain patients (with all sorts of different conditions) find that this ancient form of medicine is helpful for them. This could be because acupuncture causes your body to produce endogenous opioids.

Try changing your diet

Though there is no one proven "endometriosis diet", a large part of the symptoms of the condition can be attributed to inflammation. As such, eating foods that fight inflammation while cutting down on those that make it worse can play a role in reducing your pain, bloating, fatigue, nausea, and gastrointestinal symptoms. Foods that are going to be good for women with endometriosis include lots of fruits and veggies — rich in antioxidants — and omega-3 fatty acids (found in fatty fish, among other sources). You want to stay away from foods that increase inflammation, such as processed foods and dairy, or at least cut back, meanwhile.

You may also try an elimination diet — this means you temporarily (for a week or two) stop eating certain foods to see whether your symptoms are any better. Foods on your "temporary banned list" should include:

  • Refined sugar
  • Dairy
  • Gluten

How can endometriosis patients boost their energy?

Though not generally one of the recognized symptoms of endometriosis, research shows that many endometriosis patients suffer from chronic fatigue. The main reason behind this debilitating symptom is that your immune system is working overtime to try to fight your endometrial lesions. In the process, cytokines — inflammatory toxins — flood your body. In addition, heavy menstrual bleeding can contribute to the development of iron-deficiency anemia, one of the symptoms of which is also fatigue.

To try to boost your energy, you can discuss the following options with your doctor:

  • Painkillers — because when you're in pain during the night, you don't sleep as well, in turn leading to fatigue
  • Hormone therapy, including birth control pils
  • Surgical removal of endometrial lesions
  • Iron supplements or a diet plan to boost your iron levels
  • Working on solutions for unrelated or indirectly related problems that are also making you fatigued — insomnia, life stress, and depression

How to combat endometriosis-related gastrointestinal symptoms

Bowel-related symptoms aren't uncommon in endometriosis sufferers, and they often peak in intensity during menstruation. A significant portion of women with endometriosis has inflammatory bowel disease, the symptoms of which typically include:

  • Abdominal pain and cramping
  • Diarrhea
  • Constipation

If this is you:

  • Certain categories of food, like FODMAPs, gluten, and gassy foods, are known to trigger your symptoms. Try an elimination diet to identify other foods that make matters worse for you.
  • Make sure you get enough dietary fiber, as this will help you fight diarrhea.
  • Stay well-hydrated.
  • Engage in a regular workout routine, which will additionally boost your energy levels as well.
  • You need between seven and nine hours of sleep. If you suffer from insomnia or disordered sleep, consult your doctor about possible answers.

A subset of endometriosis patients will have bowel endometriosis — endometrial lesions that affect the bowels. The signs of this are much like the symptoms of irritable bowel syndrome, with the exception that they are usually at their worst as you approach your period and during your menstrual flow:

  • Painful bowel movements
  • Painful sexual intercourse
  • Rectal bleeding during menstruation

Painkillers, hormone therapy, and surgery are — again, just as they are with endometriosis in general — the treatment options that can be explored. Different surgeries are available to treat bowel endometriosis, but they all have the goal of removing the endometrial lesions on your bowels. Where possible, such operations are performed laparoscopically to reduce your recovery time.

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