Navigating Endometriosis Flare-Ups: Gentle Strategies for Relief

What is Endometriosis?
Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the uterus grows outside the uterus. This tissue thickens, breaks down, and bleeds during the menstrual cycle. Because it is outside the uterus, the blood cannot exit the body, which can cause swelling, irritation, scar tissue, and adhesions. The most common places this tissue is found include the ovaries, fallopian tubes, and the tissue lining the pelvis. Endometriosis can cause a wide range of symptoms, from painful periods and fatigue to digestive issues and even infertility. It is a lifelong condition with no known cure, but treatment and self-care can help manage symptoms and improve quality of life.

What is a Flare-Up?
Endometriosis flare-ups are periods when symptoms suddenly become more intense. These flare-ups can occur during menstruation, but also happen unexpectedly at other times. Flare-ups often bring increased pelvic pain, fatigue, and digestive problems that may last for hours or several days.

What Causes Flare-Ups?
Although everyone’s experience is different, certain factors are known to trigger or worsen endometriosis flare-ups:

• Inflammation: Eating foods high in sugar, saturated fat, caffeine, or alcohol can increase inflammation, leading to more pain and discomfort.
• Lack of sleep: Poor sleep can weaken your immune system and lower your ability to cope with pain and inflammation.
• Stress: Emotional or physical stress can increase pain levels and make it harder to recover.
• Hormonal changes: Natural shifts in hormones can worsen symptoms.

Common Flare-Up Symptoms
Flare-up symptoms can feel different for everyone, but some of the most common include:

• Intense pelvic cramps
• Pain during or after sex
• Painful urination or bowel movements
• Lower back or abdominal pain
• Fatigue, bloating, nausea
• Heavy bleeding or spotting between periods
• Digestive discomfort like constipation or diarrhea
• Difficulty sleeping or focusing

Coping Strategies: How to Care for Yourself During a Flare-Up
While flare-ups can be frustrating and exhausting, there are gentle things you can do to support your body and mind through them:

• Use heat therapy: A heating pad or warm water bottle can ease cramping and relax tense muscles.
• Get extra rest and support better sleep: Allow yourself to take breaks and slow down. Turn off screens before bed at night, keep a calming routine, and consider soothing sounds or scents.
  • HGIC: Sleep
• Try gentle movement: Light stretching or walking may help relieve pressure and ease stiffness.
  • HGIC: Yoga for Every Body
• Eat calming foods: Stick to simple meals that are easy to digest, such as oatmeal, rice, bananas, applesauce, or steamed vegetables. Lean proteins like chicken or fish and anti-inflammatory foods like leafy greens, berries, and fatty fish can also be helpful.  Warm herbal teas like ginger or peppermint may also soothe discomfort. Reduce intake of food and beverages that can trigger inflammation. This includes caffeine, alcohol, and processed foods (foods that contain added sugars, fats, or preservatives). Always talk with your doctor before adding any herbs or supplements.
  • HGIC: Polycystic Ovarian Syndrome
• Manage stress: Journaling, breathing exercises, or talking to a trusted friend can help ease tension.
  • HGIC: Coping with Stress and Mental Health
• Track symptoms and triggers: Logging your experiences over time can help you recognize patterns and learn what helps you feel better.

Contact your primary care provider about any symptoms you experience so they can guide you to additional support. In addition to medical care, exploring trusted educational resources and support networks can help you better understand and manage endometriosis. The organizations listed below offer information, tools, and communities that may help you find relief and feel supported.

Resources for Information and Support

• American College of Obstetricians and Gynecologists (ACOG)
  • FAQ: Endometriosis
• American Society for Reproductive Medicine (ASRM)
  • Endometriosis: A Guide for Patients
• Endometriosis Association (EA)
  • Educational brochures available in 25+ languages
• Endometriosis.org
• Endometriosis Research Center (ERC)
• MedlinePlus – Endometriosis
• Womenshealth.gov – Endometriosis

Endometriosis is a condition that can significantly impact daily life, especially during flare-ups. Learning to track your symptoms, use gentle coping strategies, and lean on available resources can help you better manage discomfort. Connecting with your primary care provider and support networks such as the organizations listed above can also give you access to treatments, tools, and communities that understand what you are going through. Remember, you do not have to manage endometriosis alone. Building a strong support system can make a meaningful difference in your quality of life.

References:

• Mayo Foundation for Medical Education and Research. (2024, August 30). Endometriosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
• Thourani, A. (2025, March 27). Endometriosis flare ups and how to cope with them. Revive Research Institute. https://www.reviveresearch.org/blog/endometriosis-flare-ups/
• U.S. Department of Health and Human Services. (2024, August 27). Endometriosis resources. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/endometri/more_information/resources

Authors:

• Bailee Floyd, Rural Health and Nutrition, Horry and Marion Counties
• Phoebe Covode, UPIC Intern, Rural Health and Nutrition