What to Expect: Diagnostic Laparoscopy for Endometriosis

After over two years of searching for a diagnosis, I can’t believe I’m sitting down to write this.

When I first started this blog, I was having chronic constipation, losing weight, and couldn’t tolerate many foods (like raw vegetables or dairy products). I saw a gastroenterologist who made me feel like I was crazy for pushing him harder. I had an upper endoscopy and colonoscopy that both came out clear. And, finally, after having my first laparoscopy at Cleveland Clinic cancelled due to COVID-19, I got on the schedule at Newton-Wellesley Hospital in Massachusetts.

This past Tuesday, I crossed the finish line. I had a diagnostic laparoscopy for endometriosis at long last, and it showed evidence of peritoneal endometriosis, and an adhesion on my left uterosacral ligament. My doc also found a pretty decently sized but benign cyst on my fallopian tube. Thankfully, it doesn’t look like my future fertility will be affected.

After seeing everything that was excised from my body, I couldn’t help but feel like it’s no wonder I was having so many symptoms. With all this tissue hanging around in my abdomen when it wasn’t supposed to be there, the constipation and pelvic pain make so much more sense.

Yet it still took me over two years from the start of my journey, and over ten years from the onset of my symptoms, to get a definitive diagnosis of endometriosis. The word didn’t even come up until a year into my constipation and painful bowel movements. No GI doctor I saw ever thought to ask me if I had painful periods. That simple question could have changed everything for me.

As frustrating as this journey has been, it makes me grateful — and emotional — to have arrived at this point. I have been through so much that I know I deserve the validation and clarity that came from this procedure. Hopefully, in the future, womxn won’t need to go through nearly as much as I have in order to get the validation and clarity that they deserve.

Sentimentality and reflection aside, you’re probably here because you want to know about the process of getting here: the laparoscopy, to be exact. Maybe you or someone you love thinks they have endometriosis and are worried about what they’ll need to go through to have it diagnosed. Or, maybe your lap is coming up and you’re getting ready to prepare for surgery. Either way, I’m here for you.

Here’s what to expect on the day of your laparoscopy, and the things that have helped me through the recovery process thus far.

The Day of Your Laparoscopy

On the day of my diagnostic laparoscopy, I was ushered into the pre-operative room basically as soon as I arrived. They called me to make sure I was here (I was waiting in the car because of COVID) and had my partner drop me off at the surgical center entrance. Then, they led me to check in, screened me for COVID, and brought me up to the pre-operative room.

Once in the pre-operative room, I was assigned a nurse and told to change into a hospital gown, leaving it open in the back. They gave me the opportunity to use the restroom before leading me back to get an IV line inserted. One thing I remember thinking was strange was that every person I met made sure to ask me what my name was and what procedure I was having. I think this is their way of ensuring that you’ve given informed consent — that you’ve not only said yes to the procedure, but that you also understand what it entails.

After the IV was inserted, I met with the anaesthesiologist as well as my surgeon. Both gave me a lot of reassurance about the procedure. Having great docs and nurses made a huge difference in my comfort and anxiety levels. I also met with the fellow who was working with my surgeon and a PA student observing the surgery.

While my surgeon mostly just wanted to check in, the anaesthesiologist asked me a lot of questions about my health history to make sure I was safe for surgery. For example, I have TMJ (an inflammatory jaw condition), so she had to adapt my intubation plan to accommodate my jaw problems.

At that point, the anaesthesiologist knocked me out. She checked my name and hospital bracelet one more time before giving me the analgesic medication. I honestly barely remember what happened. One minute, she was asking me a question and I was talking about something; the next, I was out cold and waking up in my room post-op.

When I woke up from the laparoscopy, I was given IV Tylenol, so my pain levels were not as bad as I expected. The first thing I noticed was that I was wearing a pad, which I hadn’t been wearing before. It wasn’t a surprise — that’s because they also changed my IUD during the procedure, and I had been warned to expect some bleeding — but I definitely felt it, especially since I haven’t had a period in over a year thanks to my menstrual suppressants.

My tummy felt bloated, sore, and crampy, kind of like mild period cramps, but the pain was bearable. I did have trouble sitting up on my own and needed help from the nurse. Bending at the waist in any way was the most painful type of motion. As long as I was still, I didn’t feel much pain at all, besides a bit of bloating and cramping. The worst pain was actually in my throat from the intubation. I could tell the roof of my mouth had been scraped a bit during the procedure.

I stayed in the post-op area about an hour. Somewhere along the way, I started to feel nauseous. I was given two types of nausea medication through my IV, about half an hour apart, and quickly started to feel better. I did have an episode of dry-heaving, but besides that, I didn’t have any negative side effects from the anaesthesia.

Eventually, I was able to leave the post-op area to go to the day surgical unit, where they would start to transition me toward leaving. This is a wing of the hospital reserved for people like me recovering from outpatient procedures, who are getting ready to go home soon.

Before they let you leave, the nurses have a series of steps they walk you through. They want you to eat something — usually toast or crackers. They want you to get up and walk around (which, after laying down for so long, feels like going from a cruise ship to dry land). And they want you to try to pee. Sometimes, they might even require you to pee before you’re allowed to leave so they can ensure your normal bladder function has returned, but this wasn’t the case for me.

Once I’d been through all of this and was feeling well enough to leave, the nurse allowed me to dress myself using a chair. She gathered my belongings and I was wheeled to the car in a wheelchair. Finally, I was allowed to go home! And by that point, believe me: I couldn’t wait to be in my warm, cozy bed 🙂

Tips for Recovering from Your Laparoscopy

My doctor did her best to prepare me for what to expect after my laparoscopy, but what helped me most was hearing about other people’s experiences recovering from theirs. Here’s what my recovery process has been like so far and what you can expect in the days following your laparoscopy.

Pain

I don’t know about you, but I was terrified of the amount of pain I would feel after my surgery. For me, the pain was worst the day after my surgery. On the day of my surgery, I still had a lot of drugs in my system from the hospital, including the anaesthesia, so I didn’t feel as sore as I did waking up the next morning. After that, the recovery process got much easier and less painful. For me, the pain has been worse the more I move around and better with rest, though it’s still important to get up and walk as much as you are able.

The pain was most annoying when I needed to sleep because it was hard to find a comfortable position. That made it especially difficult to fall asleep the first night, which ended up being the only time I took an opioid. Remember that your doctor prescribes pain medication for a reason. Opioids have a high potential for abuse, but you’re not abusing them by taking them after surgery. Don’t force yourself to suffer through the pain. However, your doctor will probably want you to take NSAIDs and Tylenol around the clock, too, to minimize the amount of opioids you use. This is because opioids can cause severe constipation — which I’ll talk more about in the next section.

Constipation

My doctor prepared me to experience constipation after my surgery, but I didn’t understand how severe it would be. Apparently, it’s normal not to have a bowel movement for up to four to five days following abdominal surgery. This is because of the combined effects of opioids on your digestive system and the fact that your digestive organs were manipulated during surgery. Your digestion slows to accommodate the surgery and healing process, and it can take some time to speed back up again. Plus, many people feel nauseous from the anaesthesia in the days following surgery and may follow a low-fiber diet that can contribute to constipation.

My doctor started me on a stool softener in the days before my surgery, then told me to increase to two or three a day afterwards. When that wasn’t working, I started taking a dose of Milk of Magnesia each day, divided into two daily doses, until I had a bowel movement. At first, the Milk of Magnesia wasn’t working, so I tried some other dietary and lifestyle changes. Here are my tips for keeping post-surgical constipation at bay:

  • Prunes. They sound gross and probably remind you of the elderly, but they are actually sweet like dates — and well-known for helping you move your bowels.
  • Coffee. You might not be ready to tolerate this for the first few days after surgery. Once you can, however, it can stimulate your bowels to move.
  • Walking. Your doctor will probably tell you to walk as much as you are able to move the gas from the procedure out of your body, but it can also help get your digestive system going again.
  • Fluids. You may not feel like drinking a lot of water or liquids if you are feeling nauseous, but it’s important to stay hydrated. Stool softeners and many other laxatives won’t work properly if you’re not drinking the right amount of liquid.
  • Diet. As soon as possible, try to get back to eating your normal diet. Sudden dietary changes can mess up your digestive system.

Nausea

You might feel nauseous for the first few days after the procedure as the residual effects of the anaesthesia wear off. I only had one or two short bouts of nausea that were relieved with Zofran (a medication prescribed by my doctor for migraines — I had extra so I took it during my surgery recovery). Your doctor might be able to prescribe this or another anti-nausea medication if you’re struggling. There are also things you can do at home to help.

If you’re feeling sick, my mom always swore by the BRAT diet growing up: that’s bananas, rice, applesauce, and toast. These foods are easy to digest. I would also add in plain crackers like saltines or water crackers. As long as they have no flavor, crackers are a great way to settle your stomach when you’re feeling nauseous. Sometimes, I also find it settles my stomach to suck on something sweet when I’m nauseous. Hard candies or lollipops might make you feel better, especially if they have stomaach-soothing ingredients like ginger or peppermint.

Fatigue

One of the most surprising things about my recovery was how easily I tired doing ordinary things. In the first two days after my surgery, I napped on-and-off for over six hours, in addition to my regular eight hours of sleep. Things like going for a walk with my boyfriend to get the mail or riding in the car to Starbucks for a tea would drain me for hours afterwards. Now that I’m later into my recovery, this doesn’t bother me as much. I can make it through the day without a nap, but I still hit an afternoon slump.

Now that my stomach is feeling better and I’m back to eating normal foods, drinking coffee or tea gives me a little bit of a caffeine boost when I’m feeling fatigued. Most of all, though, I would say to try and embrace it. Don’t try to fight through fatigue. Sleep is when your body heals, so it’s important to nap when you feel like you need to nap. You don’t have any obligations, so you might as well — that’s why you took time off work, after all!

Spoonie Gift Ideas for the Holiday Season

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I’m somewhat of an expert on two things: living with a chronic illness, and giving the perfect gift. The latter is the skill I am most proud of in life, to the point where I will sooner have a panic attack waiting in the T.J. Maxx returns line than give a gift to someone that I know they won’t love. As for the first, it may not be the skill I am most proud of — but it certainly serves me well when it comes to understanding how spoonies like me think and feel.

In my opinion, giving the perfect holiday gift boils down to selecting something the person will not only use, but appreciate. The saying “it’s the thought that counts” might be a bit cliched, but it’s true! At the end of the day, your loved one cares far more that you see them and are thinking of them than that you spent a certain amount of money or got them the most useful gadget.

Giving your loved one a gift that will help them make the most of their life with a chronic illness not only shows that you care, but it also shows that you understand the struggle they are going through. To someone who’s constantly gaslighted by doctors and told that she’s faking her pain, no gift could be more meaningful than receiving something that acknowledges and supports her life with a chronic illness.

These spoonie gift ideas will help you select the perfect present for your loved one this holiday season — one that not only makes their life easier, but also reminds them that you’re on their team, always and forever. And, while you’re at it, why not pick up something to treat yourself, too? After all, you deserve it. I won’t judge 😉

EllieGrid Smart Pill Box ($149)

Nothing says “peace on Earth” like remembering to take your pills everyday. If your loved one struggles to stick to their complicated medication schedule, this smart pillbox uses a built-in alarm, flashing lights, grid system, and free app to keep them on track.

Cozy Sherpa Weighted Blanket ($56)

Chronic illness can take its toll on both sleep and mental health, which makes a weighted blanket the perfect holiday gift for your favorite spoonie. Weighted blankets like this cozy sherpa one from Luna increase production of serotonin and melatonin, helping you cheer up and feel more rested.

Three Month Personalized Tea Subscription ($45)

Tea is well-known for its healing properties. This personalized tea subscription from SipsBy allows your loved one to take a discovery quiz about their tea preferences, where they can let the company know what they’re looking for in a tea before receiving a personalized monthly box customized to their tastes.

BedShelfie: The Original Bedside Shelf ($30)

You may not always be able to be physically present with your loved one to nurse them back to health — but you can give them the gift of a convenient bedside shelf that eliminates the need to be waited on hand-and-foot. As a spoonie, I can attest that one of my greatest frustrations is the inability to do things myself, and items like these make me feel much more self-sufficient.

Halfmoon Cork Massage Balls ($28)

Massages are wonderful for relieving tight muscles and chronic pain, but with the pandemic happening, the next time we’ll be able to go to our masseuse is unfortunately TBD. With massage balls like these sustainable cork ones from Anthropologie, however, your loved one can practice low-effort self-massage by rolling on these balls to release trigger points and other areas of pain.

All of My Medical Shit Pouch ($25)

All of My Medical Shit Medicine Pouch Medicine Bag Bag for Black

If you have a chronic illness, chances are you lug around an entire medicine cabinet with you wherever you go. This handmade pouch from the Etsy store Unstigma, which is dedicated to all things chronically ill, sends an important message to your favorite spoonie: you can’t control your illness, but you can control how cute you look while dealing with it!

I Heart Guts Plush Organs ($20)

Vulva+Vagina Plush - Hooray For The Va-Jay-Jay! - Plush Organ Stuffed Toy Pillow

When your internal organs never seem to be on your side, it can be easy to forget exactly how much they do for us. These stuffed organs from I Heart Guts are the perfect reminder to be grateful for what we do have. Our organs might be diseased, but these cuties are doing the best they can.

Deep Lavender Warmies Neck Wrap ($20)

A heating pad is a staple in every spoonie’s toolkit, but this aromatherapeutic one from Warmies takes it to the next level. Not only is the heated neck wrap scented with lavender, but it is also flexible to mold around sore or tender areas. While it says it’s for the neck, it can also be wrapped around the shoulder, abdomen, lower back, or anywhere else where you feel chronic pain.

Alexa, Help Me Relax Candle ($20)

We could all use a little more chill these days — and the aromatherapy-inspired scents in this hilariously-named candle are perfect for de-stressing and alleviating pain. The blend contains peppermint, eucalyptus, clove, and cedar and has a burn time of 40+ hours for extended relaxation.

Little Words Project Warrior Bracelet ($20)

Load image into Gallery viewer, Warrior- Empire

You know that your loved one is brave, but it can be easy to forget when you’re overwhelmed by fatigue and chronic pain. The next time they doubt themself, they will be able to look down at this bracelet from Little Words Project and be reminded that they are a badass chronic illness warrior.

Spoonie Holiday Postcards ($18)

Spoonie Christmas Postcards Chronic Illness Christmas image 0

One of my favorite chronic illness crafters, Spoonie Sister Shop, made these adorably hilarious postcards for the holidays. You can get a mixed pack of six for $18 — oh, and there’s a Hannukah version, too! Send them to all your spoonie friends you can’t see in person for a shared laugh this unconventional holiday season.

I Am A Chronic Illness Crusader Coloring Book ($10)

Coloring is a low-effort, stress-relieving activity that’s perfect for keeping busy in waiting rooms and during hospital stays. This chronic illness-themed coloring book features cute animals and designs surrounding funny and inspirational hand-lettered sayings about what it’s like to live life with a chronic illness.

How My Chronic Illness Led to an Eating Disorder Relapse

To be honest, I don’t even know how to begin this post. I’m embarrassed, I’m ashamed, and I’m deeply saddened that I’m writing it at all. That’s why I’ve been so silent on this blog (that, and I’m studying for the GRE). But while I wish that I could pretend that this never happened, I know that maintaining a facade of perfection isn’t helpful to me, nor is it helpful to anyone else who might be struggling with the same thoughts or feelings that I am.

So, here it goes: I’m currently recovering from an eating disorder relapse. And while I recognize that recovery is not linear, and relapses are a part of life, it’s hard not to feel embarrassed when my eating disorder recovery, and using diet to manage my chronic illness symptoms, has been such an important part of my online presence.

I think it started with this blog post (TW: weight loss): Can You Lose Weight in Eating Disorder Recovery? I stand by my answer, because I am an advocate for body neutrality and body autonomy. If you want to change your body, you should be able to — but you should do it out of love, not hatred, for your body. Yet you should never, EVER try to lose weight when you are still in the throngs of an eating disorder.

The critical mistake I made when I went on my own “weight loss journey” was believing that I was “fully recovered” from my eating disorder. I recognize now that I existed in a state of partial recovery. I stopped actively dieting and obsessively exercising, and I was no longer borderline-underweight — but that didn’t mean that I had overcome the demons responsible for my eating disorder.

That state of partial recovery was what made it possible for me to relapse in my eating disorder recovery. Even though I now weigh over 20 lbs more than I did in my orthorexia/EDNOS days, I believe that I am still, in many ways, back where I started.

Why I Relapsed

Ever since I was misdiagnosed with IBS in 2018, I have been on some form of a “diet,” masquerading as self-righteous concern for my chronic illness symptoms. Once I found out I likely had endometriosis, not IBS, I was relieved to give up the low-FODMAP diet and eat whatever I wanted again. But as soon as I gave myself permission to eat whatever I wanted again, my doctor made a simple suggestion that I try going gluten-free for my endo.

That plunged me into a world of shoddy research and iffy recommendations from people without medical or nutritional certifications, telling me that I shouldn’t eat X, Y, or Z because it would promote inflammation. I don’t blame my doctor for it, especially because I don’t think she knew about my history of disordered eating, but I do blame myself for taking her suggestion and running away with it. I actively let it derail my recovery, because, in short, I was desperate. I was tired of feeling “sick,” and I thought that going gluten-free and dairy-free would help me do that.

I did feel better, for a little while — but recently, after my second day in a row experiencing extreme hunger, it became clear to me that I had traded one type of “sickness” for another. My restrictive diet helped my endo belly and my constipation, but it was destroying my mind. Now, I know two things for sure about my relationship with food as someone in recovery from chronic illness:

Firstly, chronic illness is a significant stressor. In my dialectical behavior therapy (DBT) intensive outpatient program (IOP) two Januaries ago, we learned about the importance of relapse prevention for mental illness. Part of relapse prevention is recognizing triggers (like stressful situations) that might lead you to relapse. But because my chronic illness was so all-consuming, between doctors’ appointments and late nights spent educating myself on endo, I forgot to slow down long enough to check in with myself and recognize the stress I was feeling. As a result, I underestimated the stress of having a chronic illness in my life. That’s how I failed to anticipate my relapse before it began. All I cared about was feeling better physically. I thought that managing my symptoms would alleviate my stress, but when I turned to diet to help me “recover” from endo, all I did was trade the lack of control I felt about my chronic illness in for a faulty sense of control in the form of restriction.

Secondly, the chronic illness community encourages restrictive dieting. The endo community online is an important part of my life. They are my supports, and I would not trade the friends I have made on Instagram and through this blog for anything. That being said, there are “influencers” in the endo community who gain money and followers from recommending restrictive diet plans (*cough cough THE ENDO DIET cough*). And the thing is, people with endometriosis are more vulnerable to falling prey to these diets than the average person. Why? Because we’re in pain, and we’re desperate. I was willing to do anything — even potentially compromise my eating disorder recovery — to feel less bloated, to have regular bowel movements, and to stop having pelvic pain. So, even though my surgeon back in Cleveland told me there was no scientific evidence that cutting out food groups could relieve endo symptoms, I let those “influencers” convince me that food was the problem…. when the real problem was, and is, the f**cking endometriotic tissue growing in my abdomen!

The Truth About Dieting and Chronic Illness

Now that I’ve learned the truth about diet and chronic illness — that it’s my illness’s fault, and not my diet’s, that I feel this way — I want to shout it from the rooftops so everyone knows it. For now, though, I guess I’ll settle for sharing on this blog 😉

But thanks to the wealth of misinformation about chronic illnesses and their management that’s out there, I’ve also learned a second important truth: diet-related chronic health conditions (DRCHCs) create a perfect storm for disordered eating. In fact, there is a really fascinating study you can check out that goes into this in more depth — but I’ll attempt to summarize the most important parts of it below.

Basically, the study identifies some key factors that make chronic illnesses a breeding ground for disordered eating habits, chronic dieting, and restriction:

  1. The role of weight in chronic illness. Chronic illnesses, and the medications used to treat them, are often associated with rapid fluctuations in weight, including both weight loss and weight gain. Either can be a trigger for disordered eating, in my experience. Weight loss can become addictive, leading you to compulsively pursue more and more of it — yet no matter how much weight you lose, you’re never satisfied. Weight gain, on the other hand, can trigger self-deprecating, fatphobic thoughts that make us feel “less than” for putting on a few pounds. I strongly feel that this contributed to my relapse. In January 2020, I started taking norethindrone acetate (a synthetic form of progesterone) to halt my periods. Little did I know that progesterone was associated with significant weight gain. I had already put on weight as my gut healed from IBS — which was a good thing, considering I was underweight at the time — but as a result, I found it even harder to cope with the extra 10-15 lbs I gained from the progesterone.
  2. The role of food in chronic illness management. “Let food be thy medicine, and medicine be thy food,” is an increasingly popular sentiment in modern medicine — and, as a result, in the chronic illness community. We’ve somehow gotten it into our heads that using medical technology or treatments to manage disease is “bad,” and using so-called natural treatments like dietary restriction or essential oils is “good.” (If you’ve ever had an ED, this type of language probably feels eerily familiar to you.) I feel this is especially prevalent in the reproductive health community, especially when it comes to conditions that primarily affect womxn — like endometriosis and polycystic ovarian syndrome (PCOS). Thanks to dangerous marketing messaging from influencers, womxn are constantly plugged into this diet culture-fueled fantasy that we can “cure” an incurable disease, like endo or PCOS, through diet…as long as we pay a ridiculous fee to be part of some program or protocol, of course. What’s more, some chronic illnesses — like IBS, for example, or celiac disease — require a preoccupation with food as a central part of treatment. When I was on the low FODMAP diet for IBS, I experienced the triggering effects of not being able to eat, well, anything firsthand. I can’t imagine what it would be like if I had something like celiac disease, where exposure to gluten-containing foods would be not only unpleasant but also potentially dangerous. When diet is so intricately tied to chronic illness management, obsession and preoccupation with food necessarily follow.
  3. The role of chronic illness in body image. It’s hard to love your body when your body is a constant source of pain and discomfort. When your body feels like the enemy, it’s nearly impossible to look in the mirror and love what you see. For me, what affected my body image most was my endo belly. Let’s be real here: it’s hard to feel beautiful or sexy when you can’t button your pants! Constipation, diarrhea, and the dreaded “endo belly” are symptoms I’ve faced nearly every day of my adult life. Even when I was underweight, I genuinely believed that my bloated belly was “fat” because it was full of air, full of endo, and severely inflamed. Gastrointestinal disorders or symptoms are a component of so many chronic diseases, yet we don’t normalize the diversity of body shapes that necessarily result from a bloated stomach. In a culture that emphasizes the importance of having a “flat tummy” and “busting belly bloat,” and where influencers like the Kardashians are making millions off promoting diet teas to help us smooth out our stomachs, it’s no wonder that having a disease that causes bloat takes such a toll on self-esteem.

Conclusion

There are so many problems with the way we talk about chronic illness, both in the medical system and within the chronic illness community, that contribute to the prevalence of disordered eating among people with chronic illnesses. For some reason, we’ve become preoccupied with treating people who “heal their bodies naturally” (!!!) with diet, exercise, essential oils, and acupuncture as the “gold standard” in chronic illness management. Unless we’re basically dying (or in so much pain that we wish we were dying), turning to modern medicine is seen as the coward’s way out.

I can’t tell you how many people I’ve spoken to online who have had similar experiences as me: they began a restrictive diet for their chronic illness that either caused an eating disorder relapse (in those of us with a history of ED) or triggered disordered eating behaviors for the first time (in those of us with no history of ED).

At the end of the day, I think so much of the problem has to do with blame. We’re desperate to explain the unexplainable — like why some of us get stuck with chronic illnesses and not others — so we devise these elaborate narratives in our minds to rectify the cognitive dissonance. As a result, both chronic illness patients and society as a whole put too much blame on the individual, as if we somehow “caused” our disease through a combination of weakness, laziness, and lack of willpower.

Thankfully, what I am finally beginning to understand is that the only thing to blame for my endometriosis is, well, the endometriosis growing in my belly. The problem was never food; it was endo. Now that I know that, I honestly feel I am closer than ever to conquering my eating disorder. This time, I’ve decided, I’m going to make a full recovery. I won’t stop halfway. This is going to be the one that sticks.

How to Exercise with Endometriosis

“Try exercising,” the doctor tells you for the n-billionth time. You roll your eyes.

You’ve just asked your doctor what more you can do to relieve endometriosis-related pain and stress. Yet again, he’s told you to just “exercise,” as if lifting weights is a cure for endo. Little does he know (somehow, it’s always a ‘he’) that a single crunch can leave you doubled-over with cramps for weeks.

Let’s get real for a sec. Your doctor isn’t lying when they tell you that exercise has benefits for endometriosis — but we also need to stop acting like it’s oh-so easy to pick up and go for a run when your insides are attacking themselves. I know firsthand that it’s incredibly difficult to strike a balance between exercising enough to get the health benefits, and making sure you don’t exercise so much that you exacerbate your pain.

In my experience, working out too hard, with too few days of rest, can lead to the world’s worst endo flare. (And trust me, I had orthorexia. I know a thing or two about working out way too hard!) At the same time, avoiding exercise altogether doesn’t feel good, either. Exercise has important benefits for your physical and mental health.

So, what can you do to get in shape without making your endo pain worse? Read on to learn a little more about the relationship between endometriosis pain and exercise, and what types of exercise are best to try when you have endometriosis.

Why Exercise With Endometriosis?

I know what you might be thinking: when you’re in pain all the time, why bother trying to exercise? When my endo flares up, sweating it out in a 90-degree yoga studio is pretty much the last thing I want to do. So, why not chill in bed all day and worry less about the squats and crunches?

Well, believe me: the last thing I want you to do is worry about exercise. It’s easy to get wired about your workout when you’re anticipating being in pain afterwards (and not the good, “my-muscles-are-sore” kind of pain). If working out is more stressful than it is fun, it’s time to reassess your workout routine, to see if you either need a break or to try something different.

I’ll talk more about changing up your workout routine to become more endometriosis-frendly later in this blog post — but for now, here are some of the reasons why you should consider squeezing in a light workout, even when your endo pain leaves you breathless:

  • Exercise relieves pain. As Elle Woods said, “Exercise gives you endorphins. Endorphins make you happy.” To take a note from Elle’s playbook, happy people just don’t feel as much pain as people who don’t exercise. Not only are endorphins a powerful happy hormone, but they’re also a natural analgesic.
  • Exercise reduces menstrual flow. Um, what?! If I had known that working out could make my periods lighter, I would have started working out a lot sooner, thank you very much. But it’s true: people with periods who exercise regularly have lighter menstrual flow than those who do not.
    • It’s important, however, not to cross the line between working out to get a lighter menstrual flow, and working out to “lose your period” altogether. Some people with eating disorders suffer from amenorrhea, or lack of a menstrual period, due to excessive weight loss — that’s not healthy, and that’s definitely not what we’re trying to do here!
  • Exercise lowers estrogen levels. You probably know that endometriosis is an estrogen-dependent disease. Endometriotic implants need a steady supply of estrogen to continue growing and bleeding every month. Studies have found that elite athletes have lower estrogen levels than the average person. While you don’t need to work out at the same intensity as LeBron James, you should definitely consider the benefits of a little light exercise on your endometriosis.
  • Exercise reduces inflammation. I’ve talked extensively about how endometriosis is an inflammatory disease. You’ve probably read my posts about an anti-inflammatory diet and endometriosis — but did you know that exercise can also curb inflammation in the body? Initial evidence comparing exercise to NSAIDs found that both were equally as effective at reducing the severity of menstrual cramps.
  • Exercise works better than heat. Don’t reach for your heating pad when you could reach for your gym shoes instead. When compared to both heat and acupressure, exercise had the best results when used as a self-care tool for reducing menstrual pain. Both are great drug-free alternatives for pain relief, but exercise appears to be slightly more effective — plus, there’s no risk of burning yourself if you jog too much!

The Best Types of Exercise for Endometriosis

You might be rearing to get a workout in after reading all the amazing benefits of exercise for endo — but take a minute and pause first. It’s important that you know that not all exercise is created equal for endometriosis. In fact, some types of exercise might be more likely to leave you hunched over in pain afterward than happy you did them. Other types of exercise might make problems related to your endo, such as pelvic floor dysfunction, worse.

So, what types of exercise can you do with endometriosis? Here are some “dos” and “don’ts” to keep in mind when planning out your workout routine.

DON’T:

  • High intensity interval training (HIIT) and other types of high-impact exercise, like running, are a no-go for endometriosis. These exercises fire up the nervous system, potentially increasing your pain.
  • Strength training at the gym, with weights or machines, does not appear to benefit patients with endometriosis, according to a study summarized by Endo News.
  • Intense abdominal or pelvic floor exercises should be avoided by endometriosis patients. This includes moves like squats, lunges, and crunches. Since your goal is to relax the pelvic floor and abdominal muscles, exercises that contract those muscles may be counterproductive.
    • You might be worried that almost every exercise class incorporates these types of moves — but you should know that trainers are usually willing to help you modify them if you speak to them about your limitations before class.
  • Kegel exercises have become fashionable, thanks to “lifestyle gurus” like Gwyneth Paltrow. You might even have heard that they’ll improve your sex life. The goal of kegels is to strengthen and contract the pelvic floor. With endometriosis, most patients have problems relaxing the pelvic floor, and contracting it is counterintuitive.

DO:

  • Low-impact aerobic exercise gets your heart pumping without upregulating your nervous system, so you get the benefits of cardio without exacerbating endo pain. Swimming and walking are both great options for endo patients.
  • Yoga is great for endometriosis patients because it incorporates deep breathing, progressive muscle relaxation, and stretching in addition to building strength. This helps you release the tight muscles of your pelvic floor, without really having to think about it!
    • Next time you need to relax, check out this yoga sequence from instructor Brett Larkin. It’s available for free on YouTube, and incorporates research into the best yoga poses for endometriosis and fertility.
  • Pilates fuses flexibility, strength, and breathwork exercises into a challenging mind-body workout. The goal of Pilates is to synchronize your movements with your breath, much like in yoga. This promotes mindfulness, which has been shown to reduce pain.

What I Didn’t Know About My Chronic Yeast Infections

Disclaimer: I am not a doctor. My posts are based on my experiences as a patient and my subsequent research. Please consult your doctor before making any changes that may affect your health!

Between five and eight percent of women get more than four yeast infections in a year, known as chronic yeast infections — and since I was 17, I have been one of them.

When I started taking the pill at 15, I loved it. My cramps were less intense, my periods were lighter and my boobs were bigger — so, what wasn’t to love? Then, I became sexually active and quickly discovered that things were not as balmy as they seemed: I began experiencing pain, thick discharge and vaginal dryness with sex.

That year, I went on to be diagnosed with bacterial vaginosis and yeast infections multiple times. Each time, my doctors couldn’t quite figure out what was wrong with me. At one point, I was even prescribed a topical estrogen cream usually given to women going through menopause to relieve my pain and dryness associated with these infections. Meanwhile, at 17, my sex life was already suffering — I experienced so much pain that I couldn’t orgasm, began to view myself as a “failure” in the bedroom and started avoiding sexual activity whenever I could.

When I went off the pill, I assumed the problem would go away — but it didn’t. In college, I had recurrent bacterial vaginosis, which was always treated with an antibiotic gel that caused yeast infections as a side effect. As a result, I was having two infections a month for over a year. For so long, I wondered what was wrong with me…. and then I learned something that changed my life:

Endometriosis has been linked to chronic vaginal infections.

I learned this after my diagnosis of suspected endometriosis, and my mind was BLOWN. For years, I’d been suffering in silence, thinking there was something wrong with my body, when so much of what bothered me could be explained by a disease shared by one in ten women worldwide! I had been doing everything I could to prevent vaginal infections — taking probiotics, eating yogurt, avoiding sitting in sweaty clothing for long periods of time — yet still couldn’t seem to get rid of them. Now, things were finally starting to make sense. I was so overwhelmed with joy, I practically cried in the car on the way home from my doctor’s appointment.

Don’t get me wrong: if you suffer from chronic yeast infections, it’s important to see your doctor for testing and treatment. Chronic yeast infections can be a sign of diabetes, and untreated yeast infections can lead to Pelvic Inflammatory Disease (which may cause infertility down the line); these are just two reasons why you should always consult your doctor when you get multiple yeast infections in a year. However, if you suffer from endometriosis as well as chronic yeast infections that cannot be explained, it’s worth considering whether your endometriosis could be to blame.

Here’s what I’ve learned about the link between endometriosis and yeast infections, as well as some of the tips and tricks I’ve picked up over the years to lessen the frequency of yeast infections and help clear them up faster.

The Relationship Between Endometriosis and Chronic Yeast Infections

There’s a link between chronic yeast infections and endometriosis, but it’s still not clear why these two conditions often overlap. According to the book Endometriosis for Dummies, there’s no conclusive research to show why endometriosis and chronic yeast infections frequently occur together.

One possible explanation involves the link between endometriosis and autoimmune diseases; immunocomprimization may also increase your risk for frequent infections. Endometriosis sufferers are also more prone to allergies, which may make you intolerant to even normal levels of candida, resulting in vaginitis.

Another explanation could result from the link between candida albicans (the strain of yeast responsible for vaginal infections) and estrogen dominance. Yeast overgrowth is more likely when your estrogen levels are too high and your progesterone levels are too low — which, you may remember from my blog post on estrogen balance, is another sign of endometriosis.

How to Manage Chronic Yeast Infections

If you have endometriosis, the bad news is that chronic yeast infections may be something you have to live with forever. The good news, however, is that there are many preventative measures you can take to reduce the frequency of yeast infections and make yourself more comfortable when you do get them.

Based on my years (and years) of experience, here is some of my best advice on managing chronic yeast infections:

  • Beware of homeopathic remedies. Over the years, I’ve heard of many at-home remedies for yeast infections. (One even involved tying a clove of garlic to a string and putting it up your vagina like a tampon.) But yeast infections are not to be f*cked with, okay? The consequences of an untreated yeast infection can be serious, including Pelvic Inflammatory Disease. PID can lead to scarring of the ovaries and fallopian tubes, which contributes to infertility. That’s already a problem for many of us with endometriosis. I say you’re better off safe than sorry. While I get wanting to do things the “natural way,” yeast infections are one instance where you should definitely suck it up and buy the Monistat.
  • Stop using tampons. There is no scientific evidence that I’m aware of to show that tampons cause vaginal infections. That being said, the incidence of my chronic vaginal infections (both bacterial vaginosis and yeast infections) decreased dramatically when I stopped using them. I’m convinced that if someone were to fund a study into it, they would hear many women say the same thing. And it makes sense: tampons sit in your vagina for hours, harboring bacteria. Many conventional tampons contain chemicals that can affect your vagina’s pH, allowing bad bacteria to grow rampant. I switched to organic cotton pads with no bleach and no chlorine, and have experienced dramatic improvement in my chronic vaginal infections since. If you must use tampons, however (for example, to swim or exercise), I suggest switching to organic, cotton-only tampons with no chemicals — and changing them frequently (as in, more frequently than you think you need to!) to promote good hygiene.
  • Avoid fragrances, synthetic materials and other irritants. If you have endometriosis, you are likely more prone to allergic reactions and sensitivities than the average person — meaning you may experience yeast infection-like symptoms (read: itching and/or burning) if exposed to an irritant “down there.” Minimizing your exposure to potential irritants will make you more comfortable in the long run and prevent you from unnecessarily treating something you may think is a yeast infection, when it’s really an allergic reaction. Potential irritants include period products, vaginal hygiene products (like scented soaps or sprays) and synthetic panties. Try switching to organic, all-cotton pads, using only unscented soap on your vagina (not to mention, avoiding douching) and only wearing panties with an inner patch made of 100-percent cotton. Remember: your vagina is a self-cleaning oven and its pH is very easily thrown off by the products you use on it! Stick to the bare minimum and I promise you will see a major difference.
  • Consider supplementing your diet. Most at-home yeast infection remedies are, in my opinion, bullsh*t. However, there are a few which have a lot of anecdotal evidence behind them (and they aren’t the garlic-up-the-vagina theory) and have been effective for me. One is increasing the number of probiotic foods in your diet, such as yogurt and fermented foods (kimchi, sauerkraut, kombucha). You can also take a probiotic supplement containing lactobacillus, one of the most important “good bacteria” that lives in your vagina, for extra support. Another supplement I’ve had a positive experience with is the Perfect Condition Vitamin from Love Wellness. It contains grapefruit seed extract, which supports a healthy balance of yeast in the vaginal flora, as well as anti-inflammatory ingredients like turmeric that are overall positive for endometriosis sufferers!

Staying Safe from Coronavirus with a Chronic Illness

It’s a scary time to be someone with a chronic illness right now. Thankfully, endometriosis doesn’t affect my immune system the way chronic illnesses like cancer and cystic fibrosis might. But seeing as most of the deaths from COVID-19 are coming from those with preexisting health conditions, you might be feeling a bit uncertain regarding the relationship between coronavirus and your chronic illness.

The Los Angeles times recently released an (excellent!) article that states that an estimated six million Americans take biologic drugs for chronic health conditions. These drugs can weaken their immune system, making them more susceptible to illnesses like COVID-19.

For the 1 in 10 women like me who suffer from endometriosis, there’s a chance our immune systems may also be weakened: studies have found a close link between endometriosis and other autoimmune diseases (such as lupus), suggesting a strong immune component to endo.

The last thing I think anyone should be doing when it comes to the coronavirus is panicking — but if any young person has cause for concern, it’s a young person with an impaired immune system. Talk about people over the age of 60 dying is masking the very real fears that people like us have about coronavirus taking hold.

So, since our disease response isn’t doing much to support people with chronic illnesses, what can we do to be proactive against COVID-19? I did some research — and here’s what I’ve found.

To prevent the spread of coronavirus….

Wash your hands. If you haven’t heard to wash your hands often (and sing “Happy Birthday” twice while doing it), I have nothing to say to you right now. Wash ya damn hands. That’s all.

Don’t touch your face. Your eyes, nose and mouth should be considered off-limits when you’re out in public. At home, if you must touch your face (for example, if you need to blow your nose), wash your hands afterwards for at least 20 seconds.

Use a face mask properly. If you use a face mask improperly, you are better off wearing no mask at all. Masks are made to be disposed after one use, not reused over and over again. When you reuse the same mask for long periods of time, you actually create moisture that attracts germs.

Avoid contact with people who are sick. Whenever possible, maintain distance between you and people who are sick. If you must be around someone who is sick (for example, if your significant other is sick and you live together), self-quarantine for at least two weeks — or longer if you contract the virus.

Have at least two weeks of groceries on hand. In the event you must self-quarantine, you may need to stay at home for extended periods of time with no warning — hence why so many people are stocking up. Now, you don’t need to go to extremes, but it is a smart idea to have two weeks of nonperishable and/or frozen groceries on hand in the event of an emergency.

If you have a chronic illness….

Stock up on medical supplies. If possible, contact your doctor to receive extra quantities of prescription meds. Otherwise, try a mail order service like Amazon’s PillPack. (This is the service I use for all my meds and I love it!) You should also stock up on face masks, gloves, OTC vitamins and minerals you may take, cleaning wipes and all-purpose cleaner if possible.

Avoid public places as much as possible. When you are especially vulnerable to coronavirus, practice what is called social distancing. Keep contact with your friends via text, call and FaceTime or Skype, rather than meeting in person. Work from home if your boss allows it. Use grocery services like Instacart and Peapod to have food delivered to your home. In the modern era, it’s easier than ever to isolate yourself!

Consult with your healthcare providers. Have a plan in case you get sick of whom you will contact if you exhibit signs and symptoms of COVID-19. Telemedicine appointments are preferred over in-person ones. Talk to your medical team about whom you should call or video chat with if you believe you may have the coronavirus.

If you don’t have a chronic illness….

STOP stockpiling medical supplies. The average person does NOT need to wear a facemask (and may actually put themselves at risk by doing so) or gloves unless they are actively sick with COVID-19. Someone with a serious illness who is at higher risk of contracting coronavirus needs these medical supplies more than you do. You can and should stock up on tissues, cough drops and other items to help you recover at home — but those who have a chronic illness may not be able to recover at home if they contract the coronavirus.

How to Have a Sex Life with Chronic Pelvic Pain

The first time I had sex, it hurt. And despite what the media tells girls these days, it’s not supposed to! Little did I know that it wouldn’t get easier over time, as the media also told me. The reason why? Pelvic pain caused by my endometriosis.

It’s amazing how quickly my doctor could pinpoint the pain I was feeling during my exam. What’s less amazing is how long it took me to be heard in the medical system. I was still in high school when I first started seeing doctors for the pain I felt during sex. By the time I was in college, I was avoiding sex regularly due to the pain I was in.

I distinctly remember telling myself at one point that I could live without sex — and sure, I could. But that isn’t the point. I shouldn’t have to, and neither should you. That’s why sex is an important quality of life measure when doctors are assessing the extent of chronic pelvic pain: sex matters!

Sex allows us to build and deepen relationships, provides health benefits and relieves stress. Plus, it just feels good — and there’s nothing wrong with that.

As someone living with chronic pelvic pain, I know it can feel like sex is a part of life you’re doomed to miss out on. But despite those feelings, it isn’t. You can and will enjoy sex! You just need to understand where your pain is coming from and how to manage it — not to mention, how to cope with the difficult emotions surrounding your sex life.

Pelvic Pain and Your Emotions

When sex feels painful or even impossible, the emotions that arise can be equally painful. Whether you’re in a relationship or not, you’ll likely feel a sense of loss or frustration, among an amalgam of other complicated feelings surrounding sex. Here are just a few of the ways pelvic pain can impact the emotions that surround our sex lives.

Guilt

Conditions that cause pain during sex — such as endometriosis, pelvic floor dysfunction and vulvodynia (I have all three because I’m #blessed like that) — can also cause lack of interest in sex, difficulty becoming aroused and inability to reach orgasm. If you suffer from one or more of these side effects of pelvic pain, you might feel guilty for the way they affect your sex life.

As someone in a relationship, I know how difficult it is to feel like you’re the one always saying no to your partner’s advances. Or, you might feel bad for “taking too long” in bed or needing more stimulation to remain aroused during sex. You may even feel guilty for caring so much about your sex life in the frst place. Whatever it is, sexual guilt only furthers the problems caused by pelvic pain. In order to reclaim your sex life, you must let go of the guilt, and allow it to give way to pleasure.

Depression

Dealing with pelvic pain sucks, especially when it feels like you just can’t catch a break. Low libido can result directly from pelvic pain, or from the feelings of depression associated with pelvic pain. When our pelvic pain leaves us feeling hopeless and disinterested in our usual activities, of course our sexual desire is going to plummet as well. The subsequent relationship problems caused by constantly avoiding sex then maintain the depression, creating a vicious cycle of loneliness and low self-esteem. In these cases, learning to cope with the limitations of pelvic pain and finding happiness in what you can do may increase your libido and improve your sex life.

Frustration

When you suffer from any chronic condition, at some point you will probably find yourself wishing you could just be “normal” again like everybody else. These feelings can easily give way to frustration and resentment, especially if you fall into the comparison trap. Pick up the latest issue of Cosmopolitan and skim through the pages — I guarantee you’ll feel like everyone is having more orgasms than you, or at the very least having more sex (and enjoying it more, too).

However, it’s important to remember that you are more “normal” than you think, and that these media tropes are merely a mirage! In reality, 75% of women cannot climax from penetrative sex alone, 10-15% never climax at all and 20% experience some type of pain during sex. It’s natural to be frustrated by the pain you face, but don’t forget that you are not alone in your suffering. No one’s sex life is perfect, no matter what they say in public!

Tips for Pain-Free Sex

If you suffer from chronic pelvic pain, you probably think you’ve heard it all: try a different position. Try woman-on-top. Apply heat or cold after sex. Achieve orgasm on your own if you can’t with a partner. But these tips aren’t the end of the line when it comes to enjoying pain-free sex. If they were, most women with chronic pelvic pain would never learn to enjoy sex again!

Sadly, many women do give up and avoid sex altogether — but you don’t have to be one of them. Instead, you can decide to fight your chronic pelvic pain and reclaim control of your sex life. Empower yourself not to give up on sex by trying some of these tips to manage the pain you feel during sex:

  • Reduce external irritation. Amy Stein, author of Heal Pelvic Pain, recommends in her book applying pure Vitamin E oil to the vulva twice per day to reduce any external irritation. It’s also important to wear 100% cotton underwear, to switch to menstrual products free of fragrances or chemicals and to never, ever douche. EVER!
  • Use a quality lubricant. A safe, water-based lubricant is a must-have for any woman experiencing pelvic pain! Stein suggests avoiding lubricants with propylene glycol, an irritating ingredient.
  • Explore your sexuality outside of penetrative sex. If penetrative sex is too painful, Howard I. Glazer and Gae Rodke, authors of The Vulvodynia Survival Guide, recommend trying oral sex, mutual masturbation, sensual massage or even talking dirty to your partner to keep that spark of passion alive.
  • Set the mood. If you are going to have penetrative sex, go into sex as relaxed as possible. Light candles, put on sexy lingerie, use an aromatherapy massage oil…. Whatever you can do to reduce stress and promote relaxation prior to sex will help loosen your muscles, preventing the worst of your pelvic pain.
  • Bring props into the bedroom. I’ve previously written about the Ohnut, a flexible disk worn at the base of the penis to help partners explore comfortable penetration depths during sex. You can get $7 off your Ohnut purchase by using my promo code LOVELYLAZY7 — click here to check it out! If you (like most women) can’t orgasm from penetrative sex alone, you may also consider bringing a vibrator into the bedroom.

Want to join my FREE 7-Day Getting Endostrong e-course? Click here!

The Sick Girl’s Guide to Hacking Your Health Insurance

At the end of 2019, millions of Americans renewed their insurance or chose new health insurance plans as the New Year began.

Over the past two years, I’ve learned more than I ever wanted to know about using my health insurance benefits. However, I’ve also learned how to hack my health insurance to get the most out of it — which is important because, as Cosmo writes, “insurance and medical bills are confusing and expensive.”

They’re especially confusing and expensive if you’re someone who uses the healthcare system a lot, like me — and I do mean a lot. Between weekly therapy appointments, a 6-week intensive outpatient program for mental health and umpteen doctor’s appointments with generalists and specialists alike as I sorted out my gut health issues, I’m positive I have hundreds of dollars in unpaid medical bills lying around somewhere. (And that’s not some weird “look-how-sick-I-am” flex, I promise!)

If there’s anything to take away from this post, it’s that you need health insurance and that more importantly, you need to understand your health insurance. And as much as I’d love a universal healthcare supporter — like a Bernie or an Elizabeth — to be elected president in 2020, we can’t close our eyes and cross our fingers in the meantime.

So, without further ado, here’s how to hack the sh*t out of your health insurance this year as a gal with chronic illness. You’re welcome, boss babes!

Go with the PPO

Someone who utilizes the healthcare system frequently should NOT choose an HSA plan. An HSA plan comes with lower premiums, but also worse benefits. In the long run, as someone with a chronic illness, you’ll save more money by paying more for the PPO upfront so you can reap better benefits from your health insurance down the road.

Hit That Deductible Hard

If you have a deductible on your plan, I recommend hitting it as soon as you can. Granted, this shouldn’t be a goal if you don’t have a chronic illness — but if you’re going to make the doctor’s visits or buy the meds anyways, then go ahead and schedule that extra appointment or fill that extra prescription early on.

The sooner you hit your deductible, the sooner your health insurance plan will start covering more of your healthcare, leaving you with more money left in your pocket…. although if getting on a plan without a deductible is an option for you, I highly recommend that alternative!

Save on Meds

Drugstores like CVS and certain health insurance companies (like mine, Anthem Blue Cross / Blue Cross Blue Shield) offer savings on medication if you choose to have it delivered straight to your mailbox, rather than picking them up in-store. If you take a lot of medication for your chronic condition, I highly recommend taking advantage of this service, especially if it comes with the option to have your pills separated into daily packs for convenience and ease on-the-go.

Sites like GoodRx can also help you save a quick buck on filling your medications by giving you coupons you can print and show to your pharmacist. For example, I looked up escitalopram (the generic version of Lexapro) and found that you can save almost $50 with GoodRx if you’re paying out-of-pocket for medication. Sometimes, these prices can even be better than those your insurance offers, so make sure to compare costs before picking up your meds in-store!

Redeem Fitness Benefits

Here’s a health insurance hack that anyone can use! Did you know that many health insurance companies offer discounts on certain fitness benefits? For example, some companies will reimburse the cost of your monthly gym membership. Others will even give you a fitness tracker 100% for free. Some will even pay for classes in yoga, dance, Pilates and more.

Since exercise is a great way to manage chronic illness symptoms for many conditions, I highly recommend you call your insurance company and look into what fitness benefits are available on your plan!

Want to join my FREE 7-Day Getting Endostrong e-course? Click here!

Estrogen Balance and Endometriosis

Disclaimer: I am not a health professional. My advice is based solely on my experiences as a patient. Please consult your doctor before making any changes to your health regimen!

Happy Valentine’s Day! What better day to celebrate female hormones, amirite? (Hey, don’t look at me like that.)

If you’re a woman, you won’t be surprised to learn that everything in your body is connected to your hormones. The same is still true if you’re a man — but it’s especially true if you’re a woman.

And that doesn’t just cease to be the case if you have endometriosis. In fact, endometriosis can be a cause and an effect of hormone imbalance — especially when it comes to the female sex hormone estrogen.

As a symptomatic woman struggling to receive an endometriosis diagnosis, I identify with many of the symptoms of estrogen dominance: too much estrogen and (by comparison) too little progesterone.

But just what is estrogen dominance, and how can you tell if your estrogen is out of balance? This post covers everything from what estrogen is to how to get your estrogen levels back on track — especially if you, like me, have (or suspect you have) endometriosis.

All About Estrogen

Estrogen is a female sex hormone found in large amounts in women and smaller amounts in men. Occasionally, however, estrogen production can skyrocket — or we can be exposed to excess estrogen through hormonal birth control or our environment. This is how estrogen dominance develops.

But before we can fully understand estrogen dominance, we need to understand how estrogen functions within the body. Estrogen serves many functions in the body, especially for women’s reproductive health: produced primarily in the ovaries, it regulates the menstrual cycle and supports healthy pregnancy. Estrogen can also be produced in the kidneys and in fat (a.k.a. adipose) tissue.

According to the Hormone Health Network, the body produces three main types of estrogen:

  • Estradiol (E2): the most common type of estrogen in women of childbearing age
  • Estriol (E3): the main estrogen produced during pregnancy
  • Estrone (E1): the only estrogen made by the body after menopause

Your estrogen levels fluctuate naturally throughout your menstrual cycle. They are highest in the middle of your cycle, when you ovulate, and lowest during your period. Sometimes, however, women develop high or low estrogen for other reasons.

The most common causes of low estrogen are menopause or oopherectomy (removal of the ovaries). Today, we’ll focus on high estrogen, which consequently throws progesterone (another female sex hormone) out of whack in a condition known as estrogen dominance.

Symptoms of Estrogen Dominance

The growth and shedding of the uterine lining each month is controlled by estrogen — meaning, if you have endometriosis, the behavior of your endometriosis is also controlled by estrogen. Some recent studies (2019, Marquardt et. al.) suggest that dysregulation of the E2 form of estrogen may be partially responsible for endometriosis.

Estrogen dominance and endometriosis are intricately linked. Other signs of estrogen dominance include:

  • PMS
  • Ovarian cysts
  • Heavy and/or irregular periods
  • Early onset puberty
  • Weight gain
  • Fatigue
  • Low libido
  • Constipation
  • Anxiety
  • Bloating
  • Insomnia

Many of these symptoms surface not only because of the presence of excess estrogen, but also because the body’s progesterone levels are low in comparison.

The long-term consequences of estrogen dominance may also be grim. For example, women who started their period before age 12 (and therefore have been exposed to more estrogen) have a higher chance of developing breast and ovarian cancers, according to Bright Pink.

Rebalancing Your Estrogen

So, what’s a girl to do if she suspects she has estrogen dominance? I’m not a doctor, so I can’t promise to cure your estrogen dominance (or your endometriosis). However, research suggests that there are some surefire ways to reduce your exposure to excess estrogen from your environment, as well as to improve your overall hormone health:

  • Consume organic meat and dairy. Unless specifically labeled as hormone-free, regular meat and dairy may contain added growth hormones that can mess with your estrogen levels. Purchase organic, hormone-free meat and dairy if you choose to eat these foods.
  • Avoid BPA-containing plastics. Make sure you drink out of a BPA-free water bottle, replace your Tupperware with BPA-free containers and avoid any other sources of BPA, which can also disrupt your hormones. (Avoiding plastics also happens to be great for the environment, and is therefore great for everyone.) I love my glass BKR water bottle, which is a great alternative to plastics!
  • Take your vitamins. B vitamins and magnesium, to be exact — which have both been found to support the processing of estrogen. If you take other daily medications for chronic conditions, I highly recommend Pill Pack by Amazon, a prescription delivery service that will package your daily medications along with your OTC vitamins and ship them straight to your door.
  • Swap your personal care products. Using organic, all-natural beauty and personal care products is all the more important if you have estrogen dominance. This is because harmful chemicals like phthalates can mimic the effects of estrogen in the body — and because our skin is so porous, anything applied externally can be absorbed into our bodies and affect our hormone balance. So, swap to organic pads and tampons by brands like L. or Cora, and make sure to avoid any toxic chemicals in your beauty products.

Want to join my FREE 7-Day Getting Endostrong e-course? Click here!

Five Endometriosis Hacks You Haven’t Thought Of

Disclaimer: This post contains affiliate links, meaning I may receive payment for items purchased through my blog. Thanks for supporting Lovely & Lazy!

One of the reasons why chronic illness is so frustrating? Sometimes, it feels like we’ve exhausted every possible option. And trust me, after the 10th fruitless specialist visit, I get how it can feel that way.

Thankfully, something I’ve learned from my own struggles with chronic illness is that you’re never out of options — you simply need to know where to look. And now, I’ve done the deep digging on endometriosis so you don’t have to!

We all know the obvious tips for managing endometriosis at home: heating pads, NSAIDs and hormonal birth control all come to mind. But what about those less obvious tips you may not have thought of? That’s what this post is all about!

Electromagnetic Pulses

Although it might sound like something out of a sci-fi novel, electromagnetic pulses can help cure pelvic pain and period cramps! Livia is a scientifically-proven wearable device for controlling period pain. The Livia device attaches to the pelvis with gel pads and can be comfortably worn on the go. It works by stimulating the nerves with unique pulses that prevent the nerves from transmitting pain signals to the brain.

Kegel Exercises

In some cases, pelvic floor muscle dysfunction can result from endometriosis, worsening symptoms (particularly pain during sex). Thankfully, you can strengthen the pelvic floor muscles like any other muscle: with exercise! You can purchase relatively inexpensive kegel weights to aid in building pelvic floor muscle tone. Insert the weights into the vagina and tighten the muscles used to stop peeing mid-stream. Release and repeat for 15 minutes until it no longer feels challenging.

The Ohnut

Does sex hurt thanks to your endometriosis — especially with deep penetration? Meet the Ohnut, which was designed especially for women like you! This soft, flexible ring helps women comfortably explore different depths of penetration. Simply adjust the size of the Ohnut before inserting it to choose the depth that’s most comfortable for you and your partner.

Use my promo code LOVELYLAZY7 for $7 off your Ohnut! Click here to check it out.

Pelvic Massage

A 2010 study found that massaging the pelvis is helpful in reducing menstrual pain associated with endometriosis. Other studies have also found that women who receive regular massages have less pelvic pain associated with their menstrual periods. Manual therapy or pelvic floor physical therapy often includes therapeutic massages to reduce pain associated with endometriosis and adhesions.

Psychotherapy

Since so much of the pain experience is mental, it makes sense that psychotherapy can help with the management of endometriosis. Seeing a therapist can also help you cope with your diagnosis and any challenging emotions you may be experiencing as a result. It’s worth nothing that therapy that includes something called somatosensory stimulation (a.k.a. pressing different acupuncture points during the appointments) was more effective than ordinary psychotherapy when treating endometriosis patients.