​Endometriosis: How to identify and manage aggravation of symptoms

Endometriosis can be debilitating, especially during a flare up. The severe pain can disrupt your daily life and limit your activities. This affects your quality of life and can be emotionally very challenging. 
What causes these flare ups? It could be one of these; hormonal fluctuations, stress, increased inflammation, or fatigue. Tracking these triggers and an awareness can help you to avoid and manage them with a game plan.
An aggravation episode can be explained as a time in your cycle where symptoms are more pronounced. Endometriosis is a disease where some endometrial lining outside the uterus responds to your monthly hormonal fluctuations. This process of thickening and elimination of the lining can cause the inflammation and pain experienced.
The following are symptoms of endometriosis:

• Severe pelvic pain, even more severe than your regular menstrual cramps
• Heavy/ irregular bleeding
• Lower back pain
• Pain during intercourse
• Digestive issues like nausea and  bloating
• Fatigue and general feeling of being unwell
• Tummy pain during bowel movements or urination
• Spotting between periods
• Moodiness and increased irritability
• Headaches/ migraines
• Muscle aches or joint pain

Any of these symptoms can become more severe during a endometriosis flare up. These episodes can last for a couple of days up to two weeks. These episodes can vary greatly in intensity every month and is dependant upon your circumstances.
 
The intensity of these flare ups are dependant upon many factors and what is happening in your body. These are some of the triggers:

• Hormonal changes
• Stressful periods and chronic stress
• Dietary choices
• Poor gut health
• Certain activities like vigorous exercise or even sex 
• Some medications

Your menstrual cycle affects endometriosis directly. The most prominent hormone that can aggravate symptoms, is oestrogen. Endometriosis is an oestrogen dominance disease and a imbalance between this hormone and progesterone can be a causal factor. When you menstruate, the endometrial tissue in other areas besides in the uterus, responds similarly by growing, bleeding an shedding. This causes the pain, cramping and inflammation.
Stress  increases cortisol levels. This will increase inflammation in the body, potentially aggravating endometriosis symptoms. Chronic stress can also affect hormones in other ways, such as by decreasing estrogen or progesterone, and therefore causing endometriosis or aggravating this condition.
Foods that can contribute to gut dysfunction and inflammation are processed foods, red meat, dairy products, and foods high in trans fats or refined sugars. Poor diet can aggravate endometriosis. It is essential to have a nutrient dense rich diet dominated by anti inflammatory antioxidant rich foods.
Just as bad as inactivity, too much exercise or lots of physical activities that put pressure on the pelvic region, such as high-impact workouts or intercourse, can sometimes trigger a flare-up of your endometriosis.
A balance between good and bad bacteria in your digestive tract is essential for immune response and regulating inflammation. The bacteria in your intestines are also very important regulators of all hormones. Dysbiosis is thought to worsen endometriosis and to cause flare ups. A poor diet, stress and infections treated with antibiotics or cortisone can worsen gut function.
Medications containing estrogen can stimulate the growth of the endometrial tissue in areas outside of the uterus. These drugs could be oral contraceptive pills, hormone replacement therapy, and fertility drugs.
The following supplements may be beneficial in the management of endometriosis

1. Magnesium
2. Vitamin B6
3. Probiotics 
4. Sulfurophane
5. Resveratrol
6. DIM 
7. Chaste Tree  (Vitex agnus castus)
8. Polygonum
9. Calcium d-Glucarate
10. N-Acetyl Cysteine (NAC
11. Curcumin
12. B vitamins
13. Antioxidant

 
Living with endometriosis often means facing very uncomfortable flare-ups that can impact your daily life, such as intense pain, bloating, and fatigue. By identifying personal triggers and implementing effective relief strategies, you can achieve better symptom control and overall well-being. To better manage endo flare-ups, consider keeping a diary to track the effects of your diet, exercise routine, stress levels, and use of medications. Remember, you don't have to suffer in silence—seek support from knowledgeable healthcare professionals who can offer valuable guidance and resources tailored to your unique needs.