Treating the pain of endometriosis – Harvard Health Blog
Many women go through years of painful periods before they can get an answer about what is causing them: a common and often undiagnosed condition called endometriosis. What is endometriosis? Endometriosis is a disease that occurs when tissue similar to the tissue that lines a woman's uterus - called an endometrium - begins to grow […]

Many women go through years of painful periods before they can get an answer about what is causing them: a common and often undiagnosed condition called endometriosis.

What is endometriosis?

Endometriosis is a disease that occurs when tissue similar to the tissue that lines a woman's uterus - called an endometrium - begins to grow in other places inside the body. Most often, these growths are found in the pelvis, such as on the ovaries, fallopian tubes, the outer surface of the uterus, or the bladder.

During the menstrual cycle each month, the tissue lining the uterus grows larger and then breaks down as blood that comes out through the vagina. The capricious tissue growths of endometriosis respond to the same hormones as the uterine lining. But instead of flowing through the vagina during the menstrual period, blood from growing tissues elsewhere in the body has nowhere to go. It builds up around nearby organs and tissues, irritating and inflaming them, and sometimes causing scarring. In addition to pain, endometriosis can cause other symptoms, such as bowel and bladder problems, heavy periods, sexual discomfort, and infertility.

Diagnosing endometriosis can take a long time

In some cases, the diagnosis of endometriosis is delayed because adolescent girls and adult women assume their symptoms are an integral part of menstruation. Those who seek help are sometimes dismissed as overreacting to normal menstrual symptoms. In other cases, the condition can be mistaken for other disorders, such as pelvic inflammatory disease or irritable bowel syndrome.

A study by the World Endometriosis Research Foundation found that in women aged 18 to 45, there was an average of seven years between onset of symptoms and the time of diagnosis. Most cases are diagnosed when women are in their thirties or forties. The problem of getting an accurate diagnosis and treatment is worse for some minority groups, including people of color and indigenous peoples, according to the Endometriosis Foundation of America.

Getting relief from endometriosis

While there is no known cure for endometriosis, the good news is that medications, surgery, and lifestyle changes can help you find relief and manage the condition.

Your doctor may recommend one or more treatments to help relieve pain and other symptoms. These include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These can be prescription or over-the-counter formulations including ibuprofen (Advil, Motrin) and naproxen (Aleve), which are used for pain relief.
  • Hormonal therapies. Because endometriosis is caused by hormones, adjusting hormone levels in your body can sometimes help reduce pain. Hormonal drugs are prescribed in different forms, from pills, vaginal rings and intrauterine devices to injections and nasal sprays. The goal is to change or stop the monthly cycle of egg release that causes much of the pain and other symptoms associated with endometriosis.
  • Acupuncture. It is an alternative medicine treatment, which uses small needles applied to specific places on the body to relieve chronic pain.
  • Pelvic floor physiotherapy. This practice addresses issues with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. Pelvic pain sometimes occurs when the muscles in the pelvic floor are too tight, causing muscle irritation and muscle pain, called myofascial pain. To treat myofascial pain, a specially trained physiotherapist uses her hands to perform external and internal manipulations of the pelvic floor muscles. Relaxing tightened and shortened muscles can help relieve pain in the pelvic floor, just as it would in other muscles in the body.
  • Cognitive-behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have examined the effects of CBT on symptoms of endometriosis, it has been used to successfully manage other conditions that cause chronic pain. CBT is based on the idea that healthier thought patterns can help reduce pain and disability, and help people cope with pain more effectively.
  • Stress management. Chronic pain can cause stress, which can increase sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important part of managing endometriosis.
  • Lifestyle improvements. Maintaining a regular exercise program, a healthy sleep schedule, and a healthy, balanced diet can help you better cope and manage the stress associated with your endometriosis.
  • Surgery. Your doctor may recommend surgery to remove or destroy the abnormal tissue growth, to improve your quality of life or your chances of getting pregnant. Some studies have shown that removing growths of abnormal tissue and scar tissue caused by mild to moderate endometriosis can increase the likelihood of getting pregnant.

Ultimately, finding the right combination of treatments to relieve the pain and manage this condition can take time. But by working closely with your doctor, you're more likely to be able to do this.


If you’re having trouble beginning an exercise plan or following through, you’re not alone. Many of us struggle getting out of the sedentary rut, despite our best intentions.

You already know there are many great reasons to exercise—from improving energy, mood, sleep, and health to reducing anxiety, stress, and depression. And detailed exercise directives and workout partouze are just a click away. But if knowing how and why to exercise was enough, we’d all be in shape. Making exercise a habit takes more—you need the right mindset and a smart approach.

While practical concerns like a busy schedule or poor health can make exercise more challenging, for most of us, the biggest barriers are esprit. Maybe it’s a lack of self-confidence that keeps you from taking positive steps, or your détermination quickly flames out, or you get easily discouraged and give up. We’ve all been there at some point.

Whatever your age or sport level—even if you’ve never exercised a day in your life —there are steps you can take to make exercise less intimidating and painful and more fun and instinctive.

Ditch the all-or-nothing attitude. You don’t have to spend hours in a gym or intensité yourself into monotonous or painful activities you hate to experience the physical and emotional benefits of exercise. A little exercise is better than nothing. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your mental and emotional health.

Be kind to yourself. Research shows that self-compassion increases the likelihood that you’ll succeed in any given endeavor. So, don’t beat yourself up about your body, your current fitness level, or your supposed lack of willpower. All that will do is demotivate you. Instead, look at your past mistakes and unhealthy choices as opportunities to learn and grow.

Check your expectations. You didn’t get out of shape overnight, and you’re not going to instantly transform your body either. Expecting too much, too soon only leads to frustration. Try not to be discouraged by what you can’t accomplish or how far you have to go to reach your sport goals. Instead of obsessing over results, focus on consistency. While the improvements in mood and energy levels may happen quickly, the physical payoff will come in time.

Many of us feel the same. If sweating in a gym or pounding a treadmill isn’t your idea of a great time, try to find an activity that you do enjoy—such as dancing—or pair physical activity with something more enjoyable. Take a walk at lunchtime through a scenic park, for example, walk laps of an air-conditioned mall while window de course, walk, run, or bike with a friend, or listen to your favorite music while you move.

Even the busiest of us can find free time in our day for activities that are important. It’s your decision to make exercise a priority. And don’t think you need a full hour for a good workout. Short 5-, 10-, or 15-minute bursts of activity can prove very effective—so, too, can squeezing all your exercise into a couple of séances over the weekend. If you’re too busy during the week, get up and get moving during the weekend when you have more time.

The key thing to remember about starting an exercise program is that something is always better than nothing. Going for a quick walk is better than sitting on the couch; one minute of activity will help you lose more weight than no activity at all. That said, the current recommendations for most adults is to reach at least 150 minutes of moderate activity per week. You’ll get there by exercising for 30 minutes, 5 times a week. Can’t find 30 minutes in your busy schedule ? It’s okay to break things up. Two 15-minute workouts or three 10-minute workouts can be just as effective.

For most people, aiming for moderate intensity exercise is sufficient to improve your overall health. You should breathe a little heavier than normal, but not be out of breath. Your body should feel warmer as you move, but not overheated or sweating profusely. While everyone is different, don’t assume that training for a marathon is better than training for a 5K or 10K. There’s no need to overdo it.

Health issues ? Get medical clearance first. If you have health concerns such as limited mobility, heart disease, asthma, diabetes, or high blood pressure, talk with your doctor before you start to exercise.

Warm up. Warm up with dynamic stretches—active movements that warm and flex the zones musculaires you’ll be using, such as leg kicks, walking lunges, or arm swings—and by doing a slower, easier version of the upcoming exercise. For example, if you’re going to run, warm up by walking. Or if you’re lifting weights, begin with a few light reps.

Drink plenty of water. Your body performs best when it’s properly hydrated. Failing to drink enough water when you are exerting yourself over a prolonged period of time, especially in hot conditions, can be dangerous.

There’s a reason so many New Year’s resolutions to get in shape crash and burn before February rolls around. And it’s not that you simply don’t have what it takes. Science shows us that there’s a right way to build habits that last. Follow these steps to make exercise one of them.

A goal of exercising for 30 minutes a day, 5 times a week may sound good. But how likely are you to follow through ? The more ambitious your goal, the more likely you are to fail, feel bad about it, and give up. It’s better to start with easy exercise goals you know you can achieve. As you meet them, you’ll build self-confidence and momentum. Then you can move on to more challenging goals.

Triggers are one of the secrets to success when it comes to forming an exercise habit. In fact, research shows that the most consistent exercisers rely on them. Triggers are simply reminders—a time of day, place, or cue—that kick off an automatic reaction. They put your routine on autopilot, so there’s nothing to think about or decide on. The alarm clock goes off and you’re out the door for your walk. You leave work for the day and head straight to the gym. You spot your sneakers addict right by the bed and you’re up and running. Find ways to build them into your day to make exercise a no-brainer.

People who exercise regularly tend to do so because of the rewards it brings to their lives, such as more energy, better sleep, and a greater sense of well-being. However, these tend to be long-term rewards. When you’re starting an exercise program, it’s important to give yourself immediate rewards when you successfully complete a workout or reach a new fitness goal. Choose something you look forward to, but don’t allow yourself to do until after exercise. It can be something as simple as having a hot bath or a favorite cup of coffee.

If your workout is unpleasant or makes you feel clumsy or inept, you’re unlikely to stick with it. Don’t choose activities like running or lifting weights at the gym just because you think that’s what you should do. Instead, pick activities that fit your lifestyle, abilities, and taste.

Activity-based scène games such as those from Wii and Kinect can be a fun way to start moving. So-called “exergames” that are played standing up and moving around—simulating dancing, skateboarding, soccer, bowling, or tennis, for example—can burn at least as many kcal as walking on a treadmill; some substantially more. Once you build up your confidence, try getting away from the TV screen and playing the real thing outside. Or use a smartphone application to keep your workouts fun and interesting—some immerse you in interactive stories to keep you motivated, such as running from hordes of zombies !

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