Endometriosis is a chronic, often painful condition in which tissue similar to the uterine lining grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes and the tissue lining the pelvis. Rarely, endometriosis may involve other organs such as the lungs, brain or skin. These patches of tissue can cause inflammation and scarring. An endometriosis flare up can occur when symptoms spring up due to a variety of different triggers.
There is no cure for endometriosis, but there are treatments that can help lessen the symptoms. If you think you might have endometriosis, talk to your doctor. They may be able to diagnose endometriosis based on your symptoms and a physical exam. They may also order an ultrasound or laparoscopy to confirm the diagnosis.
What are the Symptoms of Endometriosis?
The main symptom of endometriosis is pelvic pain, often associated with your menstrual period. However, endometriosis can also cause other problems, such as:
- Pain during sex
- Painful bowel movements or urination
- Excessive bleeding during your period
- Infertility
- Fatigue
Don’t feel discouraged if you experience any of these symptoms. Endometriosis can be managed, and women with endometriosis lead healthy and fulfilling lives.[1][2]
What causes Endometriosis to flare up?
Symptoms may change with the menstrual cycle and can also occur between periods. The cause of endometriosis is not fully understood. A change in symptoms after surgery needs review with the surgical team, rather than being assumed to be a routine flare. Body size or a supposed weak immune system does not explain an individual flare. The WHO overview describes current knowledge and its limits.
Endometriosis Flare-up Symptoms
The main symptom of endometriosis is pelvic pain, often associated with your menstrual period. However, endometriosis can also cause pain during sex, when going to the bathroom and while urinating or defecating. In some cases, you may experience no symptoms at all.
A flare may involve cramping, stabbing, burning or aching pelvic pain. Pain can occur during periods or at other times, and its effect on daily life varies. Record what you feel and what you cannot do so you can discuss a care plan. Severe or changing pain needs assessment even if you already have endometriosis.
During Ovulation
Some people notice pelvic pain around ovulation. Record the timing, but do not assume that every mid-cycle pain is caused by endometriosis. New or severe pain needs assessment.
Before Your Period
Pain or other symptoms may begin before bleeding starts. Note how many days before your period they appear and how they affect your activities.
During Your Period
Endometriosis can cause severe period pain and heavy bleeding. Record changes from your usual pattern and discuss symptoms that disrupt daily life with your clinician.
After Your Period
Pelvic pain may continue after bleeding ends. Symptoms do not have to follow a single cycle pattern. Ask for review when pain persists or your agreed treatment no longer helps.
After an activity such as running or swimming
If an activity worsens pain, reduce or stop it and discuss how to adapt it. Gentle movement can support general wellbeing when comfortable, but research on exercise specifically for endometriosis pain is limited. Activity-related pain does not show that lesions are growing or shedding.
Alternative interventions: Acupuncture
Acupuncture involves inserting fine needles at specific points. Research into relief of endometriosis pain is uncertain, and it should not be presented as a proven way to control the disease or reduce pelvic inflammation. If you want to try it for comfort, discuss suitability and risks with your clinician and use a qualified practitioner. Continue your agreed medical care.
How to Explain Endometriosis Pain
Start with what the pain feels like and what it prevents you from doing. Cramping, stabbing, burning, pressure or a deep ache may fit your experience, but there is no required description. How painful endometriosis feels varies between people and over time. You do not need a comparison with someone else's pain to deserve care.
Describe your pain to a clinician
Try a short description: "I feel [type of pain] in [location]. It started [when] and lasts [how long]. It is [your rating] out of 10, and it makes [sleeping, walking, work or another activity] difficult." Add whether the pain is constant or comes in waves, spreads elsewhere, or changes before, during or after your period.
Record bleeding, bowel or bladder symptoms, fatigue, bloating and pain during or after sex if relevant. Note medicines taken, whether they helped, and any side effects. Include symptoms outside your period. Bring a short diary and your main concern rather than waiting to collect a perfect record. NICE recommends a pain and symptom diary to support the discussion.
Ask: "What else could cause this pain? What can I do during a flare? When should I seek urgent help? When will we review treatment or consider a specialist?" If you feel dismissed, restate the effect on daily life, ask for the next step to be documented, and consider a second opinion. A support person can help you remember the discussion if you want one. Descriptions and pain scores support assessment but cannot locate lesions or confirm a diagnosis.
Explain it to a partner, family member or friend
If you are explaining endometriosis to a man or anyone unfamiliar with it, start with a simple explanation: tissue similar to the uterine lining grows outside the uterus and can cause inflammation and scarring. It is more than ordinary period discomfort and may hurt between periods too. You could say, "You may not see the pain, but today it stops me from standing long enough to cook. Could you help with dinner?"
Ask for the help you need, such as a lift to an appointment, time to rest or flexibility when plans change. If sex hurts, explain your limits and discuss comfortable alternatives without pressure to continue a painful activity. The WHO endometriosis fact sheet can help someone understand the physical, social and emotional effects.
Discuss emotional strain and disability needs
Pain, fatigue, fertility concerns and missed activities can affect mood and relationships. Tell your care team if anxiety, low mood or isolation is becoming difficult to manage. Counseling, a peer support group or referral for pain management may help. Sharing reliable information can support awareness, but you do not have to disclose private experiences or campaign to justify your care.
If you want to advocate beyond your own care, contact a patient organization, healthcare provider or policymaker about access to specialist services and research funding. You can also take part in a patient advisory group or awareness event. Choose an action that fits your energy and privacy preferences.
Endometriosis can be disabling when symptoms limit daily activities. Whether it meets a legal disability definition or qualifies for benefits depends on the applicable rules and individual effects. For example, the Equality Act definition in Great Britain considers substantial, long-term effects on normal activities. A diagnosis alone does not settle every entitlement. Ask the relevant local service, occupational health team or adviser about your situation. Describe missed work, difficulty traveling, breaks needed and how symptoms fluctuate when requesting support.
Ask about assessment, laparoscopy and treatment choices
A gynecologist reviews your symptoms and may offer an examination and ultrasound, with other imaging when appropriate. A normal examination or ultrasound does not rule out endometriosis. Laparoscopy is an operation using a camera through small abdominal incisions. It may help diagnose or treat endometriosis, but surgery is not always required before treatment begins. NICE guidance on diagnosis and management explains when further investigation and referral may be appropriate.
Discuss pain medicines, hormonal treatment and surgery in relation to your symptoms, preferences, side effects and pregnancy plans. Surgery may remove lesions, cysts or adhesions, but symptoms can recur and it is not a guaranteed cure. Hormonal treatments are generally unsuitable while trying to conceive. Ask whether fertility advice, physiotherapy or mental health support belongs in your plan. The NHS endometriosis guide describes these options.
When pain needs urgent assessment
Unbearable period pain should not be dismissed as normal. Get emergency care for pelvic pain that is severe or worsening, or comes with fainting, shoulder-tip pain, breathing difficulty or heavy vaginal bleeding. Get urgent medical advice for pelvic pain with fever, vomiting, difficulty passing urine or stool, or possible pregnancy. These can have causes other than endometriosis. Follow your local emergency or urgent-care service, using the NHS pelvic pain guidance as a reference. Do not delay assessment to finish a diary or try another home remedy.
What are some lesser-known triggers?
Symptoms vary, and a diary may help you notice possible patterns with meals, stress, sleep or activity. An association in a diary does not prove a cause. Use it to guide a discussion with your care team rather than blaming yourself for a flare.
Food choices during an endometriosis flare
There is no single established diet for endometriosis pain, and evidence for specific dietary changes is limited. You do not need to remove gluten, dairy, soy or other whole food groups simply because you have endometriosis. Restrictions may be appropriate for a separately diagnosed condition, such as coeliac disease, or an individually assessed trigger.
Choose balanced meals you tolerate, with vegetables or fruit, a protein source and grains or other starchy foods. Soups or smaller meals may be easier when bloated or nauseated. Fiber can help with constipation but should be adjusted to your bowel symptoms. Foods such as fish, beans, nuts or yogurt can fit a balanced diet if tolerated, without being treatments for endometriosis.
Discuss persistent bowel symptoms with a clinician or dietitian before a restrictive plan. A low-FODMAP diet is a short-term approach for selected bowel symptoms, not a cure for endometriosis, and needs guidance. The Chelsea and Westminster NHS endometriosis guidance explains the limited dietary evidence and role of individual triggers. Food changes and relaxation can support wellbeing but do not replace prescribed treatment.
Managing Endometriosis: Triggers & Symptoms
- Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve) can help relieve endo pain.
- Hormone therapy: birth control pills, patches or shots can help to regulate hormones and reduce endometriosis symptoms.
- Surgery: Laparoscopic surgery can be used to remove endometrial tissue.
- CareClinic App: If you’re struggling to find your endometriosis triggers, the CareClinic app can help. With the app, you can track your symptoms, triggers, and treatments. This can help you to identify patterns and figure out what works for you. The app also has a community of women who are living with endometriosis.
How long do Endo flare up symptoms last?
The duration of an endometriosis flare up can vary from woman to woman. Some women only experience a few days of pain, while others may have pain for weeks or even months. If you are struggling to manage your endometriosis pain, talk to your doctor. Endometriosis is a chronic condition, which unfortunately means that it can flare up at any time.[16]
What should you do during a severe Endometriosis flare up?
– Try to get some rest. This can be difficult, but it is important to give your body a chance to heal.
– Apply heat to the area that is hurting. This can help to relax the muscles and ease the pain.
– Take over-the-counter pain medications, such as ibuprofen or acetaminophen.
– Avoid activities that make the pain worse. This might include sex, exercise, and wearing tight clothing.
– Try to relax and de-stress. Stress can make endometriosis pain worse.
– CareClinic App: The CareClinic app can be a helpful tool during a flare up. You can record your activity and any environmental factor that may have just occurred to find correlations with your pain. You can also share this information with your doctor to help them better understand your condition.
Endometriosis can be a frustrating and painful condition to live with. However, there are ways to manage the pain and symptoms. By understanding your triggers and taking steps to avoid them, you can help to reduce the frequency and severity of endometriosis flare ups.
- Download the app and create an account.
- Select “Add a Health Condition.”
- Choose “Endometriosis” from the list of conditions.
- Add Medications such as ibuprofen or acetaminophen or any other you may be taking
- You will then be able to track your symptoms, triggers, and treatments from the Check-in screen.
- View your treatment logs and charts to monitor your progress over time.
- Share and export data with your doctor or add others as a caregiver in the app.
- Work with your HCP to act on insights by adjusting your treatment.
Some benefits of tracking your condition:
Discover your triggers: By tracking your endometriosis, you can identify any possible triggers for your flares. This might include certain foods, activities, or even environmental factors.
Discover your pain level: By tracking your pain level, you can see if there are any patterns or trends. This might help you to identify what treatments are working for you and when you need to seek medical help.
Monitor your Progress: By tracking your endometriosis over time, you can see if there are any trends in your symptoms. This might help you to identify if your condition is getting better or worse.[17][18]
What is endo belly?
"Endo belly" describes abdominal bloating associated with endometriosis. It does not prove a build-up of tissue in the abdomen or identify the cause of swelling. Bloating and pain can also have other causes. Discuss persistent, new or worsening bloating with a clinician, and follow the urgent assessment advice for severe symptoms. Treatment depends on the assessment and does not automatically require surgery.
Putting it all together
Endometriosis is a chronic condition that can be difficult to manage. However, by understanding your triggers and taking steps to avoid them, you can help to reduce the frequency and severity of endometriosis flare ups. The CareClinic app is designed to help you take control of your condition by tracking your symptoms, triggers, and treatments. By monitoring these areas, you can begin to see patterns emerge and figure out what methods work best for you.
References:
https://www.womenshealth.gov/a-z-topics/endometriosis
https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20352775
https://kidshealth.org/en/parents/endometriosis.html[23]
References
- “Endometriosis”. https://www.who.int/news-room/fact-sheets/detail/endometriosis%E2%81%A0
- “Endometriosis | Johns Hopkins Medicine”. https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis/
- “Endometriosis Flare-Up Symptoms, Triggers, and Tips for Relief”. https://drbrighten.com/endometriosis-flare-up/
- “Efficacy of acupuncture on pelvic pain in patients with endometriosis: study protocol for a randomized, single-blind, multi-center, placebo-controlled trial – PMC”. https://pmc.ncbi.nlm.nih.gov/articles/PMC5992761/
- “Efficacy and safety of acupuncture-related therapies in symptomatic endometriosis: a systematic review and network meta-analysis – PMC”. https://pmc.ncbi.nlm.nih.gov/articles/PMC11920332/
- “Lifestyle Changes | InsightEndometriosis”. https://www.insightendometriosis.org.nz/lifestyle-changes
- “Acupuncture for endometriosis: A systematic review and meta-analysis – PubMed”. https://pubmed.ncbi.nlm.nih.gov/38033648/
- “6 Tips For Eating With Endometriosis”. https://intermountainhealthcare.org/blogs/6-tips-for-eating-with-endometriosis
- “Healthy Eating for Endometriosis”. https://www.healthcentral.com/slideshow/your-guide-for-smart-eating-with-endometriosis
- “Can Diet Improve Symptoms of Endometriosis? | Banner”. https://www.bannerhealth.com/healthcareblog/better-me/the-10-foods-to-eat-and-to-avoid-when-you-have-endometriosis
- “Endometriosis and Diet: Foods to Avoid and Foods to Embrace”. https://www.artfertilityclinics.com/in/en/art-blog/endometriosis-and-diet-foods
- “What To Eat And What To Avoid If You Have Endometriosis”. https://healthmatch.io/endometriosis/what-foods-to-eat-or-avoid-with-endometriosis
- “Diet for Endometriosis Pain Relief – A Guide”. https://www.nirvahealth.com/blog/dietary-strategies-for-relieving-endometriosis-pain
- “Endometriosis Diet: Foods To Eat and What To Avoid”. https://www.health.com/condition/endometriosis/endometriosis-diet
- “What are the treatments for endometriosis? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development”. https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment
- “Endometriosis Flare Up Symptoms”. https://www.rylonclinic.com/post/endometriosis-flare-up-symptoms
- “7 Effective Endometriosis Self-Care Strategies”. https://docus.ai/symptoms-guide/endometriosis-self-care
- “Living with endometriosis: MedlinePlus Medical Encyclopedia”. https://medlineplus.gov/ency/patientinstructions/000714.htm
- “What is endo belly and how can you manage it? | Spire Healthcare”. https://www.spirehealthcare.com/health-hub/specialties/womens-health/what-is-endo-belly-and-how-can-you-manage-it/
- “Endo Belly: Causes and Treatments for Endometriosis Bloating”. https://drbrighten.com/endo-belly/
- “How To Get Rid of Endo Belly”. https://health.clevelandclinic.org/endo-belly
- “What Is Endo Belly? Experts Explain”. https://www.ccrmivf.com/news-events/prevention-what-is-endo-belly/
- “How to keep an endometriosis pain and symptom diary”. https://www.bupa.co.uk/newsroom/ourviews/endometriosis-pain-diary
