It takes an average of seven years to get an endometriosis diagnosis, despite the fact that one in 10 women have it. Knowing how to move, therefore, is important, argues menstrual wellbeing coach Katherine Glyde.
There are currently 1.5 million women in the UK living with endometriosis. In my experience, working within menstrual wellbeing, movement in all its forms can support someone living with the condition, but it can be daunting starting out or coming back after taking a break from fitness.
Endometriosis is a condition where endometrial-like (the lining of the womb) tissue is found in other areas of the body, typically the pelvic cavity: the ovaries, the bladder, the bowels, but in some cases also the liver and the lungs. This tissue reacts in the same way to our hormones that our endometrial tissue does throughout the menstrual cycle, but unlike the womb, has no way of leaving the body. That then causes inflammation, irritation and chronic pain.
According to statistics from Endometriosis UK, one in 10 women have endometriosis; it can affect you from puberty to menopause regardless of race or ethnicity, and it’s a spectrum condition. That means everyone experiences different symptoms and responds differently to various treatments. Saying that, the main symptoms tend to include chronic pain, heavy bleeding, fatigue, pelvic pain and fertility issues.
Benefits of exercise for endometriosis
Exercise offers a host of benefits when it comes to supporting the menstrual cycle generally, as well as for conditions like endometriosis. Functional fitness in particular has been my own go-to pain management tool since I was diagnosed with the condition in 2018. It’s been a slow process working out how to best move my body in a way that supported my condition rather than worsened it.
I exercise to improve my mental health and for the endorphins that come as a result. Exercise has by no means cured my symptoms, but it helps me manage on a day-to-day basis and I’ve learned a load of lessons along the way.
“Physical exercise can not only help alleviate painful symptoms but also helps us release endorphins which, in my opinion, can set the tone for the day,” says Chloe White, co-founder and coach at Raw Inc Training. “Therefore, movement is a great tool to uplift physical and mental wellbeing when symptoms can become overwhelming.”
With that in mind, here are my tried and tested tips for exercising with endometriosis.
4 tips for working out with endometriosis
Be open about your diagnosis
First off, it’s important to stress that endometriosis is nothing to be ashamed of. If you join a gym or a sports club, as soon as you feel comfortable to, let the people you are working with know about your symptoms and your experience with endometriosis. On the whole, there is no medical reason why you can’t train like other people, but pain levels and energy levels can fluctuate throughout the cycle and your choice of fitness location has a duty of care to support you through them.
Sharing your diagnosis and symptoms will allow your PT or class instructor to consider how best to tweak your workouts to ensure that they work for – and not against – you.
Take things at a pace you feel comfortable with. Endometriosis can be an overwhelming experience; exercise should help rather than overwhelm you. If this is your first step into fitness, you may notice hormonal changes happening while your body adjusts.
Fatigue is a common symptom of endometriosis, and going too hard too fast could worsen that overwhelming tiredness. Apps like Couch to 5K can help, as following a structured plan can help you find a pace that is sustainable and achievable.
“As long as you are performing exercises correctly and safely, that’s all that matters,” White says. “We work with clients to move optimally rather than to hinder them, so we encourage our clients with endometriosis to work with whatever their 100% looks like on that day.
“The spectrum of intensity and symptoms is going to change from one individual to the next, and as coaches, we work really hard to be inclusive.”
Find something you love
If you’d rather hit the pavement and run than throwing weight round in the gym, do that. Prefer swimming to yoga? Great. The best exercise for you is the one you enjoy, and that really goes for everyone – whether you live with a health condition or not.
Track your cycle
When it comes to endometriosis, the more information you can gather about your body the better. There are plenty of cycle-tracking apps available but even putting pen to paper to note down your symptoms is a great habit to get used to.
Often our cycles can feel different to other people’s, so including exercise within your tracking will enable you to see any patterns that come up. However you choose to exercise, understanding how to work with your body and symptoms will help you work out which are the best days to aim for that PB and when it’s better to take things slower.
Tracking my exercise with my cycle showed me that day one of my cycle is the day to push hard, while the week of ovulation is most painful and therefore better for taking things easier.
They say you should recover as hard as you train, and this is even more important for someone living with endometriosis.
Create helpful habits to support you: staying hydrated, practising self-care and focusing on getting enough good quality sleep. Again, fatigue and chronic pain are so key to the endometriosis experience, so resting is going to ensure that you can move today, tomorrow and in the future.
Trust your instincts – you know your body better than anyone else. If something doesn’t feel right to you or doesn’t bring you joy, don’t do it.
Sarah Tella is a pelvic health physiotherapist who says that in her experience, people with endometriosis tend to have overactive pelvic floor muscles. “That’s due to flare-ups and the fact that experiencing pelvic pain can leave your pelvic floor feeling the need to be a little over-protective (a bit like a dog’s tail – when it’s threatened it contracts),” she explains.
“My top tip to anyone exercising is to remember to breathe. Try to avoid breath holding and bearing down when you exercise,” Tella explains. “With that in mind, some simple yoga and breathing moves might be a great place to start.”
If you find you are struggling with pelvic pain when trying to exercise, she recommends seeing a pelvic health physiotherapist who can assess you and provide tailored advice and treatment.
There is a huge amount of support available for those living with endometriosis. Whether you are starting out or coming back from a break, make sure you speak to your healthcare practitioner if you have any concerns about exercising, and check out Endometriosis UK for more information.
For more workout tips, healthy recipes and first-person features, check out the Strong Women Training Club library.
Recommended by Katherine Glyde
“I tried exercising based on my menstrual cycle and here’s why I’ll be sticking with it”
“I work out in period pants every single month and here’s why you should too”
Can a fitness regime reduce period pain and regulate the menstrual cycle?
“Me and my sister both have coeliac disease. Here’s how we tackle exercise”