One in 10 women live with endometriosis, yet few of us really know how to move to support our bodies. Endo exerciser Izzie Deibe explores the workouts she’s found useful in managing pain and energy.
Exercise is nature’s medicine. But, if you say this to a woman suffering from endometriosis, get ready for an argument. In 2020, I was diagnosed with stage three endometriosis following laparoscopic surgery aged 22.
For me, endometriosis feels like my insides are wrapped in barbed wire and being continuously pulled down. My lower back and abdomen constantly throb as if there’s a crown of thorns orbiting my midsection.
I rely on painkillers, my hot water bottle, a TENS machine and a stash of chocolate in my bedside table to manage flare-ups, but regular exercise has made the biggest difference in reducing the impact of endometriosis on my life.
Exercise is a touchy subject for the endometriosis community, and because endometriosis affects everyone slightly differently, some #EndoWarriors can find it jarring when people suggest that movement can treat or improve their symptoms.
The fact is, however, that keeping fit has enabled me to live a more “normal” life. Exercise can’t cure the condition – and the extreme pain it often causes means that exercise isn’t always possible – but there’s a lot to be said for kicking ass in the gym on days when you do feel strong enough.
According to gynaecologist Dr Nitu Bajekal, regular and structured physical movement benefits general health, reduces chronic inflammation and encourages more restorative sleep. In terms of pain reduction, she explains that exercise literally helps blood vessels to dilate and “flush away pain-inducing chemicals released by the body tissues”.
That combined with the fact that exercise releases mood-boosting hormones called endorphins (bye-bye anxiety, low mood and stress) makes movement a pretty powerful tool. One gym class every now and then, however, isn’t enough to make a massive difference.
If you have endometriosis, Dr Bajekal advises doing somewhere between 150 and 300 minutes of moderate activity every week (like a walk). On top of that, you should also try to do 60 minutes of muscle-strengthening exercise weekly (think: strength training, barre or pilates). Arguably more important than the amount of time you spend moving, however, is the type of exercise you do and the impact that certain ways of moving can have on your body.
Dr Bajekal warns, for example, that people living with endometriosis are better off avoiding anything that puts pressure on the pelvis, back or abdomen.
So, which workouts are safe and helpful for endometriosis? I’ve been putting five expert-backed workouts to the test to see if they can reduce pain, boost energy and lift my mood.
The women behind endometriosis accounts on Instagram regularly share funny memes in disbelief about the amount of times yoga is recommended to them. If you agree with them, please don’t hate me when I say that yoga really has worked wonders for my own symptoms.
As long as I avoid any poses that put pressure on my abdomen or which cause my pelvic floor muscles to tense up, I tend to see results instantly.
Dearbhail Ormond, the CEO and founder of endometriosis app Frendo, recommends chest openers (cobra, cow or fish pose), spine stretches (downward dog or cat and cow poses), hip fold positions (wide-legged forward fold) and alternate hip-lengthening exercises (pigeon pose or cow face pose) for reducing pain.
“Chest openers are great for releasing some of the tension we hold in our upper body as a result of the stress of managing pain,” she tells Stylist.
“Spine stretching and rolling encourages blood circulation and encourages a neutral alignment of the spine. By practising hip folds, you can relieve pressure on the back and spine and improve pelvic floor pain and bloating.
“Alternate hip-lengthening exercises open the hips and pelvis to help to ease pain, anchor the entire pelvis, strengthen the pelvic floor and ease tight muscles.”
Deep breathing is a key tenet of yoga, and it’s not only mentally relaxing but can also help to release tension in the back.
I don’t do yoga often, but when I tried these poses every day for a week, the results were astounding. The poses felt intense and overwhelming to start with, but my pain started to lessen the more I breathed and relaxed into each pose.
I felt much more agile and energetic as the week went on, so I’ll definitely be keeping these poses in my arsenal.
Low-intensity steady state training (LISS)
High-impact exercise is great for cardiovascular conditioning but can be a nightmare for women with endometriosis.
I’ve had experiences with personal trainers who’ve assumed I’m lazy when I can’t finish a set of burpees, so when Dr Bajekal tells me that high-impact exercise can aggravate endometriosis symptoms, I felt vindicated.
“High-intensity exercises like skipping, weight lifting and high-intensity circuit exercises should be avoided if you have endometriosis,” she advises. “Exercises like crunches, planks, scissors, burpees, and reverse crunches can also be problematic.”
Whether we live with endo or not, LISS training is the key to staying fit and healthy. It involves low-impact, low-stress movement – walking to work, gardening, housework. Anything that gets you moving around for a few hours without sending your heart rate soaring.
During a bad flare-up last week, I danced around the kitchen while preparing a delicious pasta bake – a far more fun and kind way of moving my body than sprinting on a treadmill.
Swimming is hands down my favourite exercise for endometriosis pain, and Ormond believes that breaststroke is probably the most suitable stroke for women with endometriosis because it opens up your pelvis and hip flexors.
Not living near a pool, I’ve never considered adding swimming to my fitness regime but actually giving it a go has changed my mind. Diving into the pool and feeling weightless as I glided through the water was dreamy, and it made a nice change from feeling burnt out by high-impact training.
When you have endo-related back pain, it feels amazing to be supported by the water – stretching out while being weightless. Of course, whether you decide to take the plunge in your local pool or have a go at breathing your way through a wild swim is totally up to you.
You can’t beat a walk in nature for your mental and physical health – even on a bad endometriosis day. Research has found that even 20 minutes of walking a day can reduce inflammation, stress and release endorphins to make you less sensitive to pain.
After my laparoscopy, I made it my mission to do 10,000 steps every single day. I quickly realised how unrealistic this goal was and I got tired of counting my steps, so I made a new goal: to get outside for some fresh air every day, for however long and whatever the weather.
I have broken this on occasion, but it’s such an easy goal to stick to most of the time (even if I just walk 10 minutes to the post office and back). It might not be the most strenuous exercise, but walking is by far the most sustainable form of exercise for endometriosis sufferers like me. Throw on something baggy, stick on a podcast and get moving. You’ll feel so much better when you get home.
Attempting to exercise during a flare-up can leave me feeling extremely dizzy, nauseated and ghostly white, so I’ve learned that sometimes I just need to rest. Living a healthy lifestyle is about treating your body with love and respect, and sometimes this means watching romcoms in your pyjamas.
When your cramps are raging and your flow is as turbulent as Niagara Falls, the very last thing you want to do is get into your lycra and head for the gym. I genuinely believe that many of us have been medically gaslit into second-guessing how severe our symptoms are, which makes us feel lazy for not exercising enough.
63% of women with endometriosis say they’ve been accused of lying about their symptoms, according to Frendo’s research; no wonder it’s hard to prioritise rest. But, as Ormond explains: “Pain is your body’s way of sending you a sign and telling you to take appropriate action.
“That can often mean rest – whether that’s watching Netflix, baking, going on a light walk, doing a gentle yoga class or whatever rest means to you.”
Only you have agency over your body and what you do with it, so rest up and don’t judge yourself by other people’s standards.
For more women’s health stories and experiences, check out the Strong Women Training Club.