March is Endometriosis Action Month, the annual event that aims to shine a spotlight on the gynaecological disease that affects one in 10 women.
“There are about 1.5 million in the UK with the disease,” says Faye Farthing, head of campaigns and communications at Endometriosis UK (endometriosis-uk.org).
The condition, where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes, can present itself in a number of ways.
“Symptoms include chronic, sometimes debilitating pelvic pain, painful periods, painful bowel and bladder movements, painful sex, fatigue, and difficulty getting pregnant.”
The cause of endometriosis hasn’t been determined by researchers, there’s no known cure, and it can be difficult to get a diagnosis due to a lack of awareness and understanding of symptoms.
“It takes an average of eight years to get a diagnosis of endometriosis in the UK – a figure that hasn’t changed in a decade – during which time, the disease may progress,” Farthing continues.
“Treatment and management of symptoms can include surgery, hormonal treatments and painkillers.”
Endometriosis and exercise
For those who have received a diagnosis, navigating exercise and pain can be a challenge, but there is some evidence that movement can help alleviate painful symptoms.
“Guidance from the European Society of Human Reproduction and Embryology (ESHRE, eshre.eu) makes what it calls a ‘cautious recommendation’ that those with endometriosis should consider exercise,” says Farthing.
It’s not just the physical effects that make a difference when it comes to chronic pain.
“Exercise can help improve symptoms for some women who have endometriosis, helping them feel better, both mentally and physically,” says Amanda Place, personal trainer and founder of Sculptrition (sculptrition.com). “The mood-boosting effects from exercise is especially important.”
While Abbie Watkins, personal trainer at OriGym (origympersonaltrainercourses.co.uk), explains: “Exercise, regardless of intensity and duration, releases endorphins, which help us feel happier and can prolong periods of time where endometriosis sufferers feel pain-free.”
That’s why we talk about ‘runner’s high’ – but you don’t have to embark on a gruelling fitness regime to get those endorphins flowing.
Slow and steady
“My first tip would be to take it slowly, making time to find the balance between what works for you and your fitness levels, and what helps with your endometriosis,” Watkins continues.
“Too quickly, and you’ll run the risk of burning yourself out, or worsening the pain you feel.
“Yoga, pilates, or any other type of low to moderate impact workouts, such as swimming, brisk walking and cycling, are typically the best types of exercise to opt for when experiencing endometriosis-related symptoms,” Place advises.
She also suggests incorporating exercises to strengthen the pelvic floor, such as heel slides and Kegel exercises.
“Aim to exercise 30 to 60 minutes a day, up to five days a week. However, the most important thing you can do is listen to your body. Overexercising can worsen pain, so pace yourself, take frequent breaks, and gradually increase the intensity of your workouts.”
Yoga can also help, Watkins says: “Certain yoga poses, such as the happy baby, chair pose, or mountain pose, offer significant benefits for the pelvic floor.”
Farthing agrees that no matter what activity you choose, listening to your body is key: “If in doubt, you should ask your GP, or another medical professional, such as a gynaecologist or endometriosis nurse specialist.”
Particularly if you’ve had surgery, she says: “It’s really important to be careful with physical activity when recovering from surgery, so make sure you get advice from health professionals.”
For an additional boost, you could buddy up with a friend, attend an exercise class or join a sports team.
“Fitness includes benefits for mental health, especially if there is a social aspect to exercise,” Farthing adds. “And we know that those with endometriosis are more likely than others to have symptoms of mental ill health.”