Dr. Saba e Firdaus, MBBS, DGO, DNB (OBGYN)
Director & Head, OBGYN Chandan Hospital, Lucknow

For many people with endometriosis or suspected endometriosis, the COVID-19 pandemic has meant that they are now managing their symptoms at home. We understand that people might need support from home, especially as the pandemic might be exacerbating symptoms. Here, Dr. Saba e Firdaus, Director and Head, OBGYN, Chandan Hospital, provides eight top tips for those who might need help managing endometriosis symptoms from home.

Endometriosis classically affects women in their 20’s, 30’s and 40’s. It is a common condition, where the endometrial tissue that usually lines the inner womb is found outside of the womb cavity. Endometriosis pain can be complicated. There isn’t necessarily a relationship between the amount and location of the disease and the amount or type of pain experienced and this type of pain is likely to be chronic and long-lasting if left untreated. For those people who might be awaiting endometriosis treatment, or might need some support with managing symptoms, here are my eight tips:

1. Don't be afraid to seek help from your GP or specialist

It’s your job to listen to your body and report any changes that you’re concerned about to a medical professional, and it is the job of the medical professional to act appropriately on these concerns. Don’t stop taking any medication previously prescribed to manage your endometriosis. Even during the pandemic, you can contact your doctor to request repeat prescriptions so things don’t flare up.

2. Pain management

Studies have shown that over the counter pain medications such as paracetamol every six hours or non-steroidal anti-inflammatory drugs such as ibuprofen 400mg every eight hours or naproxen 250mg every 6-8 hours alone or in combination with the hormone treatment your doctor prescribes can help.

3. Keep an eye on what you eat

What you eat can impact endometriosis symptoms and their severity. Your diet is likely to have changed during the pandemic and various lockdowns and you might have moved to eating more comfort food. However, it’s important to stay on the right track to improve your overall health and wellbeing. Things to avoid are fried and processed ‘fast food’, caffeine and red meat as these can impact bowel function. Women with sensitive bladders have also often reported that the pain is worsened by alcohol consumption. The foods which can be taken include:

  • Fibrous foods: fruits, vegetables, legumes, daals and whole grains
  • Iron-rich foods: Salads, dark, leafy greens, broccoli, beans, fortified grains, nuts and seeds
  • Food which is rich in essential fatty acids: fishes, walnuts, chia and flax seeds
  • Antioxidant rich foods: colourful fruits and vegetables such as oranges, berries, dark chocolate, spinach and beets

It’s also incredibly important to stay hydrated, as dehydration can lead to constipation and to more concentrated urine, which can irritate the bladder and bowel respectively.

4. Get outside for some daily exercise

It’s really important to get outside, whilst also sticking to government guidelines on social distancing and isolation. If you have found in the past that long walks cause flare-ups of your pain, then just try a couple of shorter walks or go for a bike ride. Completing ‘pelvis-friendly’ exercises at home could also be beneficial for you.

5. Try to get enough high-quality sleep

  • There is increasing evidence to suggest that sleep deprivation can amplify pain, so it’s important that you do all you can to get as much sleep as possible. It’s also key that you understand that as a person with chronic pain, your body is constantly working overtime to get to a baseline where you can function, so make sure you replenish that activity with sleep. If you think you’re not sleeping enough, it’s important you:
  • Establish a relaxing bedtime routine and give yourself enough time to wind down before bed
  • Set a regular rise time
  • Avoid napping
  • Avoid stimulants such as caffeine, alcohol and nicotine before bed

6. Stay connected to others

It can be incredibly useful to talk about your endometriosis with loved ones, friends and colleagues. It’s important that you let them know about your symptoms and hoe endometriosis is affecting you. The severity of endometriosis is often not acknowledged and therefore it can be a lonely condition to have – but it’s important you talk to people. There are also a lot of online support groups on Facebook, Instagram and Twitter, where you can also share your symptoms and experiences with others.

7. Seek physiotherapy

Physiotherapy, and in particular, pelvic floor physiotherapy, could be helpful, particularly if you have adhesions or scar tissue from endometriosis surgery. Physical therapy can help to relieve and soften some of the pressure you might be experiencing, so reach out to a endometriosis specialist and see what help can be offered.

8. Try to manage stress and anxiety

There have been some studies which suggest that endometriosis pain can be exacerbated by stress. However, trying to reduce stress levels can be very difficult when you’re living with chronic pain. Instead of trying to eliminate stress, instead focus on how you manage stressful or anxious situations when they do arise.