Endometriosis flare-ups are bursts of intense endometriosis symptoms. Increased pain is the most common symptom and flare-ups can be debilitating and unexpected. Find out about managing flare-ups and discover tips for symptom relief.
Written by Endometriosis UK.
Endometriosis is a chronic pelvic pain condition with symptoms that can differ from person to person. Some people may have symptoms that have a significant impact on their day-to-day life, others may have no symptoms at all.
Endometriosis flare-up’s, also known as endometriosis attacks, are episodes of worsened symptoms, commonly pain which is more intense than a person’s usual symptoms. Flare-ups can be cyclical, experienced around the time of a period, or they can happen randomly, at any time. The length of time a flare-up can last can also differ, with anything between minutes, to days, to weeks being observed.
Although we don’t fully understand the causes of endometriosis and flare-ups, it’s thought that symptoms are triggered by inflammation. The more the endometriosis and the surrounding tissue is inflamed, the worse the pain is.
Here we discuss the complexities of managing endometriosis flare-ups, and provide practical coping, and management techniques to support those living with endometriosis and those with suspected endometriosis.
The symptoms commonly experienced with endometriosis flare-ups can differ from person to person, as can the intensity and the duration. Endometriosis flare-ups can range from a short burst of symptoms - lasting minutes or hours, to flare-up’s lasting much longer - from days to weeks. Some endometriosis flare-ups may be manageable at home, others may require GP involvement, or even an emergency hospital attendance to help symptoms to be controlled and eased.
Hormonal changes – Endometriosis is an oestrogen dependant condition, and changes in oestrogen levels throughout the menstrual cycle can trigger endometriosis symptoms.
Inflammation - Chronic inflammation is the constant, non-specific immune activity that can trigger flare-ups, or cause diseases. Although more research is needed to fully understand the causes of endometriosis and the triggers for flare-up’s, we do know endometriosis is an inflammatory condition. It’s thought that anything that creates inflammation could potentially trigger, or flare-up endometriosis symptoms. Studies have shown that if ‘whole body’ inflammation is raised this can trigger symptoms and increase the amount of endometriosis flare-ups experienced.
Diet – Yes, it’s thought that foods can cause endometriosis flare-ups. Foods which contain refined sugars, carbohydrates, unhealthy fats, diary, red and processed meats can create inflammation in the body. It’s also important to maintain a health balanced diet, as cutting out numerous food groups can cause other health issues, so it’s important to first identify if there any food triggers in your own diet, and a food and symptom diary can help in identifying triggers.
Alcohol and caffeine can also have a hormonal effect on the body and therefore can be linked to endometriosis, which is oestrogen dependant.
Stress – Endometriosis, like other chronic pain conditions can lead to chronic stress. Higher levels of stress are linked to higher levels of pain. This is because stress creates an inflammation response within the body, this can trigger endometriosis symptoms and make it more difficult for the body to recover from and manage endometriosis flare-ups.
Lack of sleep – Lack of sleep (Insomnia) can weaken the body’s immune response. This also creates an inflammatory response. Higher levels of inflammation can trigger endometriosis flare-ups, and this can disturb sleep further, making this a vicious circle.
The frequency of endometriosis flare-ups can differ from person to person. Flare-ups can also differ in frequency, intensity and length for the same person. Some may be able to predict a flare-up others may suffer randomly.
Endometriosis flare-ups can be cyclical, where a pattern is noticed between symptoms and the menstrual cycle - during ovulation, during or around the time of a period. This is because endometriosis tissue becomes more inflamed and active around the time of a period and during ovulation. This inflammation response can trigger endometriosis flare-ups meaning symptoms may only be present during these specific times. However, everyone’s experience is different and endometriosis symptoms can change over time. Symptoms can also occur at any time, not always with a period and can last anything from hours to days, and even weeks.
An endometriosis flare-up is typically diagnosed when a person is suffering with extreme pain, or other symptoms, which are more intense when compared to their ‘usual’ endometriosis symptoms, or when their normal coping techniques become less effective. It can be easier for doctors or healthcare providers to identify symptoms and diagnose endometriosis flare-ups for those who already have an endometriosis diagnosis.
It may be more difficult to diagnose in those without an endometriosis diagnosis as the common symptoms experienced with a flare-up can also be symptomatic of other health conditions.
Endometriosis flare-up treatments can vary, and the treatment options available may not be suitable, or effective for everyone. Effective pain management would be the main focus when pain is the principal problem. Pain medication can help manage endometriosis flare-ups, anti-inflammatory drugs, such as ibuprofen, diclofenac and naproxen, help reduce inflammation in the body, which can positively improve pain management as endometriosis is an inflammatory condition. Opiates such as codeine can also provide short-term relief for flare-up symptoms, these medication work by interrupting pain signals, and reducing feelings of pain.
Although hormone treatments won’t have an immediate effect when managing a sudden burst of symptoms, they can help in the long-term with symptom management. If endometriosis is generally more controlled in everyday life, then flare-ups may be less intense and less frequent.
Lifestyle changes can also be helpful. We have already discussed the links to diet, sleep and stress with endometriosis flare-ups. Lifestyle changes won’t prevent endometriosis flare-ups, but avoiding inflammatory triggers may help manage pain and symptoms, making it better in the long-term.
Endometriosis is a complex condition, and managing flare-ups adds to the difficulty and unpredictability of living with a chronic pain disease. This blog aims to help identify common symptoms linked with endometriosis flare-ups and provide tips and advice on coping techniques and treatment options.
Endometriosis flare-ups can affect different people in different ways. No matter how endometriosis is impacting you, it’s important to seek support, whether that be talking to friends or family, accessing community support, or seeking medical assistance. You shouldn’t suffer alone or in silence. Recognising symptoms and getting support to improve them will equip you with the tools needed to better manage endometriosis and future flare-ups—giving you control back.
Living with endometriosis is challenging, but with the right strategies and support, you can manage your symptoms and improve your quality of life.
