"A period pain is not normal if it's throbbing, burning, searing or stabbing pain that lasts for many days and can even occur between periods. It doesn’t improve with ibuprofen can be so bad to cause vomiting and unable to carry on daily life (miss school/ work)"
- Laura Briden, author of Period Repair Manual

Do you struggle with debilitating period cramps?

Endometriosis affects one in 10 women and the biggest symptom of endometriosis is pain during menstruation, often severe, in the pelvis, rectum, bladder, or legs. It can also occur at other times, during ovulation or sex. Other physical symptoms would include: bladder & bowel problems, abdominal bloating, nausea and vomiting, headaches, fever, bleeding between periods. And endometriosis is also one of the causes for infertility and recurrent miscarriage.

If this is something new to you, I don't mean to scare you. Perhaps talking about your menses might feel awkward for you? But if not me, then who?

I wished I was more attentive to my cycles when I was younger, or that I had someone to talk to. It was something we don’t even talk about at home even though we are a family of 5 girls. It was a taboo topic and it’s no wonder I felt ashamed when I had my menses, and I tried my best to be effective (and strong) and not use it as an excuse to not do stuff.

Knowledge is good - it can help you better advocate for your own health, and with social media, it’s so much easier to find support. Some doctors and even your loved ones can dismiss your symptoms as something that "you need to bear with it because giving birth is worst!" or this is part and parcel of being a women.

BS.

I always tell my students, "when pain disrupts your everyday life, be it period pain, back pain, knee pain - go do something about it."

Some of you may be doing yoga because you want to to cure your pains and aches, but the truth is yoga is not the magic pill. I'm not afraid to refer a student (and I have done so) to my chiropractor when I know that yoga will worsen her pain.

I'm not a doctor nor a medical professional but as a yoga teacher, I can share with you how yoga can help with period pains, alleviate the endometriosis symptoms and better your quality of life (QOL).

So in my post today you’ll discover:

5 benefits of doing yoga for endometriosis (the WHY)
Other ways to cope with Endometrosis from a holistic perspective (+ medical intervention)
Include Yoga as your non-negotiable Self care Ritual

WHY Practice Yoga to Manage Endometriosis Symptoms

YOGA DOESN’T doesn't cure endometriosis, what's the point of doing it?

Well don't you want a better quality of life (QOL), where you are empowered to manage your own pain, and live the best possible life?

If yes, read on.

(1) Reduce pain

There were studies conducted by Gonçalves et al (2017) and Ravins et al (2022) that showed that yoga helped reduce “levels of pain” and improve QOL in women with endometriosis.

To be honest, I don't have endometriosis (touch wood) nor "debilitating period pain" until I was 41. I just got off my IVF meds after my first (unsuccessful) IVF transfer. The period pain was so severe, that I couldn't even move, nor lie down. I couldn't even bear to be touched by my husband.

Obviously when you are in so much pain, yoga is the last thing on your mind. I'm the same. I didn't want to move. I just wanted to curl up wherever I was.

My point being, you don’t have to do yoga there and then or force yourself to do 30 mins yoga session. Yoga can be a simple extended breathework practice and/or doing ONE simple pose like a a Supported Reclined Butterfly Pose, which creates spaces and softens in the abdominal and thus gives a gentle stretch in the pelvic area, providing relief from pain.

Reclining Butterfly pose
Photo Credit: PopSugar.com

(2)Reduce Stress

Although there is no evidence that endometriosis is caused by stress, but endometriosis can cause and may exacerbate stress and anxiety.

In 1993, a psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins (Low et al), reported that patients with endometriosis have reported higher level of stress due to the negative impact of the symptoms in all aspects of life, including work, relationships and fertility."

In short, endometriosis is a vicious cycle of chronic pain that affects the mental health and quality of life, which can lead to increased physical pain and worsening of the mental and emotional health and so forth.

So it’s very important that we look at managing the stress levels so we can stop the vicious cycle and yoga's breathing exercises and meditation techniques can help reduce stress levels and promote relaxation, leading to a decrease in symptoms.

There is plenty of research done out there that showed yoga is effective in reducing stress, anxiety, and depression (Shohani et al., 2018), and the same study by Ravins et al (2022) showed that yoga also helped women with endometriosis reduce level of stress. Learning pranayama or breath control has also been shown as an effective tool in reducing stress and improving emotional and mental well-being. (Zaccaro et al., 2018 and Fincham et al., 2023)

(3)Improve circulation and Hormonal balance:

As a healthy woman, awakened to my feminine needs, I want to achieve hormonal balance and optimal fertility health regardless if I’m trying to conceive or not. And I hope this is what you want too.

When you’re not in pain or not on your menses, certain yoga postures, such as inversions like shoulder stand and headstand, or forward bends helps to improve blood, oxygen and nutrients flow, into and around your reproductive organs. And restorative yoga may help balance hormones and regulate menstrual cycles, and this is safe to do for all phases of your menstrual cycle.

(4) Boost immune system

A regular yoga practice has been shown to boost the immune system, which promotes healing and can help fight off inflammation and infection in the body. This is especially important for women with endometriosis, as the condition can weaken the immune system and make it harder to fight off infection.

(5)Improve flexibility:

Endometriosis can cause adhesions and scar tissue to develop in the pelvic region, which can lead to stiffness and reduced flexibility. Yoga postures, such as downward dog, warrior II, and triangle pose, can help improve flexibility and range of motion, which in turn reduce pain and improve QOL.

HOLISTIC ways to cope with Endometriosis

Consider a multi-prong approach, when dealing with Endometriosis pain and symptoms. Don't go in thinking it’s going to be a quick fix but try what you can with you have.

Surgery is a last resort, but surgery will not cure it either. Check out what other options you can try from a holistic perspective:

YOGA (For the 5 Reasons listed above)

TCM & ACUPUNCTURE (Herbs can vitalise blood circulation, including danshen, chishao and taoren and Acupuncture to relieve pain, regulate blood circulation and correct energy imbalances.)

SUPPORT (You are not alone. Get support from your endo community online. You can start with @e4endo and follow other endo warriors to make you feel less alone. Consider getting support at home and at work. However this might be difficult to do as it’s an asian culture that we don't talk about our periods nor our infertility. But what's possible is that they might be understanding and it also helps educate one more person about endometriosis.)

ENDO TOOLKIT (have on standby Painkillers, Heat pads/ hot water bottle, Koyok or medicated heat pads, medicated oil + whatever else you need)

FIND THE RIGHT DOCTOR (Don't let doctors dimiss your pain as normal. If you feel like its too much pain, it probably is.)

BE KIND TO YOURSELF (Be kind, not judge if you have to take painkillers or to take time off from work. And to take care of your physical, mental and emotional health. )

Include Yoga as your non-negotiable Self care Ritual

It’s easy to feel a loss of control when you’re experiencing pain and symptoms caused by endometriosis.

Yoga will empower you to take back the control of your life, because when when you practise yoga on the non-icky days, or even your endo-version of yoga on the icky days, you are choosing to feel good and to create space for self care.

Having a regular practice will help keep you grounded and connected to the present moment. A regular practice can also help your body remember what it feels like to be calm whenever you are in an anxious or a stressful situation.

CONCLUSION

In conclusion, yoga can be a powerful tool for managing endometriosis symptoms. By relieving pain, reducing stress, boosting blood circulation and immune system and improving flexibility, yoga can be a wonderful support for women with endometriosis to help you live more comfortable and fulfilling lives.

It is important to note that yoga is not a cure for endometriosis, and should part of a multi - prong approach to manage the symptoms. In addition, not all yoga poses are suitable for women with endometriosis and sometimes a pose may feel easeful and some days not.

It's important to listen to your body and to work with a qualified yoga teacher who has experience working with women with endometriosis, to ensure that the practice is safe and effective.

If you have endometriosis, consider adding yoga to your self-care routine, and consult with your healthcare provider before starting any new exercise regimen.

March is Endometriosis Awareness Month

In honour of Endometriosis month, I’ll be teaching a Yoga for Endometriosis LIVE on Instagram for Fertility Support Singapore , this Thursday, 23 March 2023. at 8pm SGT

It’s FREE. You just have to show up at 8pm on the FSS feed. Do follow them @fertilitysupport.sg if you want to receive notifications.

AND if you ready to make yoga non-negotiable for you, I teach Self Care Yoga for Women every Tuesday 8pm SGT. Cost is SGD15. Link to register HERE

Have you ever tried yoga to help alleviate with your Endometriosis symptoms? Comment below on your experience on how it has helped you.

Resources:

Moving with The Moon By Ana Davis

References:

Fincham, G. W., Strauss, C., Montero-Marin, J., & Cavanagh, K. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports, 13(1), 432. https://doi.org/10.1038/s41598-022-27247-y

Gonçalves, A. V., Barros, N. F., & Bahamondes, L. (2017). The practice of hatha yoga for the treatment of pain associated with endometriosis. Journal of Alternative and Complementary Medicine (New York, N.Y.), 23(1), 45–52. https://doi.org/10.1089/acm.2015.0343

Low, W. Y., Edelmann, R. J., & Sutton, C. (1993). A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins. Journal of Psychosomatic Research, 37(2), 111–116. https://doi.org/10.1016/0022-3999(93)90077-s

Ravins, I., Joseph, G., & Tene, L. (2022). The effect of practicing “endometriosis yoga” on stress and quality of life for women with endometriosis: AB design pilot study. Alternative Therapies in Health and Medicine. https://pubmed.ncbi.nlm.nih.gov/35839113/

Shohani, M., Badfar, G., Nasirkandy, M. P., Kaikhavani, S., Rahmati, S., Modmeli, Y., Soleymani, A., & Azami, M. (2018). The effect of yoga on stress, anxiety, and depression in women. International Journal of Preventive Medicine, 9, 21. https://doi.org/10.4103/ijpvm.IJPVM_242_16

Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353. https://doi.org/10.3389/fnhum.2018.00353

How Yoga Can Help with Endometriosis