Welcome to Part 3 in my series on endometriosis and weight gain. The culprit today? Something that seems like it would be apparent but often isn’t thought of immediately. Exercise … or lack thereof.

Endometriosis and Physical Activity: Reality Check

Endometriosis can create a powerful disincentive to physical activity due to the severe pain and discomfort it causes. For many individuals, the chronic pelvic pain and cramping associated with endometriosis can be so intense that even simple movements become agonizing. This constant pain often leads to a reluctance to engage in any physical activity, as movement can exacerbate discomfort. The fear of triggering or intensifying pain can make the idea of exercise seem daunting, further contributing to a sedentary lifestyle.

In addition to pain, endometriosis can lead to fatigue and a general sense of exhaustion. The body’s continuous battle against inflammation and pain can drain energy levels, making the thought of exercise feel overwhelming. When every day feels like a struggle, finding the motivation to work out can be challenging, and physical activity might be perceived as an added burden rather than a beneficial endeavor. This fatigue often compounds the cycle of inactivity, reinforcing the desire to avoid movement.

Finally, the impact of endometriosis on daily life can affect mental health, contributing to a lack of motivation for physical activity. Coping with the stress and emotional toll of chronic pain can lead to feelings of frustration, depression, or anxiety, which can diminish enthusiasm for exercise. The combination of physical pain and emotional strain creates a significant barrier to moving, as the effort required to engage in physical activity might seem disproportionate to its potential benefits.

Everyone Else and Movement — Not Much Better

On the flip side of the coin, no one else is moving much either… and this is everyone: healthy and unhealthy, young and old, male and female, endo or not. We have DoorDash or Uber Eats for easy food delivery to our couch, Amazon for groceries and necessities, online shopping for almost anything, and Uber or Lyft to easily get from one door to another. The phone and Netflix often beckon. Usually, we’re sitting, and that’s really bad for endo (all about endo and sitting here) and for weight gain

On top of that, restaurant food is insanely high in energy! A nutrient-dense and delicious salad you may make at home could have upwards of 1,200 calories in a restaurant (check this out, it’s not uncommon). Now think about the fried foods, breaded and fried foods, and everything else that’s available at restaurants… energy overload in addition to lack of movement.

I write this to help you simply be aware of your personal habits as they are now (knowing they can change!). As you know, a personal mantra I like endo sufferers to repeat is that “endo is not the cause of all my symptoms,” because that takes personal responsibilty out of the equation. For example, what if you’re blaming endometriosis for weight gain but the reality is that you work a lot, eat out a lot, and don’t move much?

Catching what I’m throwing?

Before you blame lack of movement on endo, do a reality check and see where you’re at in this realm of movement.

The Role of Exercise in the Endometriosis Equation

Now, imagine exercise as your superhero in this story. Exercise isn’t about getting washboard abs. For those with endometriosis, regular physical activity can be a game-changer. Exercise helps release endorphins, those feel-good chemicals that act as natural painkillers. It’s like having your personal cheerleaders who also happen to be really good at blocking pain signals.

Fun Fact: Exercising regularly has even been shown to endometriosis-associated pain more than painkillers!

Moreover, exercise helps reduce inflammation, a key factor in endometriosis. It’s like giving inflammation a timeout. Regular physical activity also helps regulate hormones, which can sometimes go a bit haywire with endometriosis. It’s like hitting the refresh button on your hormonal system, giving it a much-needed reset.

I’m so obsessed with the benefits of increased movement for endo I have a gazillion blogs about it. Click this link to see allllllll the many blogs I’ve written on movement and endometriosis and get inspired.

I also dedicated an entire chapter of my Best-Selling Endometriosis Book on it.

Exercise Deficiency: The Villain in the Story

Exercise deficiency is like that pesky villain who keeps showing up when we’re tired, overworked, stressed, addicted to screens, or really busy. No matter how you justify it, if you don’t get enough physical activity you might experience increased pain, fatigue, and even weight gain. Without regular exercise, your body might not cope with pain as well, much like having a leaky roof when it rains—pain gets through more easily.

Your metabolism can also become sluggish without exercise, which can lead to weight gain. It’s akin to trying to start a car with an empty tank. Additionally, the emotional impact of not exercising can make you feel down, which might lead to comfort eating. Think of it as stress-induced snacking, adding another layer to the challenge.

And, in a vicious cycle, the increased pain and fatigue can make you even less likely to exercise.

The Endometriosis-Sedentary-Weight Gain Connection

Obviously, weight gain sneaks in when there’s exercise deficiency. And when you’re dealing with endometriosis, weight gain can sometimes exacerbate symptoms, creating a bit of a vicious cycle. Extra pounds can increase inflammation and pressure on your body, which isn’t exactly the best scenario for someone with endometriosis.

In fact, simply being overweight has been measured (in this really cool study I talk about here) as 3x more inflammatory than excess alcohol consumption, while being obese is 3x more inflammation than consuming loads of added sugars or even smoking.

This means we need to really talk about how to get more movement in your life if you are, like most Americans, struggling with finding time to exercise.

Best exercises for endometriosis sufferers?

Of course, working in the endo world, I deeply understand the amount of pain some of us are in. I get it. At one point, my endo was so painful (month round) that I couldn’t do anything that would “jolt” my body: running, jumping, even hitting potholes in a car. Even weirder, if my heart rate went up to aerobic capacity, I felt like my uterus would fall out. Wtf.

If this is you, know that I empathize on every level. Been there, suffered that.

But please, do not use pain as an excuse to not move!!!!!!!! I BEG YOU!!!! Remember, the less you move, the more pain you will be in, the more muscle tension you will have, the less your digestion will work, the poorer your core function, the worse your pelvic floor function … the list goes on.

Rather, find the movement that works for you right now. Meet your body where she’s at! For example, walk every day. Work up to 3-5 miles a day. Not enough time? Do less. But still walk. Here is a GREAT blog I wrote on the benefits of walking for endometriosis]

Or swim. Or dance. Or do P.volve which is neat online class that helps strengthen and lengthen muscles which can be really helpful with endo (no, I’m not affiliated).

Feel weak or injured? Get a referral to a physical therapist.

Have prolapse or a weak core? Please do Angie’s Core Recovery class.

Have terrible pain one day and can’t move? Don’t make yourself! But get back up off that couch when you feel better. Force yourself for the sake of healing.

A Quick Personal Story For Inspiration

In April 2024, I felt very out of shape. I felt like I had no time to fit in even something so simple as walking. Besides, I was exhausted by being a full-time mom without breaks, having a never-ending to-do list at home and work, and all the nervous system dysregulation that comes with such large amounts of responsibility. If I had the time, how could I muster the energy???

But I knew I needed to move. I realized that not moving could be a source of exhaustion in itself. So, I navigated it with my 60-hour-a-week working husband, and we decided I could finagle an hour in early each day, as long as I was back at 6:30 a.m.

5 am it was.

OMG the first week was brutal. B-R-U-T-A-L. Like, I was exhausted. Who exercises at 5 am??! Not to mention I was out of shape so running was really walking with a “sloppy jog” thrown in.

But after the first week I felt it … a glimmer of more energy. Even more, a better mood throughout the day. Yes, 5 am wake-ups were still challenging, but I started to feel like I wanted to go out and run (ahem, slog) because it was indeed making me feel better.

Fast forward 2 months and I was waking up at 5 am regularly and could run a solid 4 miles. High-five me! Moreover, I felt so much better: Better energy, less anxiety about silly things, more robust in my own skin. My cravings were down, my caffeine needs were axed, and I felt happier in my body and in relationships. Whoa, really cool, all from that first week of TERRIBLE AWFUL complaining but not giving up. Plus, I saw a lot of morning rainbows :)