How Stress Makes Endometriosis Worse, and How to Address it
A lifestyle of depravity can lead to much more pain and suffering than necessary. With endo, we may be depriving ourselves of certain foods, comforts, or people, activities, or events. This leads to a feeling of … isolation. Isolation, of course, leads to stress, and research shows the more stress we have, the worse our disease.
How Stress Makes Endometriosis Worse
While our bodies are made to deal with stressors in short bouts, they are not hardwired to deal with stress that never ends. And in today’s fast-paced, tech-heavy, and sugar- and caffeine-laden worlds, our stress can become chronic. This will begin to affect immune system behavior, which relies on complex communication links between the hormonal and nervous systems to know when to prioritize an immune attack (inflame) or tissue repair.
When your body is ramped up with fight-or-flight hormones, your nervous system kicks into sympathetic mode where inflammation is prioritized. This would make ancestral sense since a body in a fight-or-flight mode would actually be in a life-or-death scenario (not just being canceled on social media), so the immune system would prioritize inflammation in case you need to heal a wound fast. Conversely, when you’re peaceful and relaxed, the switch is flipped to parasympathetic mode where healing, rejuvenation, and repair are prioritized.
Unfortunately, high levels of both cortisol and adrenaline are associated with endometriosis establishment and progression. This is thanks to the hormone–immune conversation, where a constant surge in adrenaline tells the immune system to produce many of the exact inflammatory immune players endometriosis relies on to thrive. Not to mention that chronic stress promotes “stress-induced immune dysregulation,” which has been associated with a state of chronic low-grade inflammation. This may be why mice subjected to chronic stress tests developed endo lesions twice the size of those without chronic stress. Conversely, blocking adrenaline production has been noticed to stop the rooting down and progression of endo. This is how stress becomes an actual endometriosis lesion provoker and grower, much more than just affecting symptoms. [1-4]
If You Have Endometriosis, You’re Probably Really Stressed (even before the endo….)
While so many in today’s world are dealing with chronic stress, those of us living with a health condition like endo may have even more. Studies have shown that over 2/3 of women with endo have mild to high levels of stress, while 57% of women with endometriosis reported so much chronic anxiety they viewed it as a personality trait compared to 8.3% without endo. [5]
This is so different from experiencing a stressful event that then passes and we’re calm again. Nearly two-thirds of us believe it’s part of who we are at our core—we’re just “stressed people” who are chronically anxious, fluttery, worried, nervous, or overwhelmed. It may be due to your endo that you feel this way (chronic pain and emotional wear can do that), or it may be because society as we know it has done that to us. Probably a bit of both. Unfortunately, a chronic stress mindset like this may be directly fueling endo-ing in the body.
Stress Affects Endometriosis Symptoms Too
Symptom-wise, stress continues to be an endo-provoker. Over time, a chronic stress response will affect your master regulator of stress hormones (called the Hypothalamic-Pituitary-Adrenal Axis, or HPA), creating dysfunction. Dysfunction can look different depending on how long your body has been dealing with stress. Initially, you may be stuck in an alarm phase, where your body is no longer picking up cues that your “threat” is gone and instead keeps you in a fight-or-flight response. You may now constantly feel anxious, worried, agitated, or “wired but tired,” yet are unable to relax.
When the alarm stage goes on for too long, cortisol levels will eventually start to drop. While this may not sound problematic at first, know that cortisol isn’t just used for stress but also for proper wakefulness, rest, and moods. If your cortisol level is blunted, you may find yourself in a state of deep exhaustion—chronic fatigue if you will—something many of us with endo are known to have. You may not be able to wake up easily nor perform your daily tasks without crumbling. You may have brain fog, be irritable, and be unable to focus. I was there too, with chronic fatigue being one of my worst symptoms, something so different from being just “tired” that many days it would feel like a Herculean effort to simply get up and take a shower.
HPA dysfunction is associated with endo in numerous other ways. Low cortisol is associated with the type of incapacitating pain women with endo experience, while high cortisol levels were significantly higher in endo patients dealing with infertility. In fact, being stressed during ovulation may reduce your chances of conception by nearly 50%! You may have noticed your own symptoms of stress directly affect your own cycle, either through reduced production of healthy cervical fluid at ovulation, delayed ovulation or irregular periods, increased PMS symptoms, or more painful or heavy periods. Are you beginning to see the stress–endo connection more clearly?
What To Do When Our Society Wheels and Deals With Stress?
Sorry to say, a sensitive endometriosis soul may not have been cut out for our society today, one that uses stress to sell, sell, sell.
Stress, anxiety, and fear are the driving market forces of the day, keeping our eyes glued to screens and our credit card coming out again and again as we scramble to keep up with all the trends lest we left behind: fashion, personal brand, apps, games, beauty, supplements, you name it. We feel like we’ll be left behind if we leave social media for too long, feel compelled to check our email or social channels just one more time…
As technology becomes our own addition, it fuels even more isolation. While we may feel like we socialized through social media, participated in the community through the news, or even went outside by watching screens filled with nature, we’re really not. And your body knows it! The more screen time the higher the anxiety, the more sedentary, the poorer the health.
That's why your journey to create the ultimate endo lifestyle includes the increasingly endangered art of connecting: Connecting to yourself, to others, and back to nature.
Natural Endometriosis Remedy: Reconnect
Connecting to yourself should really be about cultivating pleasures back into your life. Chances are you've been putting the authentic you on the sideline, trying to accomplish all your "to-do's"s while under a lot of stress and a mountain of pain. Remembering what makes you happy and inserting that into your life will add happiness back in with it. Cultivating old and new friendships will lift a burden off your shoulders you didn't know was there. Getting outside and giving yourself a big dose of vitamin Nature will help you thrive.
Even if you're in quite a bit of pain, there are lots of things you can do to reconnect to a life worth living. For me, it was cooking! As I delved into my diet plan and nutrition, I spent a lot of time in the kitchen. Rather than let it stress me out, I learned to love to cook. It was so fulfilling to take fresh ingredients and turn them into delicious foods that even my friends loved to eat. Suddenly, people liked to come over for dinner ... a win-win.
That's why this lifestyle piece is the mortar that holds the other building blocks together. Joy in your life will make any diet okay, any stress dissipate, and any disease curable. If you haven't found joy in your life for a while, it may take a while to remember what pleasures truly tickle your fancy, but they're there waiting for you to come back to them. Promise.
Check out the following pages to learn more about how to reconnect to a world that may be really missing you!
Reconnect to Yourself
Endometriosis may have thrown you a curve ball and you might not be able to do what you used to, but that doesn't mean your life has ended! Cultivating pleasure back into your life with a new approach will help you create a new normal. Look at the many ways to find resilience in the face to pain, and reconnect to a happier you.
Reconnect to Others
Many of us are getting our social fix through social media these days, but that's a poor substitute for touching, belly laughing together, sharing meals and stories. These memories create the fabric of our lives, and there's no time like the present to start weaving. Reintroduce social times into your life and smile bigger, more often.
Take The “Chronic” Out of Stress
Did you know there’s a magic trick that will turn stress into something manageable? It’s really cool. Read this blog to find out the magic trick and apply it today!
Take a Social Media Break
I hate to break it to you, but while social media has so much endometriosis “information”, it won’t heal your endo. More often, it creates a sense of overwhelm, information overload, and behavioral change paralysis. Want to get off social media for a bit to focus on what really matters? Learn how, and why, here.
Guo, S. W., Zhang, Q., & Liu, X. (2017). Social psychogenic stress promotes the development of endometriosis in mouse. Reproductive Biomedicine Online, 34(3), 225–239. https://doi.org/10.1016/j.rbmo.2016.11.012
Gouin, J.-P. (2011). Chronic stress, immune dysregulation, and health. American Journal of Lifestyle Medicine, 5(6), 476–485. https://doi.org/10.1177/1559827610395467
Guo, S. W., Zhang, Q., & Liu, X. (2017). Social psychogenic stress promotes the development of endometriosis in mouse. Reproductive Biomedicine Online, 34(3), 225–239. https://doi.org/10.1016/j.rbmo.2016.11.012
Long, Q., Liu, X., Qi, Q., & Guo, S. W. (2016). Chronic stress accelerates the development of endometriosis in mouse through adrenergic receptor β2. Human Reproduction (Oxford, England), 31(11), 2506–2519. https://doi.org/10.1093/humrep/dew237
Brasil, D. L., Montagna, E., Trevisan, C. M., La Rosa, V. L., Laganà, A. S., Barbosa, C. P., Bianco, B., & Zaia, V. (2020). Psychological stress levels in women with endometriosis: systematic review and meta-analysis of observational studies. Minerva Medica, 111(1), 90–102. https://doi.org/10.23736/S0026-4806.19.06350-X; Quiñones, M., Urrutia, R., Torres-Reverón, A., Vincent, K., & Flores, I. (2015). Anxiety, coping skills and hypothalamus-pituitary-adrenal (HPA) axis in patients with endometriosis. Journal of Reproductive Biology and Health, 3, 2. https://doi.org/10.7243/2054-0841-3-2