Living with endometriosis can feel like an endless uphill battle. Here, Laura Roscioli shares seven things that help her manage the physical and emotional pain, and expert-approved tips for addressing symptoms of endo.
As one of the ten per cent of women who live with endometriosis, some months are total hell. I experience periods in a way that I’ve found hard to explain to anybody, even still.
Each cycle is different. Some months I get excruciating cramps, nausea, lightheadedness and hardcore headaches during the days I bleed and nothing on either side. Other months, I have all of those symptoms in the week before my period, plus super sore boobs and back pain. Sometimes I have all of the symptoms either side of my period as well as during, and a nice dose of premenstrual dysphoric syndrome (PMDD) beforehand, too.
I remember the first time my period felt unfamiliar. I was eighteen, and in Venice with my parents. My stomach started to hurt in a way it never had before. I thought I might have food poisoning or a bladder/kidney/bowel infection. It was this stabbing pain in my lower stomach that radiated all the way through to my back. Panadol wasn’t helping. I was wearing high-waisted jeans and felt like they were going to burst. I begged my dad to take me back to the hotel so I could just curl up in a corner in the dark.
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When we got back to the hotel, I went to the bathroom and realised I had my period. I’d had it for three years at this point, but I’d never experienced this level of pain. When I told my dad, he was relieved. “Oh is that all it is?” he asked. “Thank god.”
In a way I was relieved too, because at least I didn’t have to go to hospital, it was just my period. I knew people suffered with cramps, so this just must be it. But why did no one tell me they were this painful?
I know now that extremely painful periods aren’t normal, but we’re not really taught about the inner workings of our reproductive system growing up. We’re taught how to make babies and what that looks like inside our bodies, but we’re not informed of all the wonderful and complex ways our bodies work, with hormones, genetics and all the different elements of our health that can impact how our body may respond to our menstrual cycle.
Endometriosis has certainly taken me on a journey. At first I listened to my GP and went on the pill. The classic GP response goes that contraception can help with endo because it works to reduce your estrogen levels. And, while this may work for some people, it doesn’t for all. It certainly didn’t for me.
“While endometriosis is a hormone-driven condition, it’s not just about your hormones,” says naturopath Freya Lawler, “it’s a chronic inflammatory condition.”
“We know this because if you’re put on the pill, it can work to calm the symptoms, but the endo lesions can still grow and develop.”
Endo lesions are like hormone-producing factories, Lawler explains, producing up to 400 times the amount of estrogen, making them highly inflammatory. But, if you’re someone who has endo and contraception hasn’t stopped the symptoms, it could very well mean that you have progesterone resistance.
“Progesterone resistance essentially means that synthetic hormones that are typically used to lower your estrogen will have the opposite effect – the synthetic hormone will actually behave like estrogen in your body.”
She says it can be caused by high levels of estrogen, inflammation and genetic causes. Symptoms can include chronic pelvic pain, subfertility, poor response to hormonal contraceptives and generalised inflammation.
Similarly, with the Mirena, I caved and tried it for three months as per my GP’s recommendation. Not only did my symptoms remain, but I had crippling anxiety and depression for the entire duration I was on it. I felt disassociated from my body and mentally numb.
But perhaps we’re putting too much pressure on our GPs, Lawler suggests. “Doctors are there to diagnose disease and look for red flags,” she explains. “Subtle changes to your hormones aren’t a red flag.”
Plus, the conventional reference range is super broad, she adds. Basically, this means that if a doctor is doing your blood work, they’re only going to detect a major deficiency. If your estrogen is extremely high or low, it won’t be over the conventional reference range. GPs are not educated to comprehensively review your hormonal levels and what that might mean for your body.
Realistically, in a seven-to-15-minute consultation, they don’t have the knowledge, time or resources to make you feel seen.
Through my own journey, I’ve often felt isolated by doctors. And truthfully, it’s not their fault. But there’s no denying that the experience of feeling not great, going to the doctor and being told that you’re completely fine – is lonely and stressful. You feel a little crazy, as though you’re not being taken seriously.
But equally realistically, we don’t all have the financial means or accessibility to go to an integrated GP, specialist, or amazing naturopath like Lawler herself. So, what do we do?
Having tried the “band aid fixes” that contraception can provide to people with endo, and finding that they didn’t work for me, I’ve built up my own little repertoire of things that help me get through my worst weeks with endo.
And, while I’m not medically educated by any means, I think that a lot of my own personal health journey has been a mental health journey, too.
A few weeks ago, as I went about an especially bad endo week, I started noticing all the little things I do to help myself and thought that maybe, they could help someone else too. Every person is different, every individual experience with endo is different and the things that we find to help us will certainly be different, too.
That being said, here are seven things I do to get through my worst weeks with endo – maybe you can try some of them too.
Drink fennel tea
Fennel is a natural anti-inflammatory and there’s really not much that is more comforting than a warm drink. Put the two together, and you have an incredible combo.
My nonna used to soak fennel seeds in hot water for me whenever I felt nauseous. I never knew why, but when I started to get cramping and nausea during my period, I thought I’d give fennel tea a go. It’s one of the only things that can instantly relieve my nausea during a bad bout of endo.
You can buy fennel seeds from the supermarket, pop them in a tea strainer and brew your own (it’s definitely stronger this way), or you can buy ready-made fennel tea. I buy mine from the Mediterranean Wholesalers on Sydney Road in Brunswick, Melbourne – but you should be able to get some from any wholefood or health stores.
Invest in Italian digestifs (and avoid gluten, if possible)
Another nonna classic is Italian digestifs. Spirits like Cynar or Averna are consumed in Italy after a big meal to help with digestion. They’re usually made from herbs and are super medicinal, plus generally good for your gut health.
According to Lawler, endo is very closely tied to gut health. “90 per cent of people with endo will have some form of digestive complaint,” she says.
“A lot of theories about endo come down to inflammatory bacteria, which could be due to gut health. Endo is a chronic inflammatory condition, so gut health is super important when it comes to managing and minimising your symptoms.”
I suffer from gluten intolerance, and I find that in the months I’m on top of keeping gluten out of my diet, my cramps are less extreme. This would be the same for any food intolerance you might have. In simple terms, intolerances make your body inflamed and work harder to digest. If you suffer from bad periods or endo, the less inflammation the better.
However, if you find that you’ve had a bit of a lazy month with food – you’ve eaten a few things that haven’t agreed with you or your general digestive system isn’t feeling great – an Italian digestif with some ice and lemon before bed should help.
Use neroli oil
I’m a huge fan of and advocate for essential oils. When I was little, my mum used to diffuse lavender and eucalyptus in my room when I was sick and I find them extremely calming.
Something I experience during my worst weeks of endo is quite a lot of anxiety. Some symptoms, such as brain fog, lightheadedness and nausea make me feel anxious, because I feel I don’t have any control over them and that stresses me out – especially in public or at work.
Neroli oil is my own little pocket hero. Produced from the blossom of an orange tree, it smells sweet, honeyed and a little spicy. When inhaled, it’s said to encourage the brain to release serotonin and reduce cortisol levels. Basically, it alleviates stress.
I dab some on my wrists and the base of my neck.
Keep ginger tablets on hand
Bad endo weeks often look like really intense nausea that comes on without warning in waves. I always make sure I’m stocked up with a specific ginger tablet called Travacalm –which is literally just 500mg of ginger in one small tablet.
It’s designed for motion sickness but works an absolute treat for hormonal nausea. I take two at a time when I’m super nauseous, and I’m yet to have it not work.
You can buy Travacalm from any mainstream chemist. There are two types – make sure you get the 100 per cent ginger one.
For me personally, I’ve found that natural remedies work best when it comes to managing my symptoms. I lean on things like ginger and fennel to get me through my nausea, essential oils to manage anxiety etc. And recently, I came across some natural products that were specifically designed for period pain and reproductive health; and they’ve been super effective for me.
The brand is called The Fix and it was started by Kate Everitt and Julie Moulder during covid, when they had the shocking realisation that there were no natural products in market that were made specifically for period pain.
“How have we suffered every month for 40 years of our lives and gone without treating it?” Everitt asks, as a way of explaining the thought that began their business.
The Fix has five products – XBloat, XCramp, XMood, XBreakout and XAll – that look to tackle symptoms aligning with different hormonal experiences, utilising only natural ingredients.
I’ve been using the XBloat and XAll together, which has been working super well for me. The XBloat is basically a natural anti-inflammatory, and has things like milk thistle, turmeric and fennel in it to support natural cleansing and help with inflammation (always read the label and follow directions for use if you are giving these a whirl!).
“We’re coming full circle as a society and revisiting what had been common practise decades ago for pain,” Moulder says.
“More and more women are coming off the pill and learning what synthetic hormones have been doing to their body, and it’s amazing to see that conversation happening.”
You can “shop by symptom” on The Fix’s website, and their platforms act as an educational resource too. The founders are behind all of the comms, so if you ask them a question via IG, they’ll be the ones responding. And they do so in an extremely considered, helpful and supportive way.
Chocolate and tears
Honestly, sometimes it’s just good to cry.
Hormones are connected to our emotions, and “Reducing stress can reduce inflammation directly,” Lawler says.
I’ve found it useful to sit in my uncomfortable and unpleasant feelings, instead of trying to will them away. For me, a block of 70 per cent Lindt chocolate and a film that’s going to make me cry is an indulgent and necessary experience when I’m feeling heavy and sore.
There’s no harm in trying it.
Being brutally honest with those around me
One of the biggest things about endo, for me is the shame surrounding periods and pain. I used to really struggle to be honest with those around me about how much pain I was in, because I was afraid they would roll their eyes at me, think I was being overdramatic, that I was a princess, that I couldn’t handle a little bit of extra emotional stress.
But it’s something I’ve been working on. Because period pain is valid and important, and chronic pain is extremely underrepresented. When we’re talking about a pain condition that others can’t see – especially when it’s gender-specific – it’s often misunderstood and not taken seriously. How can others empathise with something they’ve never felt and can’t see? Not to mention there’s minimal accessible information and education surrounding it.
It’s a fact that when we try to hide our pain, when we feel ashamed for feeling it at all – it just makes it worse. I’ve put myself in plenty of situations that have caused me great stress, anxiety and extra pain, just because I was too embarrassed to be honest about what I was going through.
But now I tell anyone who will listen. It doesn’t have to be extreme, if you’re having a painful day, you can just say “I just want to let you know that I have endo, and I’m having a bad day with it today” to whoever is around you – your work colleagues, friends and family. It’s actually considerate to let them know what’s going on with you, and a relief for you too – so you can be easier on yourself about how you might be presenting that day. Plus it helps to inform others of a very real experience that exists for one in ten people who menstruate.
Additional recommendations from Freya:
- “Book a consultation with a specialist if you can afford one. Endometriosis can take ages to diagnose if you keep talking to people who aren’t specialised in reproductive health and endo itself.”
- “Have an internal ultrasound. You can now be diagnosed with endo via a well-performed pelvic ultrasound by an endo specialist. It’s not a super affordable endeavour, but is a worthwhile investment to your future health. Go to an endo-related women’s clinic if possible.”
- “Make sure you’re getting plenty of zinc, magnesium, Vitamin D and B12.”
- “Avoid inflammatory foods like refined sugar, refined oils, alcohol and coffee where possible.”
- “Look into hormone testing if you can.” It’s a way of reviewing your blood work that is focused on your hormone levels – however subtle – and can help you to understand your internal makeup better.
- “Castor oil packs are amazing. Literally get a warm flannel, douse it with caster oil and hold it over your pelvis, or the pain area. It’s a bit more of a holistic intervention and can be messy. But there are zero side effects and my clients have seen incredible results. It’s worth a try.”