person on ground reaching for a heart shaped rock on a climbing wall

The Good and Bad of Exercise For My Endo

Everyone agrees that exercise is good for both physical and mental health. And a recent study shows it may even reduce the size of endo lesions. That's what happened when endo-primed* rats swam. Experts think it's because physical activity can lower oxidative stress, which contributes to inflammation.1

But for me, not all workouts are the same.

My physical therapist would agree that swimming is a good choice for someone with endo. That's because high-impact options, like running, are hard on your pelvis and lower spine. And that's terrible for someone with pelvic pain or sciatica, she told me.

And she was right. As soon as I stopped trying to run every day, some of my symptoms stopped flaring up so much. Here's a little bit more about fitness journey.

The bad parts of exercise

Running makes my endo symptoms worse. Last year, I went to see handful of doctors about pain related to running — OB-GYN, gastroenterologist, pelvic floor and physical therapists. My diaphragm cramped after half a mile. And it aggravated my sciatica, hip pain, and gave me endo belly.

My OB-GYN sent me to a GI doctor, who found nothing amiss on my upper abdominal ultrasound and endoscopy. I did do physical therapy, which helped improve my posture and ease some of my daily pain. But running still sucked. So I gave it up.

I also chose to skip the treadmill after I found out that high-impact aerobic activity can aggravate GI symptoms, especially if you have an inflammatory bowel condition.2  And long-distance running can sometimes lead to internal bleeding and anemia, especially in female athletes.3

None of that sounded good for my endo. So I found other ways to get my fitness on. More on that later.

A hard workout can amplify fatigue and muscle pain. I wouldn't say I get sleepy, but I do get physically tired during my luteal phase. That's the 12 or so days before my period starts, when progesterone rises and peaks. And if I try to do an intense workout then, exhaustion will take over for a full day or two after. My body will sometimes feel like it's bruised.

On their website, the Centers for Disease Control (CDC) explains that people with chronic fatigue or fibromyalgia — which often overlaps with endo — can get "post exertional malaise." That's when symptoms get worse 12-48 hours after physical, mental, or emotional exertion. "Vigorous aerobic exercise" can be harmful if you have these conditions, the CDC warns.4

I don't know if that's what happens to me. But it certainly feels like it. And it's helped to take it easy during my luteal phase.

The good parts of exercise

I started indoor rock climbing! Technically, it's called bouldering. It's great because it's not jarring to my pelvis or hips. Instead, I mostly use my arms, back, and core. And I can climb for hours without totaling wiping myself out. But I'm still working my heart and muscles.

Workouts always boost my mood. Research shows exercise can raise serotonin levels.5 So I agree with fellow endo advocate Jessie Madrigal, who said she likes to exercise because the mental health boost is always worth it.

How to pick the right way to work out

I can't really answer that for you. Instead, you'll need to listen to your body. For me, running and some kinds of yoga are out. But I can go for long hikes and do 15-30 minute high-intensity interval workouts (HIIT)** without paying for it, too much, the next day.

But research shows low-impact exercises, like walking and swimming, may help. And endo pain decreased in people who did the following 3 times a week:5

  • Posture correcting exercises
  • Diaphragmatic breathing
  • Lunges and squats
  • Relaxation and muscle awareness
  • Stretches for back and pelvic floor muscles
  • Walking for 20 minutes

Just try to move a little each day and do what feels right for you. And don't feel bad if you can't run a marathon. I know I don't. And my aging knees thank me.

*Scientists can take endometrial cells from humans and put them in rats. It's called an in-vivo.6
**Research shows HIIT is safe for people with inflammatory bowel disease too.2

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