Endometriosis starts when cells that are similar to the ones that normally line the inside of your womb grow outside of it. From there, the condition can affect many other parts of your body, even your whole well-being. Over time, the constant stress of managing endometriosis can weigh down your quality of life.

“The mental impact of pain and endometriosis are tied to physical well-being,” says Cara King, DO, a gynecologic surgeon and surgical educator at Cleveland Clinic. “They’re not separate things.”

Here are some tips to live your best life with endometriosis.

Work With the Right Doctor

Endometriosis can be a tricky disease. Not every gynecologist or OB/GYN is trained to treat it. It can take them a while to fully recognize your symptoms. That can lead to delayed treatment and needless frustration.

“Not being taken seriously and not having a comprehensive evaluation and treatment plan with proper goals can be very demoralizing for patients,” says Patrick Yeung Jr., MD, director of the SLUCare Center for Endometriosis in St. Louis.  

It may help to see a doctor who treats a lot of women with endometriosis. That’s often a surgeon with special training in minimally invasive gynecologic surgery or reproductive endocrinology and infertility.

If your doctor doesn’t -- or can’t -- answer all your questions, “it’s OK to get a second opinion,” King says.

Care for Your Mental Health

Living with ongoing pain can lead to depression and anxiety. And if you’re not feeling your best mentally, your physical pain may hurt even more.

Many women with endometriosis have trouble getting pregnant. That can leave you feeling frustrated or sad.

A behavioral health psychologist should be a member of your endometriosis care team, King says. A mental health professional can help you learn ways to manage your stress, including deep breathing and mindfulness. Research shows meditation may help ease depression symptoms if you have chronic pain.  

You can also ask your doctor if an antidepressant is right for you. Some medication for endometriosis contain hormones, which can affect your mood.

Get Help for Your Sex Life

Endometriosis can make you hurt before, during, or after sex. That can be tough on you and your relationship. It’s important to speak up about your pain. Your doctor may not ask you about it. A sexual therapist can guide you on how to talk openly with your partner, and learn how to relax if you get anxious about sex.

Find the Best Exercises

Movement may ease some of your endometriosis symptoms because it lowers your levels of estrogen and inflammation. At the same time, it may boost the levels of feel-good chemicals in your brain called endorphins and ease your pain.  

Jessie Madrigal, 40, dances, does yoga, or goes out for a slow jog.

“Exercise has become a really big thing in my life,” she says. “The physical side is very important for my own mental health.”

But you may need to try out a few things to see what helps. That’s because some high-impact workouts, like running, may worsen endometriosis symptoms, says Ken Sinervo, MD, medical director of the Center for Endometriosis Care in Atlanta. Instead, he suggests yoga or Pilates for more passive, gentler workouts.

Pelvic floor therapy may be a good option too. It can ease some of your muscle pain and soreness with sex.

Be Kind to Yourself

This is how Madrigal keeps her endometriosis from getting the best of her: She’s her best cheerleader.

“I realized I’m never going to be a lot of the things I thought I was going to be because I was comparing myself to people who were completely healthy,” she says. “You have to make peace with that. Then you’ll see the little triumphs. You’ll see the little things that you’re doing that are pretty incredible.”

Madrigal had trouble walking before a surgeon treated her endometriosis. She still tires a lot. But that didn’t stop her from recently running her first marathon. Madrigal wasn’t fast, but she finished.

Seek Support at Home and at Work

You may not want to tell your employer about your illness. But it’s possible that confiding to your boss may help them be more understanding if you miss work regularly because of pain or need special accommodation. For instance, they may be open to tweaking your work schedule around your menstrual cycle.

Tap your friends and family when you need a break. Give them a chance to lend a hand. Be honest with your kids or partner when you have a flare or just a tough day. They’ll be more understanding if you have to watch from the sidelines instead of joining them.

Also joining a support group online or in person can make you feel less alone. They may even help you find the care you need.

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