Despite the pain and discomfort caused by endometriosis, one of the worst symptoms of all can be the fatigue that comes along with it. Constant fatigue affects every area of your life, so if you experience this and you’re wondering what to do about it, we’re diving into the physical and emotional tiredness that can occur when living with long-term endometriosis:

How many people experience endometriosis fatigue?

It appears to be common. One study of 1,120 people with endo and 560 without found 50.7% of those with endo reported frequent fatigue, compared to just 22.4% of those without. Results remained consistent when researchers considered factors like BMI, history of depression, insomnia and more. No matter how intense other endo symptoms may be, fatigue can be present and negatively affect many areas of life. 

What is endo fatigue and why does it happen?

In other words… what is it about this condition that makes people so bloody tired?! It’s thought endo-related fatigue happens as a result of the body trying to get rid of diseased tissue. The immune system tries to attack endometriosis, causing cytokines (inflammatory toxins) to be secreted by the tissue, and these chemicals are often the cause of fatigue. 

Similar to when you feel fatigued and run-down during a bout of flu, it happens when your immune system is busy fighting something off, which takes up all your energy. Heavy menstrual bleeding is another common symptom of endo, and losing a lot of blood can lead to low iron and possible anaemia, which is known to cause fatigue. 

Why do I keep hearing about chronic fatigue syndrome? 

Chronic fatigue syndrome (CFS) is pretty much what it says on the tin; a long-term, sometimes inexplicable symptom of tiredness - in many cases, symptoms of endo can lead to this. CFS has been found to be more common in people with periods, and one 2011 study suggested those who have experienced endometriosis, ovarian cysts, irregular periods, gynaecological surgery or pelvic pain are more likely to develop CFS. 

“When I was first diagnosed [with endometriosis] I became extremely tired, even having a shower would leave me in bed for the rest of the day. I was later diagnosed with Chronic Fatigue Syndrome (CFS).”  - Louise, speaking to Endo UK

Is my endo fatigue anything to worry about? 

You shouldn’t put up with endometriosis pain, and we would encourage anyone with symptoms to visit their GP and discuss what can be done. That said, it’s not life-threatening, just incredibly frustrating, as extreme tiredness can cause you to miss out on things in favour of sleep or rest, and affect how much energy you can give to certain areas of life, for example, career, relationships, time with your kids, social activities, and more. 

In one study, 22 subjects reported feeling endo-related fatigue with varying intensity, and the majority said their tiredness was at least “somewhat bothersome”. If at the very least you experience mild fatigue every month, this is still something to discuss with your GP.

How do I handle the physical fatigue of endometriosis? 

Just like when we said it’s similar to having the flu; endometriosis fatigue can be due to a chemical reaction in the body, and therefore it’s unlikely you’ll be able to simply ‘sleep it off’.

Speak to your doctor to discuss treatment possibilities like medication, hormone therapy or surgery. They may also want to check your blood to ensure nothing in your iron levels, blood sugar or thyroid hormone could be contributing to your fatigue.

A healthy diet rich in protein can boost energy throughout the day. You could also try avoiding excess sugar, anything processed, and any ‘junk food’ for a while. 

Supplements can also improve your energy levels and have you feeling loads better in just a few weeks. Your doctor can recommend any nutritional gaps you may have. 

When you’re feeling lethargic, exercising is the furthest thing from your mind, but maintaining a gentle, low-impact exercise routine can actually improve fatigue. Try short workouts, yoga, swimming or walking to improve energy levels. 

Maintain a healthy bedtime routine to improve daytime fatigue. 7-9 hours is recommended, but try to get as much as possible by going to bed at the same time each night, having a bath beforehand, avoiding screens - all that good sleep hygiene!

How do I handle the emotional fatigue of endo? 

Endo-related fatigue is a symptom that can take a real toll on your mental health, so it’s important not to fight against tiredness, but rather, accept your need for more self-care and compassion than you may normally give yourself. Understand your body’s limitations and try restorative activities to maximise the times when you’re feeling more energised. 

Talking to others about your fatigue can also help. Covering up why you can’t make certain social plans may work as a short-term solution, but it’s much better to let friends and family know what you’re experiencing and the times when you are more likely to feel your best. If cocktail night tends to wipe you out, ask your friends to go for brunch instead - adjust your plans for a while to help manage your social life while still giving your body rest time.

Should I speak to my doctor about my fatigue?

Yes! Yes, a thousand times, yes. Please don’t ever feel that tiredness is something you can’t speak to your doctor about. If it’s negatively impacting your life, get advice on how to lessen its effects, and hopefully treat the root of the problem. 

Do you suffer from endometriosis-related fatigue? We’d love to find out how you manage it day-to-day so we can continue to share advice with others. You can ask questions on our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplementsand much more delivered easily and regularly through your letterbox, which is one big load off your mind each cycle.

Daily Life With Endometriosis Fatigue

If you’ve spent any time on the Full Stop blog, you’ll have heard the word ‘progesterone’ before, so we’re breaking down everything there is to know about this hormone. Let’s take a look at what it is, its function in the body and menstrual cycle, and the signs that indicate your progesterone levels may be out of whack. Let’s go…

According to the Society for Endocrinology, progesterone is one of a group of steroid hormones called ‘progestogens’, and it’s secreted by something called the corpus luteum inside the ovary. This happens in the second half of your menstrual cycle, and it’s important for maintaining the early stages of pregnancy, among other things. 

Is progesterone different from progestin?

Ah, yes - good question! Progeste-rone is the hormone that occurs naturally in the body, while proge-stin refers to a synthetic version that’s created in a laboratory and used for a number of medical reasons, most commonly in oral contraceptives and hormone replacement therapy. It’s pretty much the same thing and has a similar function, but one already exists within the body, and the other is man-made. 

OK, let’s get into the nitty gritty of its function. When the level of luteinizing hormone rises in the middle of your menstrual cycle, ovulation occurs, which means an egg is released from one of the ovaries. When this happens, the corpus luteum (a regular cyst that forms on the ovary every month) appears and begins to produce progesterone. This happens in order to prepare the body for pregnancy by encouraging glandular development and new blood vessels - the ideal conditions for a fertilised egg to implant. 

If the egg doesn’t implant, the corpus luteum breaks down, causing progesterone levels to dip again, which triggers your period. If a pregnancy does occur, the corpus luteum sticks around and continues to produce progesterone, which keeps blood vessels stimulated to supply the endometrium and provide nutrients to the embryo. As the placenta forms, it produces more progesterone than the corpus luteum, and this level remains constant throughout pregnancy. Along with its many other functions in the body, progesterone also helps to encourage the lactation process. 

If your progesterone levels are too high, it’s mostly nothing to worry about, but it is sometimes associated with a condition called congenital adrenal hyperplasia. High levels of progesterone are thought to occur because of this condition, they do not cause it. 

If you’re wondering whether or not the progestin in your hormonal birth control could cause it to rise to a dangerous level, the answer is: probably not. High levels of progestin are thought to be associated with a slightly increased risk of developing breast cancer, but there’s still a lot of research to be done in this area, so if this is something you are worried about, speak to your doctor about your concerns.  

Progesterone is mainly important if you are trying for or having a baby, so if your progesterone levels are too low you may encounter fertility issues, or issues with your pregnancy, but your doctor will monitor this to make sure everything is as it should be. If you aren’t pregnant or trying, there are other (mostly harmless) symptoms you may want to get checked out. These include headaches or migraines, mood changes like anxiety and depression, an irregular menstrual cycle or abnormal bleeding. 

If progesterone is too low, estrogen can sometimes become the primary hormone, which can lead to symptoms like weight gain, mood swings, low libido, depression, an irregular cycle or heavy bleeding, breast tenderness, fibroids, and gallbladder issues, so keep track of any symptoms your doctor may need to know of so they can decipher what the issue may be. 

Why does my doctor want to test my progesterone levels?

There are a few reasons your doctor may want to test your progesterone levels. This could be to find out why you are experiencing fertility issues, why you may have abnormal bleeding, to diagnose an adrenal disorder, or something else. Overall, testing your hormones just makes sure they’re doing what they’re supposed to do each month.

What are the signs that progestin is causing a problem?

If you’re taking birth control or another medication that contains progestin, you can keep an eye out for side effects that include headaches, breast tenderness, tummy issues, appetite changes, weight gain, fatigue, muscle pain, mood swings, anxiety, discharge, and more. 

It’s also important to check for more serious symptoms that need attention, such as any changes in the breasts, migraines or dizziness, changes in speech, coordination or ability to swallow, weak limbs or leg swelling, shaky hands or seizures, breathlessness, a racing heartbeat or chest pain, coughing up blood, blurred vision or eye changes, unexpected vaginal bleeding, stomach pain, skin rashes, and any unidentifiable swelling. 

This list may seem exhaustive, but many of these symptoms can indicate a problem that needs medical attention sooner rather than later, so speak to your GP or call 111 if in doubt. 

Got a question about progesterone? We’re all ears! Ask away over in our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, so that's one less thing you'll need to keep an eye on.

Menstrual Cycle Progesterone: What's It For & What It Does

If you suffer from anxiety attacks, you’ll know how scary, inconvenient and downright annoying they can be… but what triggers them? There are lots of reasons an anxiety attack might rear its ugly head, and turns out your PMS could be to blame. We’re looking at what anxiety attacks actually are, why hormones could be responsible, and how to manage them.

You’ll likely have heard the terms ‘anxiety attack’ and ‘panic attack’ used interchangeably as the symptoms are often the same, but there are some differences between the two. Symptoms of anxiety and panic attacks include a sudden, intense feeling of anxiety or fear, racing heartbeat, feeling faint or dizzy, feelings of losing control, sweating, shaking, rapid breathing, a tingling feeling, nausea, and more. 

These can last anywhere from 5 to 30 minutes, and although they’re scary, they aren’t physically dangerous. Sometimes it can be hard to distinguish the difference between a panic attack and anxiety attack, but it’s thought that anxiety attacks are mostly triggered by something seemingly stressful or threatening, and can have different levels of intensity, while panic attacks are immediately very intense and seem to appear out of nowhere.  

Looking at general anxiety, there are many reasons why this occurs. Common causes are anything that induces stress, like work pressure, financial issues, family or relationship issues, big life changes like moving house, divorce or death, and more. Other conditions that can trigger more severe anxiety attacks include social phobias, (PTSD) post-traumatic stress disorder, certain medications, or having a history of substance abuse.

Unfortunately, when it comes to anxiety and panic attacks, there’s often a vicious cycle at play; the person experiencing them becomes fearful of having another attack in public or a specific situation, and avoids this situation, leading to stress, leading to further attacks. 

Dan Harris, an American television host and author of the book 10% Happier, famously experienced a panic attack live on television, and realised his hectic lifestyle was to blame: 

“... what I had experienced on air was an overwhelming jolt of mankind’s ancient fight-or-flight response, which evolved to help us react to attacks by sabre-toothed tigers or whatever.” - Dan Harris, author of 10% Happier

For people with periods, the cause of anxiety and panic attacks could be a little different. Anxiety in general is a common symptom of PMS, due to changing levels of the hormones estrogen and progesterone. When levels rise and fall frequently during your cycle it can affect the neurotransmitters in your brain, like serotonin and dopamine, which control your mood. This is what leads to emotional symptoms of PMS such as depression, mood swings, and our old friend anxiety. 

Research suggests if you already suffer from anxiety attacks or panic attacks, then your PMS could intensify these. Also, if you suffer from a more severe form of PMS, called PMDD (premenstrual dysphoric disorder), this can cause panic attacks. One study suggests people with periods may be more susceptible to panic attacks due to hormones making them more reactive to external stressors. Another study confirms this, finding 41% of the sample reported “premenstrual worsening of panic symptoms”.

Panic attacks are a recognised symptom of PMDD (premenstrual dysphoric disorder) so if you suffer from these attacks around the same time each month, look out for other symptoms of PMDD, which include an intense irritability or anger that can affect your relationships, extreme feelings of sadness or despair, or even thoughts of suicide, intense anxiety, brain fog, fatigue, trouble sleeping, and more. If you suffer from several of these symptoms then PMDD is a possibility, and you should discuss this with your doctor. 

Managing anxiety attacks or panic attacks is easier said than done, as they can be very scary in the moment. If you are worried about anxiety attacks in day-to-day life, there are some things you can do to help prepare and ease them quicker. When an attack comes on, counting slow, deep breaths can help, but it’s mostly about remembering some key information until it passes. If possible, keep in mind:

You’re not trying to fight the attack - just let it pass

It’s not life-threatening, even if it feels like it in the moment 

It will pass, sometimes in a matter of minutes

No one around you is judging you, they only want to make sure you are OK

After an attack, pay attention to what your body needs, rest up, and if you feel up to it, tell someone you trust what happened. If you spend a lot of time with this person, let them know the signs to watch out for so they know if you’re having another one, and what to say to help you get through it. 

Having anxiety attacks at certain times during your cycle should put your mind somewhat at ease, as this confirms it’s a hormone issue and there’s nothing physical to worry about. That said, it doesn’t make them more fun or easier to manage! 

If you experience attacks throughout the month, or severe panic attacks, it’s best to speak to your doctor so they can ensure any other symptoms (such as a racing heart, nausea, etc.) are nothing serious, and start treatment that may include psychotherapy or medication. 

Do you suffer from PMS-related anxiety or panic attacks? We’d love to know your tips for managing them in daily life. Chat to others about this over in our Full Stop FB group, or reach out to us on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, which is one less thing to worry about through the month.

What's Up With PMS & Anxiety Attacks?

Jeez, make up your mind already! If your period keeps starting… then stopping… then starting again, and you can’t seem to find a pattern, you may have irregular periods, also known as oligomenorrhea. If you’re wondering what the heck is going on, here’s a deep dive on all things irregular periods. Let’s see what could be happening to your body.

What does it mean to have irregular periods? 

Having irregular periods means the length of your menstrual cycle and your bleed keeps changing, with periods arriving early or late every time and not lasting the length you expect. The average is 28 days, but not everyone will experience a cycle that’s exactly 28 - most will be shorter or longer. When puberty is over, most people end up with a cycle with a similar length of time between periods, but it’s normal for this to fluctuate by a few days each time. 

Irregular periods are normal during puberty, and if this has always been the norm for you then it’s likely fine. If not, the most common reasons for experiencing irregular periods after puberty include the use of hormonal contraception, extreme weight loss, stress, pregnancy, the beginning of menopause, or an underlying medical condition (we’ll cover these later). 

Is it normal for periods to stop and start?

For some, yes. Periods that are start/stop are pretty common, with around 14-25% of people with periods experiencing irregular menstrual cycles, according to the National Institutes of Health. It is thought that the average person loses around 2-3 tablespoons of blood in one period, consisting of some blood and some tissue from the lining of the uterus.

Sometimes this lining doesn’t shed at regular intervals, so you may have lighter and heavier days. And sometimes tissue can block the flow of blood through the cervix, resulting in a lighter flow, and potentially a start-stop pattern. If your period still lasts 3-7 days, a little fluctuation in blood flow is considered normal and probably nothing to worry about. 

What if the stop-starting happens throughout the month? 

Having a period that stops and starts frequently is often the result of hormone fluctuations. While bleeding, your estrogen and progesterone levels are low, and in the first 4 or 5 days of your cycle the pituitary gland produces more follicle-stimulating hormone (FSH) while your ovaries produce more estrogen. Then around days 5 to 7 estrogen levels reach their peak, the pituitary gland releases luteinizing hormone (LH), and progesterone levels go up. 

So there’s quite a lot happening hormone-wise! And all that activity can result in - for some people - periods that start, then stop, then start again. Hormones are typically the culprit, but outside factors that also affect this include being overly stressed, losing a lot of weight very quickly, over-exercising, pregnancy, breastfeeding, and some underlying health conditions. 

Usually irregular periods are nothing to worry about, but if you used to have a regular flow and it’s changed recently, it’s probably best to get it checked out. In some cases, a change in period flow or regularity could be an indication of an underlying health condition, such as:

Fibroids - abnormal benign growths that grow in or on the uterus

Endometriosis - when tissue grows outside the uterus, where it’s not supposed to be 

Polycystic ovary syndrome (PCOS) - when the ovaries produce excess androgen hormones and sometimes small cysts form in the ovaries

Can irregular periods themselves cause any issues?

Usually, no… but sometimes yes. Irregular periods that last a long time could cause you to be more susceptible to other issues:

Iron deficiency, or anaemia: If you lose a lot of blood due to more frequent periods, you could develop an iron deficiency 

Fertility issues: Irregular periods could mean you’re not ovulating, and therefore could struggle to get pregnant if you are trying to have a baby 

Osteoporosis: The ovulation part of your cycle produces more of the estrogen hormone, which - fun fact - helps keep bones strong! If you don’t ovulate, you may have less estrogen and have a higher risk of osteoporosis

Cardiovascular disease: As above, a lack of estrogen can also increase your risk of cardiovascular disease

Endometrial hyperplasia: Without regular periods to shed the uterine lining, you could be at higher risk of developing this condition in which the uterus lining becomes abnormally thick. This can increase the risk of endometrial cancer, so it’s important to have it checked out 

Irregular periods may not seem like something to go to a doctor about, but if you have just started experiencing a random pattern of periods and you don’t know why, it’s probably a good idea to get it checked out to make sure everything is A-OK. Similarly, if you are in any pain, you should always see your doctor to rule out anything serious. 

You get abnormally heavy bleeding (as in, need more than one tampon or pad every hour for a few hours)

Your periods last longer than 7 days (yikes!), or they’re less than 21 days apart, or more than 35 days apart 

Your periods have disappeared for longer than 3 months (and you’re not pregnant)

You have bleeding or spotting between periods, or experiencing unusual discharge 

You experience any severe or new pain during your period, or nausea and vomiting

You have any of the symptoms of TSS (toxic shock syndrome) like fever, diarrhoea or dizziness

Still wondering why your period might be irregular? You can chat with others over on our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie - we’re always happy to help you find the answers you need! Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, whatever your flow.

Periods Stopping & Starting: What's Happening?

PCOS has a lot to answer for, but whether its symptoms include worse period pain is up for debate. We’re taking a closer look at how PCOS affects menstruation, and answering the big questions; is this what’s making your period pain worse? What’s with the heavy bleeding and irregular menstruation? When is it time to see a doctor? Let’s dive in. 

PCOS stands for polycystic ovary syndrome and it’s thought to affect around 1 in 10 people who menstruate in the UK. It’s when the ovaries contain harmless follicles that can grow up to 8mm in size. These are underdeveloped sacs where eggs grow, but in those with PCOS the eggs don’t always release, which means ovulation doesn’t always occur. The main feature of PCOS is irregular periods due to lack of ovulation, but could it be the cause of painful periods too? 

One of the main symptoms of PCOS is having irregular periods or in some cases no periods at all. Some people with PCOS may also experience heavy bleeding during menstruation - the technical name for this is menorrhagia. It’s caused by low levels of progesterone associated with PCOS. But how much blood is too much, you ask? 

Good question. Menorrhagia is often characterised by heavy bleeding that lasts more than 7 days, and while the average blood loss in a normal period is around 40ml, those with menorrhagia might pass more than 80ml of blood, and experience clots too. 

How does irregular or heavy bleeding occur? 

There are different intensities of PCOS, but if you have the condition, your cycle most likely works a little differently to others; each month, a follicle matures and is released by an ovary to be fertilised, but if you have PCOS you may have high levels of androgen hormones (like testosterone) which interfere with ovulation. This hormone imbalance causes the follicle not to develop or release, and instead it just stays put in the ovaries. 

But what’s with the heavy bleeding? When ovulation doesn’t occur, the uterus doesn’t know it’s time to shed its lining, and so your period may not arrive on cue like it should. This looks different for everyone with PCOS, as some people experience a regular cycle with no issues and will bleed every 28 days, while others may only have a period every 30-40 days, making it much heavier. Or they may not get a period at all. 

If you’re of the mindset that fewer periods is a good thing (who needs ‘em, right?!) you should still see a doctor if you are getting fewer than 8 or 9 periods a year, as this can negatively affect your long-term health. 

So could PCOS be what’s causing my painful periods? 

PCOS is known to make periods heavier, irregular, or disappear entirely, and produce what’s considered a ‘normal’ level of period pain from cramps, but there’s little research on whether or not it’s the cause of severe period pain. Although PCOS can lead to heavy periods, and enlarged ovaries with cysts which could be the cause of severe menstrual pain, it’s less likely this is the case and more likely there’s another condition at play. 

The more likely scenario is a secondary condition, such as endometriosis, which is known to make periods severely painful. If you have already been diagnosed with PCOS and you’re experiencing intense pains, it may be a good idea to get this checked out to make sure nothing else is going on. Don’t assume it’s PCOS and put up with it; if in doubt, go see your doctor. It’s rare to have both PCOS and endo, but it’s not impossible. 

What can I do about intense period pain? 

The first step is always to see your GP so they can rule out any major issues and find the root of the problem. Your doctor can recommend treatments for PCOS or any other condition they find to be causing the pain. Alternatively, they may simply treat the pain itself by recommending a change in diet and exercise to improve your overall health. If you have PCOS, a healthy diet is often recommended as this can help your body to utilise insulin more efficiently, lower blood glucose levels, and increase ovulation activity.

Your doctor may also treat period pain by recommending hormonal birth control to help regulate the menstrual cycle and lower androgen levels. In rare cases, some other medications are recommended (like diabetes medication) which can be used to lower insulin resistance in people with PCOS and reduce androgen levels to help with regular ovulation.

How can I speed up the process of diagnosis? 

Although doctors are much more aware of period-related conditions than in years gone by, it’s still helpful to provide as much information as possible about the symptoms you are experiencing in order to get to the root of the problem faster. 

Keep a diary of your symptoms and any other helpful information that can offer insight into your day-to-day. Doctors can use this to spot patterns and figure out what might be going on with your hormones. Write down symptoms like period pain and heavy bleeding, how long they last, when they occur. If you take painkillers for period pain, it’s also a good idea to write down what kind you take and how often you need them. The more information you can provide, the easier diagnosis will be, and the quicker you’ll be treated. 

Got a question about PCOS or period pain? Our Full Stop FB group is a great place to discuss symptoms with others who may have similar conditions. You can also reach out to us directly on Instagram at @itsyoppie, and our team will do our very best to help. Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to help keep at least some of that PCOS pain under control each month.

PCOS Period Pain: Is It Really Worse?

Those with long-term endometriosis symptoms will know it can take over your whole life. From career to relationships to simply doing your weekly food shop; everything is affected when symptoms arise, and while sometimes they only show up during your period, this isn’t always the case, and the mental health symptoms of endo can appear any time. Let’s look at what’s causing them and how to cope…

What are the physical symptoms of endometriosis? 

Endometriosis is a condition where tissue that’s supposed to grow in the uterus grows elsewhere in the pelvis, like the ovaries and fallopian tubes. The main physical symptoms of endo typically happen in conjunction with your period - but not always.

These include pelvic pain, cramping, lower back and abdominal pain, pain during or after sex, pain when going to the toilet, excessive bleeding, bleeding between periods, fertility issues, fatigue, and more. Just a whole lot of pain and discomfort really! Everyone experiences different levels, but whether symptoms are mild for you, or severe and debilitating, you could still experience emotional symptoms alongside. 

These can include low mood, anxiety, depression, irritability, and more. One 2013 study found people with endo had a lower quality of life, with the reasons being primarily chronic pain and dyspareunia (pain during sex). The study found around 86% of 109 patients reported depression symptoms, while 87% reported anxiety symptoms.

What’s causing these emotional symptoms? 

According to a 2017 literature review, people with endometriosis reported high incidences of psychiatric conditions like depression and anxiety, and while research suggests there is a link between the two, it’s not clear whether or not endo directly causes depression. Here are some of the other potential causes:

A 2018 meta-analysis suggested endo sufferers who experienced pelvic pain as a primary symptom had significantly higher rates of depression. Researchers recommend further study in this area, as it’s unfortunately difficult to untangle this vicious cycle: your endometriosis causes chronic pelvic pain, which leads to psychological distress, which leads to increased pelvic pain, and the cycle continues. 

If fatigue is your primary endo-related concern, this could be what’s causing your emotional symptoms. Endo fatigue happens when the body tries to get rid of diseased tissue, causing cytokines (proteins that are inflammatory modulators) to be secreted, causing fatigue. Endo-specific fatigue can cause a change in attitude; a good example of this is if you have ever found yourself skipping day-to-day activities when you’re normally a social butterfly. 

Studies have also found those with endometriosis sometimes suffer from lower self-esteem and negative body image due to, for example, limitations the body experiences when in pain, or physical changes from endo surgery scars, weight gain from hormonal therapy, and more. 

Endometriosis is known to cause fertility issues for some people, so those who are trying for a baby and struggling to conceive may also experience emotional symptoms such as depression and anxiety. 

And then there’s the fact that as of 2017, getting an endo diagnosis in the UK took on average 7.5 years. Yes, years. One study titled ‘The social and psychological impact of endometriosis on women's lives’ stated “Several papers suggest that prior to diagnosis, women commonly experience repeated visits to doctors where symptoms are normalized, dismissed and/or trivialized, resulting in women feeling ignored and disbelieved.”

Very good question! If you are in a relationship and suffering from endometriosis, or you are in a relationship with someone who has the condition, it can affect the mental health of both partners. It’s difficult to see a partner in pain, and this can have a negative impact on the quality of your life together; work, social responsibilities, childcare, financial responsibilities, your sex life, everyday tasks around the house and more, it’s all at risk of disruption. 

Whichever side of the coin you find yourself on, communication is key. As the person in pain, sharing what you need will help your partner learn how to support you, and remember you can both attend a GP appointment together if you feel comfortable, to support each other, absorb information, and discuss the best possible treatment for you and your family. 

My endometriosis is taking over my life. What can I do about it? 

If you are experiencing any of the symptoms mentioned above, under no circumstances should you be ignoring the pain or downplaying it - whether you suspect endometriosis or not, go see your doctor without delay. 

Although historically many people have struggled to get a diagnosis for endo, there is now much more awareness around this condition, so speak to your doctor about possible treatments which may include pain medications, hormone therapy, fertility treatment, and in some cases surgical treatments. Treating the underlying endometriosis can have an immediate and significant positive impact on your mental health.

Dealing with chronic pain is a notoriously difficult thing to handle, and although your doctor can help you get a proper diagnosis and improve your symptoms, in the meantime maintaining a healthy lifestyle (such as exercising when possible and eating nutritious foods) can help you feel more in control of your symptoms. 

In addition, joining a community of others with similar issues could provide a place to talk it out. Endometriosis UK has a list of support groups focused on living with endo, and you can also join our Full Stop FB group to discuss it with others suffering from their own period-related conditions.

Got a question about endometriosis and mental health? You can always reach out to our friendly team on our Instagram at @itsyoppie. Don't forget that our personalised period box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, which is one big load off your mind each cycle.

Endo Feels: Endometriosis & Mental Health

If the idea of having your cervix prodded makes you feel a bit ill, we’re here to break down everything you need to know about this rather uncomfortable but incredibly necessary test; what it is, why you need it, what happens during, what the results mean, and more. It’s time to take the scariness out of cervical screening because it’s really nothing to worry about… smear-ly a quick test to make sure everything’s healthy!

Cervical screening is often referred to as a “smear test”, which isn’t the nicest sounding name, we’ll admit! It’s basically a quick swab-style test that checks the health of your cervix - that’s the opening of your womb. It’s good to remember this isn’t a test for cancer, it simply checks for abnormal cells that could help prevent cancer further down the line. 

Scary stories of painful screenings are largely untrue, and are the reason so many people avoid getting their test done, even though often it’s barely felt and over in seconds. During a cervical screening appointment, a tiny sample of cells will be taken from your cervix and checked for certain types of HPV (human papillomavirus). These types are considered “high-risk”, and more likely to cause changes to cells that can lead to cancer. Pretty much all cases of cervical cancer can be linked back to these high-risk types.

Cervical cancer is very rare in people younger than 25, so in the UK the NHS cervical screening programme invites women between the ages of 25 and 64, even if they have been vaccinated through the HPV vaccination programme, as this does not protect against all kinds of HPV. 

Cervical screening is also offered to anyone who has a cervix but does not identify as female (for example trans men or non-binary people). According to the Gov.uk website, anyone within the age range above who is registered with a GP as female will automatically receive an invitation to book a test. However, this means people registered as male may not receive this invitation. If this applies to you, remember you are entitled to screening if you have a cervix, so speak to your GP or another service (see below) about getting this done.

I really don’t want to do it. Do I have to?

Many people hesitate to book their appointment, but we can’t stress enough; this screening could save your life. Yes, it’s uncomfortable. And yes, it’s probably not the top of your to-do list, but for most people it’s a very small price to pay to prevent something that could turn into a major issue. If you don’t want to visit your GP for this, you can do it at a separate sexual health clinic, and there are also specialist clinics for people who may need additional support. 

CliniQ is a holistic sexual health and wellbeing service for trans people, partners and friends, offering cervical screening in a safe, confidential space for those who don’t feel comfortable using mainstream services. My Body Back Project is a specialist service offering screening to those who have experienced sexual assault, with specially trained, all-female staff.

What can I expect at a cervical screening? 

It’s recommended to go for your screening on a day when you don’t have your period, and you may want to bring some wet wipes to freshen up ‘down there’ before the screening begins. It’s typically a female nurse who will do the test, which will only take a minute or two - sometimes less. You will be asked to take off your clothes from the waist down, including underwear, and lie on a bed with a paper towel to cover your hips, with your knees apart. 

The nurse will use a plastic instrument called a speculum covered in a lubricant so it slides into your vagina easily. This helps them see and access the cervix, and sometimes feels more uncomfortable if you are tense, so try to take deep relaxing breaths before insertion.

A soft brush will be inserted and rotated a few times to take samples of cells from your cervix. Many people don’t feel this at all, but if you do it’s unlikely to be painful. The speculum is removed, you get dressed again, and the sample is put into a pot of liquid and sent to the lab for testing. Job done! 

For most people, nothing! You'll usually get your results in around 2 weeks, and this letter will explain any further action needed. You’ll then be invited again in 3 to 5 years, depending on your age and where you live. In some cases, you may be asked to return in 3 months to have the test again. This doesn’t mean anything is wrong, it could just mean the results were unclear. Although it’s frustrating, it’s best to go along and get another test. 

To put the results as simply as possible: 

‘No HPV found’ means you do not have high-risk HPV, and you will be invited back for cervical screening in 3 to 5 years depending on your age and where you live 

‘HPV found with no cell changes’ means you have high-risk HPV, but no changes to cervical cells, meaning you will be invited for cervical screening sooner (often in 1 year) to check the HPV has gone away by itself 

‘HPV found with cell changes’ means you have high-risk HPV and cervical cell changes, and this is when you will be invited to go for a colposcopy and further tests, and potentially discuss treatment to prevent further cell changes 

Many people see anything less than a normal result and assume ‘it must be cancer!’ but that’s rarely the case. The majority of results come back normal, but if anything needs looked into further, your doctor will explain the course of action to keep you healthy. 

Got a question about cervical cancer screening? Our Full Stop FB group is an inclusive, understanding place to share your worries, or you can ask us questions directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, so that's one less thing to worry about with everything that can be going on down there.

An All-In Guide To Cervical Cancer Screening

More and more people are choosing to try initiatives like meat-free Mondays and Veganuary, or becoming full-time vegans or vegetarians, whether for their health, their love of animals, or for the environment. Going vegan or veggie can be a positive choice for a number of reasons, but we wondered; what if it could help your PCOS symptoms? Let’s take a look…

How does my diet affect my PCOS symptoms? 

Diet has such a big impact on every part of our lives, even if we don’t suffer from a health condition. For those with PCOS however, symptoms can sometimes worsen depending on what you eat. This is because people with PCOS are often insulin resistant, and when they experience a higher insulin level than normal and their blood sugar rises, their body tries to balance it by producing more insulin. It’s these high levels of insulin that can cause the ovaries to make more androgens… the hormones responsible for the PCOS symptoms you know and loathe!

Though more research is needed in this area, it is believed that consuming excess red meat - such as steaks, hamburgers and pork - could exacerbate the symptoms of PCOS, so in theory, a vegetarian diet could help. Some studies have found mixed results, stating that those who ate a typical Western diet, and those who ate solely plant-based, were associated with a higher risk of PCOS, while those who ate a mixed diet were associated with a lower risk of PCOS. If this is the case, it could suggest that a semi-vegetarian approach may be the way to go, i.e. eating more plant-based as opposed to entirely plant-based. 

So being a full-time vegan… won’t help my PCOS? 

There is a lot of anecdotal evidence to support the idea that eating vegan will cure just about any ailment you can think of. This is untrue (case in point; the study mentioned above suggests veganism produced less results when it came to easing PCOS symptoms)... however! We can’t ignore that a plant-based diet has been found to produce some rather undeniable anti-inflammatory benefits which can have positive effects all round, whether you have PCOS or not. 

Since PCOS is known as a pro-inflammatory syndrome that’s linked to issues such as high cholesterol, nutrition deficiencies and gut health, a vegan diet that is high in fibre and essential nutrients can lower cholesterol and LDL (low-density lipoprotein) levels, and improve symptoms as a result. And being a diet that naturally eliminates some of the most inflammatory foods, it has the potential to help improve gut bacteria, reduce inflammation, control insulin resistance, balance hormones and more. 

It would also appear from this study (which features a number of different diets) that a vegan diet was the most effective in producing weight loss results in those with PCOS, which can subsequently benefit symptoms. Taking into account these anti-inflammatory and weight loss elements, there seems to be the potential to improve PCOS symptoms with a plant-based diet, so with your doctor’s approval, it may be one to try if you want to improve yours. 

What about a diet that’s just anti-inflammatory?

If you’re not quite ready or uninterested in switching to a fully vegan diet, you could still see benefits from simply focusing on anti-inflammatory foods. One study published in the North American Journal of Medical Sciences found that those with PCOS who followed an anti-inflammatory diet for three months were successful in losing 7% of their body weight, and showed notable improvements in blood pressure, cholesterol and inflammatory markers. They also noted improvements in patients’ menstrual cycles, with 63% of participants returning to a ‘normal’ cycle, and 12% conceiving while following the diet. 

As with anything diet-related, it’s important to note that not everyone will have the same positive results, but it’s good to know your options when it comes to managing PCOS symptoms. And remember, always consult your doctor to ensure they know of any drastic changes you plan to make, in case these affect your treatment or medications. 

I’m still not sure. Should I go vegan or veggie for my PCOS symptoms? 

Ultimately, if you want to try a plant-based diet and your doctor feels it won’t interfere with any treatment you are on, then this could be a good way to improve symptoms. Remember to ensure you include enough of the nutrients that are important for those with PCOS but sometimes neglected when eating plant-based. We’re talking fibre, plant-based protein, omega-3 fats, and more - it’s not just about cutting foods out, it’s about including the vitamins and minerals you need. 

If you’re not ready to join in on the plant-based hype yet, you may still see results by reducing your meat intake and focusing on including more nutritious foods. A sort of flexitarian approach, if you will! This can help you see how your body reacts, and if the results are positive, slowly transition to more of a plant-based diet if you feel it’s right for you. 

Have you tried a diet change to help improve PCOS symptoms? We’d love to hear about your results! Our Full Stop FB group is a great place to chat to others who may be trying to improve symptoms, and if you have any Qs reach out to us on Instagram at @itsyoppie. Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to help keep at least some of that PCOS pain under control each month.

Can A Vegetarian Or Vegan Diet For PCOS Actually Help?

Wait, what?! Yes, you read the headline right. Firstly, if you suffer from heartburn or indigestion issues during PMS you can breathe a sigh of relief - it’s not all in your head (well, for the most part). PMS is known for causing gastrointestinal issues, but the reason behind this may surprise you (spoiler: it’s the brain). Here’s everything you need to know about these unusual PMS symptoms, why they happen and what to do about it… 

You’ve probably heard of the period poops (we wrote a whole article on them here), but what if your issues start further up the digestive tract? Gastrointestinal issues are common PMS symptoms both before and during your period, and can include anything from general indigestion to bloating to reflux. They mimic symptoms found in those with IBS (irritable bowel syndrome), like abdominal bloating, cramping, diarrhoea, constipation, gas and more. If you suffer from IBS, your period may exacerbate your usual symptoms. 

One study found 73% of respondents said they experienced at least one of the main gastrointestinal symptoms around menstruation, with abdominal pain being the most common. If indigestion is your thing, this is likely caused in the same way; rising estrogen can affect receptors in your stomach and small intestine, causing all sorts of symptoms. 

What about PMS heartburn? Is that normal?

PMS-related heartburn is no different to regular heartburn, and it tends to feel like a burning sensation in your chest - near your breastbone - after you eat. This can intensify if you jump or bend over, for example during exercise. It happens due to the same hormone fluctuations, which can cause the muscles in the oesophagus to relax, leading to food, liquid and stomach acids making their way back into the oesophagus and causing an irritating acidic sensation - hello heartburn! It’s relatively common (and totally normal) although it can be uncomfortable. 

What if I have heartburn but my period never comes?

It’s also worth noting that heartburn can be an early sign of pregnancy, so if you notice digestive issues that differ from your usual symptoms, and you think you might be pregnant, it’s best to take a test or speak to your doctor to either confirm or rule this out. 

This is where it gets really interesting! In the same study mentioned earlier, those who experienced emotional issues before or during their period (such as depression and anxiety) were more likely to report multiple (that’s two or more) gastrointestinal issues as part of their PMS symptoms. Those who suffered from fatigue before and during PMS found they were also more susceptible to gastrointestinal issues. 

In recent years, science has become fascinated with emerging data around the gut-brain connection, thanks to a cool nerve called the vagus nerve (yes, like viva las vagus). This nerve is the longest of the 12 pairs of cranial nerves that come from the brain, and the most complex, transmitting information to and from the brain to elsewhere in the body. There’s still so much we don’t know about this incredible connection, but what we do know - put very simply - is this: what you eat affects your brain, and your brain affects your stomach and abdominal area. Amazing, but no doubt frustrating if you suffer from these issues.

Although gastrointestinal issues with PMS symptoms can be irritating and uncomfortable or even painful, there are some treatment options that can help. Here’s what to try: 

PMS-related heartburn can be treated in the same way as regular heartburn, with an over-the-counter medicine to neutralise stomach acid and reduce discomfort. If you think you need something stronger, or your body gets used to this medicine, you may wish to speak to your doctor and find a treatment that will work for you long term. 

Be mindful of what you eat before your period. Foods that can trigger heartburn or indigestion differ from person to person, so spend time figuring out what may cause your upset stomach and cut this out in the week before your period is due. Removing anything acidic or spicy is a good place to start, but if bloating is your main problem try removing some of the cruciferous veggies and fizzy drinks from your diet. 

Sit properly when eating a meal (no slouching) and if needed, elevate your head and chest while sleeping to manage reflux. This can be achieved by placing a pillow or another object underneath the head end of your mattress to create a slight incline. 

Birth control may also help to relieve some gastrointestinal issues, with one study finding the combined pill improved bloating. 

Exercise regularly to ease the discomfort of gastrointestinal issues. It can seem counterintuitive when all you want to do is be horizontal, but moving around can help to relieve trapped wind and get your stomach working as it’s supposed to. 

Mindfulness isn’t for everyone, but if you’re into the gut-brain connection like we are, then this one may be up your street; one study found mindfulness meditations helped relieve symptoms of depression in those with gastroesophageal reflux disease, so there could be benefits in incorporating mindfulness practice into your routine.

Do you suffer from issues with indigestion and heartburn during your cycle? Chat with others over on our Full Stop FB group, and reach out to us on Instagram at @itsyoppie to ask any questions you may have. Don't forget that our personalised period box can get organic tampons, supplements for bloating and much more delivered easily and regularly through your letterbox as often as your cycle needs it, to stop those PMS symptoms from completely ruining life.

PMS Heartburn & Indigestion: Is Your Brain To Blame?

Having balanced hormones is a good way to keep everything running smoothly; as well as all that female body stuff your body is loaded with hormones that act as messengers between your body’s cells and systems. Things always go wrong if messages can’t reach their destination or get garbled on the way (and we don’t just mean when your email accidentally hits a spam filter), so paying attention to these hormone postmen is worth your time.

Of course there are plenty of annoying conditions out there like PCOS or endometriosis that can diddle with your hormone levels and cause side effects from fatigue to acne and more, but even if you’re stuck with something like this you can still tailor your workout plans to get a bit of re-balancing benefit for those pesky pituitary problems! Give these four exercise types a try, courtesy of some tips from the workout experts at Adidas…

HIIT is great for an intense but brief workout – maximum sweat, minimum minutes! It focuses on boosting heart rate which makes it great for boosting growth hormones (the guys that build muscle and burn fat) and improving insulin sensitivity. Most routines are short but pretty punishing; for example, 30 seconds of sprints followed by 45 seconds of rest for 15-20 minutes a couple of times a week. Oof!

Get that body pumping! Good strength training is a full-body workout, great for both building muscle (duh) and burning fat as you do. It also promotes hormonal changes, improving the release of testosterone and balancing cortisol levels; since cortisol is an “alarm system” hormone that handles reactions like stress, motivation and mood, this is definitely one you want to keep in a good place as both too much and too little can cause problems. Handily, strength training 2-3 times a week helps everything stay on an even keel, so as well as weights you can include resistance moves like pushups, pullups, squats and lunges.

Yep, definitely an easy one! Whether by yourself, with a pal or with a dog (or whatever) walking is a great and simple way to help keep stress hormones down and endorphins (the “feel good” chemicals that relieve pain and boost happiness) on the up. You can speed walk or just amble along to smell the flowers, so this doesn’t need to be an intense workout so much as some light exercise. There are other benefits to getting outside for a bit, but even on a treadmill a 30 minute walk 3-5 times a week can see benefits.

Yoga is a classic workout for stress reduction and in general less stress = better balanced hormones. Even better, a lot of yoga routines include a focus on breathing, which helps your endocrine system (that’s the thing in your body that’s all hormone powered) function more effectively. That’s got to be a winner, right?

You can try some different flavours of yoga to mix things up a bit. Hatha Yoga, for example, has a slow, relaxed flow that focuses on balancing body and mind. Physical postures are gradual and sustained, with more flexibility and strength needed in poses alongside good breathing technique. For something more intense, try Vinyasa Yoga, which moves directly from one pose to the next while coordinating with your breathing – the idea is to feel like your breath is directly moving your body. Very zen.

Try a little record sheet or workout app (like one of these) to help you track what you’ve tried and what seems to work best for you. Don’t forget to include a rest day, and to allow flexibility in the schedule depending on what stage of your menstrual cycle you’re in – tailoring workouts to your cycle will help boost those benefits and avoid losing heart from an “off” day.

Make sure you use good equipment like proper weights or dumbbells (Glamour has a nice buyer’s guide) and decent workout clothes that are comfy but practical (not hard to find, from the cheap and cheerful like Matalan or Decathlon to the more fancy and technical like Gymshark or Under Armor). Good footwear is a must (you can do yoga barefoot but probably want trainers for everything else!) whether you grab a bargain from somewhere like Shoezone or go more high end with a brand like our pals at Adidas, don’t forget a solid sports bra (most gym clothes sellers will do these too) and, of course, a cute water bottle to make sure you stay hydrated.

How do you like to plan or schedule your workouts? Have you tried a hormone-balancing exercise routine, and did it work? Shout out in our private Facebook group or drop us a note on Insta @itsyoppie to tell us all about it! Don't forget that our personalised period box can get organic tampons, PMS supplements and more delivered easily and regularly through your letterbox, giving you more time each month to focus on those fitness (or other!) goals.

Talking Hormone Balancing Workouts With Adidas

On top of all the other things endo stops us doing, now it’s here to ruin our Friday night glass of Chardonnay?! Before you swear off the booze altogether, let’s take a closer look at the relationship between endometriosis and alcohol. Whether you take a drink occasionally, regularly or often, we’re sharing everything you need to know about how it affects your endo symptoms, and what to do about it. 

You can drink even if you suffer from endometriosis, but it could be affecting your symptoms, so - depending on how bad you experience those symptoms - it may not seem worth it to you. Understanding how your body works and how different substances could affect it is key in keeping your symptoms under control. 

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Daily Life With Endometriosis Fatigue

Menstrual Cycle Progesterone: What's It For & What It Does

What's Up With PMS & Anxiety Attacks?

Periods Stopping & Starting: What's Happening?

PCOS Period Pain: Is It Really Worse?

Endo Feels: Endometriosis & Mental Health

An All-In Guide To Cervical Cancer Screening

Can A Vegetarian Or Vegan Diet For PCOS Actually Help?

PMS Heartburn & Indigestion: Is Your Brain To Blame?

Talking Hormone Balancing Workouts With Adidas

Endometriosis & Alcohol: The Stealthy Symptom Aggravator

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