Endometriosis affects approximately 600,000 women in Australia and 176 million women worldwide and, according to Endometriosis Australia, as many as 1 in 10 women suffer from this disease.
What is it?
Endometriosis occurs when endometrium-like tissue (the same tissue that lines the uterus) shows up outside the uterus, most often on the pelvic organs, the side walls of the pelvis, the outside surface of the uterus, the bowel, the ovaries, the fallopian tubes, the area between the vagina and the rectum, and sometimes the bladder.
Endometrial growths have even been known to appear on the lungs, thighs, arms, and just about anywhere in the body!
These stray bits of endometrial tissue or ‘lesions’ can behave like real endometrial tissue and bleed during menstruation, and they cause irritation and inflammation to the tissue and organs that surround them. Scar tissue forming around the lesions can result in adhesions that stick the pelvic organs together. This scar tissue may become even worse after surgery to remove the lesions. Due to the adhesions, the ‘fused’ organs are unable to move freely, making ovulation, sexual intercourse or going to the toilet painful. Over time, the endometrial lesions on the ovaries may enlarge and form cysts. These cysts are called ‘chocolate cysts’ because they are filled with old blood that is chocolate-like in colour.
Symptoms of endometriosis include painful periods (often involving intense cramps that may continue beyond the first day of bleeding), heavy bleeding, irregular periods and spotting, pelvic pain outside of menstruation, painful intercourse, and lower back, thigh or leg pain. Endometriosis can also cause infertility.
Women with severe endometriosis suffer emotionally due to anticipation of the pain, the ongoing nature of this pain and discomfort, and related difficulty in falling pregnant.
‘The pain can be totally horrific, sometimes to the point where you have to vomit. I even had a nurse recently tell me that is it considered worse than child birth,’ writes nutritionist Alexandra Middleton.
For many women with this condition it can take up to seven years to get a correct diagnosis. It’s hardly surprising therefore that women with endometriosis report feeling depressed, stressed, angry, anxious and hopeless.
Yoga for Endometriosis
There is no hard evidence that stress causes endometriosis, but it is clear it can make the condition worse and also that the condition causes stress—what’s known as the ‘vicious cycle’ of endometriosis. That’s why, as in many of the other menstrual disorders like amenorrhea (absent periods), heavy bleeding (menorrhagia) and PMS, it’s important to first and foremost make sure you reduce and manage stress in your life.
From a yoga perspective, focus on relaxing, restorative yoga practices and allow plenty of time for deep relaxation practices like Yoga Nidra. Research shows that Yoga Nidra has provided relief for women who suffer menstrual pain.
It’s also important to take time out for yourself for rest and nurturing during your menstrual period. Take a ‘dark moon’ holiday every month by reducing your domestic and external workload and withdrawing from social engagements – where possible. At the very least, practise a gentle, nourishing ‘Dark Moon Yoga Practice’ that subscribes to the all important guidelines for safe and appropriate menstrual yoga practice.
These guidelines include avoiding inversions, strong twists and backbends when you’re bleeding.
A guideline that is specific to endometriosis is to avoid deep forward bending postures as these postures constrict the belly which is already ‘jammed-up’ with the endometrial-like tissue.
Instead, focus on postures that open and create space for the abdominal and pelvic area, like supported backbending postures.
This video (a snippet from our Online Level 2 Yoga for Fertility Teacher Training course) provides a demonstration of a space-creating, ‘endo-friendly’ pose to practise during your bleed that may provide some relief.
Finally, a women who suffers from endometriosis, and in fact any of the other menstrual imbalances, should practise inversions regularly. That is of course, outside of the bleeding time. Inversions help calm the nervous system and balance our hormones.
Managing the pain
Manisha was a student of mine who suffered from severe endometriosis that caused debilitating menstrual cramps. On some days of her period she was forced to take time off work, doubled up in pain, despite taking strong painkillers. Manisha found the relaxation practices of yoga beneficial. ‘I loved the relaxation time at the start of our class, when you are encouraged to check in with your body,’ she remembers. ‘It helped me move from one space to another, like a “circuit-breaker”.’
As she lay there in a supported restorative pose, or in Savasana (the relaxation at the end of the class), Manisha was able to reflect, ‘I’m in pain, but I’m in control’.
Relaxing and breathing in this way provided Manisha with an opportunity to focus in on the pain, but not in a negative way. ‘Rather than fight the pain and feel I had to push through it, yoga taught me to simply set the intention: “Now I’m going to heal my body”,’ she explains.
For more information on yoga for endometriosis and other menstrual anomalies like fibroids, adenomyosis, polycystic ovary syndrome, amenorrhea, PMS, and heavy menstrual bleeding and cramping, read Ana Davis’ book, Moving with the Moon: Yoga, Movement and Meditation for Every Phase of your Menstrual Cycle and Beyond. This topic is also covered in depth in our upcoming Online Level 2 Yoga for Fertility Teacher Training Course.
 “Anxiety and depression in patients with endometriosis: impact and management challenges,” Lagana et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440042/
 “Six-month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform symptoms,”Rani, et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530296/
Ana Davis, Founder and Director of Bliss Baby Yoga, has a passion for a feminine approach to yoga, and supporting women with yoga through all ages and stages of their life. Ana has collaborated with Bliss Baby Yoga fertility specialist yoga teacher Rosie Matheson to create our Online Level 1 Yoga for Fertility Teacher Training. She is also the lead trainer on our popular Online Prenatal & Postnatal Yoga Teacher Training Course and Online L1 & L2 Restorative Yoga Teacher Training courses, and offers private mentoring and yoga sessions online, and online yoga classes – including a Dark Moon Classical Yoga for Menstruation Online Class.
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