Endometriosis Flare Up: Causes, Symptoms and How to Relieve

endometriosis flare up

An endometriosis flare up can cause frustration and even feelings of hopelessness; but, fear not. There may be reasons why your pain seems to be increasing some of which you can tackle yourself and some may be signs pointing to additional testing. In any case, use this as a starting point to learn more about what might be going on with that pain in the endo.

endometriosis flare up

Disclaimer: This post, while informative, does not replace the diagnosis, assistance and treatment of a doctor for serious medical conditions and is not intended to diagnose or treat your health issues.

What is an endometriosis flare-up?

An endometriosis flare up is when your symptoms have largely been under control, or at a certain tolerable level, and then grow increasingly worse. You may notice a big change all at once, or progressively over the course of several months. Typically, if you are here on this page, the symptoms may even feel unmanageable and they are interferring with your daily life in a not-so-great way.

Can endo flare suddenly? Yes, it sure can depending upon several factors and your specific situation.

Endometriosis flare-up symptoms

Symptoms of endometriosis flare-up may vary from person to person. While the most popular flare symptoms are listed at or near the top, other endometriosis flare up symptoms on this list might be recognizable as well.

What does an endometriosis flare up feel like?

Symptoms of endometriosis flare up:

  1. Increase in menstrual cramps
  2. Increased bloating
  3. Feelings of fullness
  4. Headaches including around ovulation or your menstrual cycle
  5. Hives
  6. Joint soreness
  7. Increase in fatigue
  8. Increase in anxiety or depression
  9. Increase in general moodiness or ADHD
  10. Insomnia (trouble going to sleep or staying asleep)
  11. Tummy bulge that you can’t lose no matter what
  12. Increased sensitivity towards certain foods or food groups
  13. Bowel troubles (diarhea or constipation)
  14. Getting sick more easily or sore throat flare ups / generally feeling like you’re getting something
  15. Dizziness / heart palpitations after getting up or after a meal

Of course, there may be other symptoms or other co-occuring health conditions going on that could be jointly interferring with your health, but these can also be symptoms that endometriosis is thriving in your body.

What causes an endometriosis flare-up?

To understand what causes an endometriosis flare up, one must understand endometriosis at a certain level. Endometriosis is a serious, chronic disorder where endometrial tissue grows outside the uterus commonly causing severe pelvic pain and infertility. 11% of women worldwide are affected by this condition.

Endometriosis is believed to have a genetic component, so you can look at your mom, sisters or aunties and chances are if at least one has it, your chances of incidence increase.

Other causes include dysregulated gut, dysregulated immune system, retrograde menstruation, and blood sugar dysregulation. One thing all of these causes have in common on the body is STRESS. They cause stress. Throw in a stressful environment, stressful relationships, trauma or a big stressful event, and your system may hit the tipping point and cascade into endometriosis gone wild. Enter the endometriosis flare up.

When these biological processes aren’t working as the body expects, the Hypothalamic-Pituitary-Adrenal (HPT) Axis is impacted. This HPT Axis also regulates stress.

endometriosis flare up HPA and HPT axis

So, what causes endometriosis to flare up?

All of the above causes lead to a stressful situation from your body’s point of view. Let’s quickly review what stress can include:

  • Psychological stress
  • Traumatic stress
  • Electromagnetic stress
  • Infectious stress
  • Allergic stress
  • Dysbiotic stress
  • Xenobiotic stress

What does this look like more specifically?

Some of the most common causes of an endometriosis progression include:

(These explanations below are hypothetical, but commonly occur in women experiencing an endometriosis flare up).

  • Poor sleep – You go to bed late at night, reading or watching something on your phone therebyexposing yourself to blue light, EMF, and are always tired.
  • Poor diet – You have strong food cravings at all hours of the day and frequently indulge; or you have known/unknown food allergies to something that is irritating your gut and immune system.
  • Blood sugar dysregulation – You snack every few hours, usually something sweet and processed.
  • Allergies – You have known or unknown physiological reaction to a particular food that is a part of your diet frequently; you may even get hives for reasons unclear.
  • Poor detoxification processes – Your bowel movements are not regular or particularly happy experiences.
  • Low or improper movement – You might sit at a desk job all day and for get to move throughout the day.
  • Increase in adhesions, cysts or growths in the reproductive arena or throughout the body – Maye your doctor recently found ovarian cysts or uterine fibroids.
  • Infection or sickness – You have been under the weather a lot frequently and seem to catch everything, or you are recovering from a long hauler illness which taxed your immune system.

So, stress, from emotional to physical injury can trigger the stress response in the body. Add in the complexity of chronic disease such as endometriosis, poor diet and poor movement, and you are well on your way to an endometriosis flare up.

Let’s look more in depth at a few of the most common culprits. Most women with endo have these to some extent, guaranteed if flare up symptoms are being experienced.

Dysglycemia (AKA Blood Sugar Issues)

Dysglycemia occurs when the body’s fasting blood sugar is either too high or too low. The condition is a key BRAIN STRESSOR an will make the brain more sensitive and increase the liklihood of pain signaling.

If one’s blood sugars are not balancing correctly, this can be a trigger for and endometriosis flare up and cause increase pain signaling.

Fun fact: Did you know that the week before you ovulate is the most protective time for blood sugar dysregulation and insulin resistance? This is becasue estrogen has protective effects on insulin resistance. That estrogen helps you feel your best, have confidence and usually experience the least flare ups. Of course if your hormones are out of whack, this may not the be case for you, but it is a generalization.

However, too much estrogen (like those amounts found in areas of adhesion growth) can cause additional adhesions and lesions to grow. Too much estrogen can impact nerve fibers leading to nociceptive pain. This ties in with detoxification pathways as well, which help eliminate excess estrogen.

You may also like: 5 Easy Ways to Break Your Sugar Habit

Dysbiosis (AKA Gut Issues)

Dysbiosis is a huge topic all in itself, so much so that entire books can be writtne about it. There is a delicate interplay between the gut, the immune system, estrogen detoxification and several other factors (such as enzyme activity, probiotic environment) that are beyond the scope of this post. Do know that if the gut is not functioning properly, one may have difficulty binding and eliminating excess estrogen (that we already discovered can lead to nerve pain).

You may also like: Digestion and Endometriosis – Top 10 Easy Ways to Improve

Poor detoxification

There are many ways that the body can struggle with detoxification, but know that sluggish detoxification processes can lead to an endometriosis flare up. For one, it can interplay with dysglycemia and/or dysbiosis (which as we learned can lead to heightened sensitivity to pain or increased nerve pain). For another, it can cause released toxins to re-circulate in the body and cause havok. Hello autoimmune conditions, immune system dysfunction, and generally feeling horrible.

Poor motility (bowel function)

One sign of poor detoxification involves poor excretion. If you aren’t eliminating yesterday’s food today, and having at least one or ideally 2-3 bowel movements per day, chances are you are not eliminating toxins properly.

This should be double downed for women with endometriosis who have more than their fair share of toxin load in the body. (You can search my posts about living toxin free and clean living).

If you are constipated and not eliminating regularly, this can be a cause of your endometriosis flare up.

Poor liver metabolism

Remember back to that scientific chart outlining the HPA and the HPT Axis? The stress column indicated several different types of stress that can lead to dysfunction and a heightened bodily stress response.

Well, the liver is the major organ in the body that sponges up the blood and basically (ideally) cleans the blood so the blood doesn’t poison you. But sometimes that liver is doing such a huge job dealing with the toxins in our environment (air, food, water), pharmaceuticals, and any of those re-circulating toxins that haven’t yet been eliminated. Throw in some leaky gut and it is now also dealing with food debris.

All of these scenarios can lead to a sluggish liver. When the liver is sluggish, toxins aren’t filtered through efficiently or possibly at all. This back up can lead to headaches, bloating, food sensitivity, pain, and so many of the endometriosis flare up symptoms.

Excess Estrogen

A note on excess estrogen: Xenoestrogens can be found in plastics. You can find my post on the best water bottles for plastic free options, as well as explore my low toxin living posts for plastic-free recommendations. Help your liver out.

Simple Ways to Alleviate a Flare Up

How do you calm an endometriosis flare-up?

Sometimes, holistic and integrative solutions can help reduce your endometriosis flare symptoms. You know they are working when you do them for a few weeks to a few months and begin to notice subtle or huge changes in your symptoms.

Hydration: Aim for .5 ounce per pound of your body weight. Hydration nourishes your body, joints, and helps to calm your nervous system. It also pushes toxins through for excretion and elimination. If you aren’t drinking an adequate amount of filtered water each day, you aren’t taking advantage of a relatively easy approach towards healing.

Dietary practices: You may want to check out my post on getting 30 plant based foods into your diet each week, because a nutrient dense diet with help not only counteract oxidative stress, but it will nourish your nervous system, help balance your blood sugars, help with elimination and excretion and help reduce you body’s toxic load.

Getting adequate protein and fat is also important as these help slow down the sugar released in carbohydrates. Note that all vegetables are carbohydrates, though they are undoubtedly healthier for you than processed carbohydrates.

If you have known food allergies, avoid those foods long term. If you are going gluten free, make sure you are focusing on prebiotic food replacements. 70% of your dietary prebiotics come from gluten which is unfortunate because so many women with endo have gluten intolerances or allergies.

You may want to check out my post on meal spacing, as this practice can help with rest, nourishment and elimination as well.

Stress management: Work on lowering your stress load in every way possible at this time. Get adequate sleep, laughter and fun time. Slow down to a level that feel managemeable given your current situation.

Reduce Your Toxin Exposure: Start or deepen a practice related to going toxin free. Aim to review your cook and bakeware, personal products, mattress, processed foods, home allergens, VOC in new products or home renovations. Some people are very sensitive to these and they can be a component of your endo flare.

You may also like: Anxiety and Stress Relief – 10 Best Ideas At Home

Possible Signs of a Serious Flare Up

There are time when your endometriosis flare up symtoms aren’t as easily solved with lifestyle medicine. If you try to go it solo by making dietary and lifestyle changes, it can be risky. You may want to consult a doctor about assessing the severity of your endometriosis and its progression. Sometimes, an excision surgery is the only way to maximize your healing and physical wellness.


If you are experiencing an endo flare know you not alone and your situation is not hopeless. There is a pathway towards healing from the root cause and supporting your body and your time is one critical way to walk the path. Wishing you vitality!

endometriosis flare up
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