Perhaps you've never heard of it, or maybe you've come across the name but aren't quite sure what it means – endometriosis is a relatively common condition, affecting one in ten girls, women, and those assigned female at birth who can menstruate. That adds up to 1.5 million people in the U.K. alone. Yet the condition continues to be widely misunderstood.

Endometriosis develops when cells similar to the ones lining the womb grow outside of it. These cells will still respond to the hormones in the menstrual cycle, which can cause extremely painful periods, inflammation, chronic pelvic pain, infertility, and fatigue. Although symptoms can vary significantly from person to person, it isn’t uncommon for endometriosis to interfere with day-to-day life, and exercise.

Gym Training Around Your Menstrual Cycle

Everything I share here comes from my personal history of training with endometriosis and my experience as a coach and trainer to help others navigate their fitness routines around this condition. It is important to understand that this is not medical advice. If you are unsure about what’s best for you, please check with a medical professional.

Much has been written about training around your menstrual cycle. The general consensus, based on an average 28-day menstrual cycle, is as follows -

• Menstruation (days 1-7) - Your oestrogen and progesterone (two key hormones in your cycle) levels are at their lowest. You may feel very tired and suffer with period cramps. Rest or gentle exercise such as yoga, walking, swimming, and low-intensity weight training is recommended during this phase.

• Follicular phase (days 8-13) - Your hormone levels increase, resulting in increased energy levels. This is the time for high-intensity exercise on the Air Bike and strength training.

• Ovulation (day 14) - Your hormone levels continue to be high and for some women, this is when they feel their strongest. This can be a great time to push yourself and break past plateaus or try for a new personal best. Those 20kg Dumbbells will feel so much lighter than on other days

• Luteal phase (days 15-28) - In this phase, your oestrogen levels will start to drop while progesterone levels peak. As your menstruation approaches, you’ll start to feel tired more quickly, and training can feel like an uphill battle. Time to reduce the intensity, pick up a Fabric Resistance Band, and go a little easier on yourself.

How Does Endometriosis Impact Exercise?

For many women, planning their training around their cycle has been a useful way to optimise their routines. However, it’s not a one-size-fits-all approach. And for women with endometriosis, training around their cycle might look very different.

Their menstruation phase is an entirely different experience. During menstruation, the cells growing outside the womb will break down and bleed like normal uterine tissue. However, there is no way for these cells to leave the body, which then leads to severe pain, inflammation, and the build-up of scar tissue. This can leave women bedbound for days. I would like to stress that this time spent in bed (and away from the gym) is absolutely not the same as resting. Resting means relaxing and a recovery of strength. An endometriosis flare-up means being actively ill. Rest and recovery, then, need to happen once the symptoms have calmed down. This period of rest, followed by a gentle return to exercise, will likely extend into the follicular phase, leaving you with less ‘good days’ for intensive training.

Whereas ovulation can be a peak-performance day for some, for people with endometriosis, it can trigger a mid-cycle flare-up. Due to chronic inflammation, scar tissue, and perhaps even adhesions between organs, this phase in the cycle may cause severe pelvic pain. Your ability to move, brace your core, and even breathe can be affected. These are not conditions in which attempting a personal best would be advisable.

Some people with endometriosis experience chronic pelvic pain and flare-ups that are not in any obvious way connected to their cycles. This can have a serious impact on someone’s energy reserve regardless of hormone levels.

How To Exercise with Endometriosis

Regular and progressive training may seem less straightforward for people with endometriosis – and it often is. But it is certainly not impossible to enjoy exercise and train hard with this condition. Over the years, I have found ways to train and use Gym Equipment that work for me. It has been a road of trial and error, but the overall benefits of moving and challenging my body have always outweighed the negatives. If you suffer with endometriosis and are trying to find an exercise routine that works, I have the following tips for you -

• Know your triggers - Some women find that heavy lifting triggers pain. Others have experienced something similar when they run or jump. However, there is no conclusive evidence that suggests certain exercises should be off limits for people with endometriosis. This then means that you get to experiment with what type of exercise works for you. Try logging your training and symptoms. Do you see any connections between the two? Use this information to adjust your routine if needed.

• Listen to your body - Endometriosis can cause a very wide range of symptoms that may evolve over time. What works for you one month may not work the next. It’s important that you are open to the signals your body is sending you and are flexible with how you train. Pushing yourself through intense workouts when your body needs to take a break can aggravate symptoms and lead to injury.

• Seek expert advice - If you are having trouble finding a type of exercise or routine that works with your symptoms, don’t be afraid to ask for help. A specialised personal trainer or medical professional can guide you in the right direction.

• Keep moving - Rest is essential when managing endometriosis, but I would also encourage you to keep moving when you can – even when it’s just a short walk outside or some light mobility exercises. Staying active, even on rough days, helps to keep exercise a part of your routine, which can make a huge difference in how you feel both physically and mentally.

Endolife Documentary

I recently wrote and directed a short documentary about living with endometriosis called ‘Endolife’. I made this film to shed light on the impact of the condition for people who are not familiar with it. Endometriosis isn’t visible, and in my experience, many people find it hard to understand just how debilitating the symptoms can be. I also hope that this film will start more conversations about the condition. If 10% of women have endometriosis, chances are that you know at least one person who has it – and they’d love your support.

‘Endolife’ is about to begin its festival run, which means it will show at film festivals around the world throughout the coming year. To stay updated on the latest developments, follow @endolifefilm on Instagram or visit www.endolifefilm.com.

For More Information on Endometriosis

Endometriosis doesn’t mean you have to give up on sports or fitness. It may, however, mean you need to be more flexible with your training and patient with yourself. But, when you consistently manage to take small steps in the right direction, you can still achieve your fitness goals. You’ve got this!

For more information about endometriosis and to access support, I’d recommend visiting www.endometriosis-uk.org.

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Tags: Misc > Lifestyle