Nothing in life is ever certain. But if you live with endometriosis, you can pretty much bet on one thing: You’re going to hurt.

Your periods will hurt. Sex will hurt. It might even hurt when you use the toilet. Sometimes, the pain is so intense, you’ll find yourself doubled over in bed, praying for relief.

When the pain starts acting up, try these 10 life hacks to find comfort.

1. Soak in it

If you’ve got endometriosis, heat is your friend — especially wet heat. Submerging your belly in warm water relaxes tense muscles and eases cramps.

Once you’ve filled up the tub, toss in some Epsom salts. In addition to being effective pain relievers, these crystals are high in magnesium, which is good for your bones.

Or put some essential oils mixed with a little bath or mineral oil in your tub. Clove essential oil might be one to try, as it shows promise as a treatment for endometriosis. Essential oils are meant to be inhaled or diluted with a carrier oil and applied topically.

Pop in earbuds and turn on soothing music to transform your bathtub into a spa escape. Tune out the world and soak for at least 15 minutes to get the maximum benefit.

2. Loosen up

Belly bloat is one rarely talked about, but highly distressing, endometriosis symptom. Since most women with this condition get a bulging belly at some point during their menstrual cycle, it’s worth addressing.

You can mourn for your once-flat belly, but don’t try to squeeze into your favorite jeans. They’re going to hurt.

Remind yourself that the change is temporary, and stock up on loose-fitting sweatpants and pajama bottoms that you can slip into when your jeans become unbearably tight.

To look presentable for work or another event, throw an oversized top over comfy leggings.

3. Go green

The better you eat, the better you’ll feel. That’s especially true when you have endometriosis. Women who eat a high-meat, low-vegetable diet are more likely to get endometriosis than those who eat primarily from the produce aisle. Stay away from high-fat diets. Talk to your doctor about a gluten-free diet.

What’s the connection between endometriosis and diet? Experts have a few theories. One possibility is that extra fat in your body stimulates estrogen production. More estrogen means more painful endometrial tissue deposits. Fat also increases your body’s production of prostaglandins — chemicals that stimulate uterine contractions (read: cramps).

4. Step up

When you’re curled up in bed with a heating pad on your belly, going for a run around the neighborhood or taking a step class might not be at the top of your to-do list. But exercise should at least be somewhere on your mind. Here’s why:

  • Exercise keeps your weight in check. Extra body fat means more estrogen, which means worse endometriosis symptoms.
  • Exercise releases pain-relieving chemicals, called endorphins. After about 10 minutes of kickboxing, running, or another aerobic exercise, these potent natural painkillers kick in. Result: Your pain goes down, and you get a euphoric feeling as a bonus.
  • Exercise gets your blood flowing. More oxygen-rich blood makes for healthier organs.
  • Exercise lowers stress. The less stressed you are, the less tense your muscles will be — and the better you’ll feel.

5. Eat your omega-3s

Got fish? If not, you probably should. Their high omega-3 fatty acid content should make these water-dwellers a staple on your plate. In one study, women who often ate foods high in omega-3s were 22 percent less likely to develop endometriosis than women who ate fewer of these foods.

How can fish help with endometriosis? Fish oil is linked to lower levels of prostaglandins and inflammation — both of which are pain triggers.

To maximize your omega-3 intake, choose fish with the highest levels, including:

  • salmon
  • canned light tuna
  • pollock
  • catfish
  • sardines
  • trout
  • herring

6. Take a chill

It’s hard to escape stress when its triggers are everywhere — from the rush-hour traffic to the pile of work mounting on your desk. When stress reaches uncontrollable levels, you’ll feel it in your belly.

A study of rats with endometriosis found that exposure to stress made endometriosis — and its symptoms — worse. Though you’re nothing like a rat, stress could have similar effects on your body.

Stress relief can take many forms — including massage, meditation, yoga, and deep breathing. Pick a method you like, but stick with it. Get into a stress-relieving routine, and both your body and mind will stay in the relaxation zone long term. Find some guided imagery online to listen to. Think about taking a stress management class.

7. Get needled

A needle might seem an unlikely place to find relief from pain, but acupuncture isn’t your average needle stick. Stimulating various points around the body with very thin needles triggers the release of pain-busting chemicals. It might also block the pathways that make you feel uncomfortable sensations. Research finds that this alternative medicine staple helps with several different types of pain — including endometriosis pain.

8. Keep pain relievers handy

A bottle of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) or naproxen (Aleve) can be your best friend when your belly is seized with cramps.

Use these pain relievers when you need them, but be cautious. Taking too many painkillers can lead to side effects like stomach ulcers, liver and kidney problems, and bleeding. If you feel like you need more than the recommended dose, talk to your doctor about other pain relief options.

9. Find a doctor you trust

Getting treated for endometriosis means having to discuss your most personal, intimate experiences with a doctor. You need to find someone you trust and feel comfortable opening up to. You also want a doctor who takes your symptoms seriously. If your current healthcare provider doesn’t meet these criteria, start interviewing new candidates.

10. Get support

When you’re in the throes of a flare, it can seem like you’re the only person in the world in this much pain. You’re not. Search online, or check in with an endometriosis organization for a support group in your area. You’ll find lots of other women whose experiences mirror your own.

There’s a real sense of solidarity in looking around the room and seeing a whole group of women who’ve battled the same painful symptoms as you. Support group members who have lived with endometriosis for a while can also offer other helpful life hacks you might not have considered.