Endometriosis is a disorder where the tissue that lines the uterus (endometrium) grows in other places in the body. Its symptoms include things like:

  • painful periods
  • excessive bleeding
  • bloating

Chronic fatigue is another common symptom you may encounter, though it hasn’t been supported by much formal research.

Discover how to manage your fatigue and improve your quality of life.

Jessica Kohler started experiencing endometriosis symptoms when she was a teenager. She didn’t receive a formal diagnosis until she was 24. Although that diagnosis lead to a prescribed management plan, she still experiences symptoms like fatigue.

Severe fatigue is especially common around the time of her menstrual cycle. She describes it as “that dizzy, low-energy feeling — as if there’s no blood coursing in your body.”

Kohler says that when it was at its worst, she’d find herself napping for hours at a time. She’d even experience a blackout sensation if she moved too fast or stood up too quickly.

Accepting that fatigue may impact your day is key. For Jessica, that fatigue usually sets in around 6 pm. For you, it may be a different time.

Regardless, resist the urge to power through times when you’re feeling tired and sluggish. Fighting it may make symptoms worse.

There are many systems at play when it comes to fatigue. See your doctor to get your levels checked and to rule out conditions that may further contribute to low energy.

A simple blood test will evaluate your iron, blood sugar, and thyroid hormone levels for conditions like:

  • Anemia. If you’re deficient in iron, your body may have trouble making red blood cells. These cells carry oxygen to your body’s tissues. One of the main symptoms of anemia is fatigue. Other symptoms include shortness of breath, weakness, and lightheadedness.
  • Low blood sugar. Hypoglycemia is a condition that affects your body’s resting blood sugar. When your blood sugar dips, you may feel fatigue. You may also feel shaky, irritable, and anxious.
  • Thyroid issues. Hypothyroidism is a condition where your thyroid gland doesn’t make enough of certain hormones. Along with feeling more tired, you may also experience weight gain and joint pain.

What you eat may also affect your energy levels. A diet that includes a solid source of protein — like nuts, seeds, beans, and fish — may help you feel more energetic throughout your day.

Foods to avoid include those with added sugars, namely processed foods and sweets. These can make you feel fatigued as your blood sugar spikes.

“A pretty clean macrobiotic diet has done wonders for me,” Jessica said. “I cut out most of the grain and everything [except] organic full-fat dairy.”

For Jessica, switching up her diet cut out the bloat and sluggishness that she was feeling.

“I was eating more because I was tired and thought I wasn’t eating enough — a really bad cycle to get into,” she said. “Having macros eliminated that insecurity and let me know that I was indeed eating enough and the foods that my body needs.”

Regardless of which foods you eat, don’t skip breakfast. Not only can doing so affect your blood sugar and energy levels, but it may also make you gain weight and have trouble thinking.

Grazing on healthy foods throughout the day may also help keep your glucose levels steady.

If you’re lacking important nutrients like iron, your doctor may suggest taking supplements to boost your levels. Speak with your doctor about the benefits and risks of supplements, as well as possible interactions with medications or supplements that you’re already taking.

Although you should be able to get your daily nutrients with a healthy diet, a daily multivitamin can help fill in nutritional gaps.

Women with endometriosis who are taking estrogen-lowering medications may benefit from taking calcium and vitamin D supplements to protect their bones. Vitamin D may also improve symptoms of fatigue.

Exercise may also help you manage your fatigue. Jessica said that her fitness around the time when she was diagnosed was “zilch.”

“I found some fitness bloggers — all distance runners — and I tried my hand at that and was horrible at it,” she said. “Long workouts just wipe me out.”

After dealing with a mindset of “you’re sick, you shouldn’t do as much,” Jessica tried CrossFit and high-intensity interval training (HIIT). These workouts were short and intense, but they made her feel much better.

“My recovery was much less painful, and the strength training gave me more energy rather than depleting it,” she said. “Plus, I think it’s done a lot for my mental game and approach to self-care.”

Don’t know where to start? Low-impact exercise may be your best bet. Activities like walking, swimming, and dancing can help with your energy.

Activities that involve running and jumping, on the other hand, may make endometriosis symptoms worse for some women.

Experts recommend getting between 7 and 9 hours of sleep each night. If you’re missing the mark, it may affect your daytime fatigue. A bedtime routine can help you wind down. For example, try taking a bath in the hour or so before bed or sipping on some chamomile tea.

And while you’re at it, try heading to bed the same time each night and waking up at the same time each morning. A predictable sleep schedule will help your body get into a good rhythm.

The environment in which you sleep is also important. Follow these sleep hygiene tips to get a better night’s rest:

Taking care of yourself also involves letting others know that sometimes you’ll be fatigued. Be open and honest about activities or times of the day when you feel more tired than usual.

At the same time, Jessica encourages women with endometriosis to “be your own advocate and test the waters.” After all, your own symptoms and limitations will be different from someone else’s.

Although your doctor is a good resource for finding support, they aren’t your only resource. If you aren’t getting what you need from your doctor, it’s okay to ask them for a referral.

“I was trying to press for answers on what was wrong with me, but [the doctors] were treating me like a whiny girl who was upset about her heavy period,” Jessica said. This experience lead her to explore more holistic health measures.

“Self-care is big with me now,” she said. “I feel a lot more in tune with what my body is telling me.”

You may also find online support groups helpful. You can connect with women across the globe who are dealing with endometriosis and related fatigue.

You can share tips about what helps you deal with your symptoms, as well as learn new tricks. The Endometriosis Support Group on Facebook, for example, has almost 18,000 followers. The administrators of this group regularly share articles about the latest in research and news.

Other endometriosis organizations include:

If these tips and tricks don’t help you, contact your doctor. You may have other underlying medical conditions that are contributing to your fatigue. Otherwise, be patient. Endometriosis is unique to each person, and everyone has a different set of symptoms and circumstances.

Jessica’s parting advice? “Try diet, exercise, and lifestyle changes. Let them sink in for at least 6 weeks and continue to tweak things until you find your balance. You can do more than you realize — a lot more.”