Do you suffer from endo belly on the regular? Ugh! Not only does it invite endless comments about being pregnant due to the amount of bloat, but it’s also really painful! Not only do we want to have some go-to options when endo belly is happening but a few changes to prevent it from occurring. 

• Activewear—We all love to live in our activewear, but those high-waisted tight-fitting leggings can be doing more harm than good.  They are causing you to brace and do not allow full range of motion and function of your abdominal muscles and diaphragm.  
• Dehydration—Remember your uterus is a muscle too!  Just like you can get a cramp in your calf muscle due to dehydration, your uterus can do the same thing. 
• Choose low-impact exercises—Low-impact exercises are less likely to aggravate the symptoms of endometriosis ⁽¹⁾, such as pain and bloating. Some good options include swimming, walking, biking, and yoga. 
• Modify exercises as needed—If an exercise is too difficult or painful, modify it or try a different exercise. For example, if you cannot do a full squat, you can try doing a half squat or a wall sit. 
• Listen to your body—If you are experiencing pain, fatigue, or other symptoms, stop exercising and rest. 
• Focus on core strength exercises—Core strength exercises can help reduce back pain and improve pelvic stability. Some good options include planks, crunches, and leg raises. 
• Avoid exercises that put pressure on your pelvic floor—exercises such as crunches and sit-ups can put pressure on your pelvic floor and aggravate endometriosis symptoms ⁽²⁾. 
• Don’t forget to cool down after exercising—Cooling down helps to prevent muscle soreness and inflammation. 
• Get enough sleep—It is essential for overall health and well-being. When you are well-rested, your body is more capable of coping with stress and inflammation. 
• Manage stress—Stress can worsen endometriosis symptoms ^(3,4,5), including bloating. Find healthy ways to manage stress, such as exercise, yoga, meditation, or spending time in nature. 

Ultimately do what works best for you and reach out to your allied health and medical team to find a treatment plan best suited to you and your symptoms. 

REFERENCES: 

1. Bonocher CM, Montenegro ML, Rosa E Silva JC, Ferriani RA, Meola J. Endometriosis and physical exercises: a systematic review. Reprod Biol Endocrinol. 2014 Jan 6;12:4. doi: 10.1186/1477-7827-12-4. PMID: 24393293; PMCID: PMC3895811 

2. Shafrir AL, Martel E, Missmer SA, Clauw DJ, Harte SE, As-Sanie S, Sieberg CB. Pelvic floor, abdominal and uterine tenderness in relation to pressure pain sensitivity among women with endometriosis and chronic pelvic pain. Eur J Obstet Gynecol Reprod Biol. 2021 Sep;264:247-253. doi: 10.1016/j.ejogrb.2021.07.029. Epub 2021 Jul 22. PMID: 34340095; PMCID: PMC8449805. 

3. Appleyard CB, Cruz ML, Hernández S, Thompson KJ, Bayona M, Flores I. Stress management affects outcomes in the pathophysiology of an endometriosis model. Reprod Sci. 2015 Apr;22(4):431-41. doi: 10.1177/1933719114542022. Epub 2014 Jul 11. PMID: 25015902; PMCID: PMC4812689. 

4. Brasil DL, Montagna E, Trevisan CM, La Rosa VL, Laganà AS, Barbosa CP, Bianco B, Zaia V. Psychological stress levels in women with endometriosis: systematic review and meta-analysis of observational studies. Minerva Med. 2020 Feb;111(1):90-102. doi: 10.23736/S0026-4806.19.06350-X. Epub 2019 Nov 12. PMID: 31755674. 

5. Cuevas M, Flores I, Thompson KJ, Ramos-Ortolaza DL, Torres-Reveron A, Appleyard CB. Stress exacerbates endometriosis manifestations and inflammatory parameters in an animal model. Reprod Sci. 2012 Aug;19(8):851-62. doi: 10.1177/1933719112438443. Epub 2012 Apr 23. PMID: 22527982; PMCID: PMC4046310.