Why endo fatigue beats pain

You go to bed early only to wake up tired.

Every day tasks are energy sucking and you start feeling lazy because you postpone or ignore them.

You get yourself together, every day, to try and function at work, knowing this means you’ll spend your evening on the couch.

Your friends ask you to go running with them after work because it’ll do you good, but you just can’t.

Recognizable? You’re not alone.

Research shows that women with endo are more than double as likely to suffer from fatigue compared to the non-endo population.

If you ask me, fatigue is the most debilitating consequence of endometriosis, and the most overlooked.

I know this is an unpopular opinion, since pain usually takes first place. So let me explain why I stand by this:

What endo would look like without fatigue

Many days you wake up, feeling energetic. You dance (or walk) through your day, running both your household and your job. In the evening you’re obviously somewhat drained but you go running with your friends anyway and feel refreshed after moving and talking to them.

painfree days could be good days if it weren't for the fatigue

Add pain

Let’s say you have 15 bad days per month where you need to cancel plans because of pain, or try to power through it. You stay on the couch, or the only way to get off it, is thanks to an unhealthy amount of painkillers combined with a TENS machine.

That’s 15 days.

You now have 15 days per month left, feeling awake enough to keep looking for a solution. Yet another doctor’s (dis)appointment, reading yet another book, contacting a peer group, listening to podcasts, trying out different diets, supplements, exercises. You see your friends and family, move regularly, plan a weekend trip with your partner.

Add fatigue

How many days are you in too much pain to do anything?

Many of us have a good deal of good days left in the month, when only considering pain.

But if you now also consider the tiredness, how many good days do you have left?

• How much time and energy can you spend on really finding help?

• On working out to feel better mentally and reduce inflammation?

• To see friends and reduce stress and anxiety?

• To cook healthy meals and eat less highly processed foods?

• To read research papers on supplements?

The truth is that most of us aren’t in debilitating pain every day. But so many of us are feeling exhausted. Every. Single. Day.

Fatigue worsens endo

Let’s add another layer.

By preventing us from moving regularly, cooking healthy meals, having a fulfilling social life, fatigue doesn’t just prevent us from healing. It makes us more sick.

Among the other mechanisms of endo, we identified inflammation, pelvic muscles and mental health. All of these are worsened by fatigue and its consequences. It’s a negative spiral that becomes increasingly difficult to escape the more tired you feel.

Energy first, pain second

If we can reclaim our energy, we can escape the vicious cycle that leads to more pain.

Hence, our focus should be on energy first, pain second.

Ignoring your energy availability when trying to adopt lifestyle changes is just setting yourself up for failure. We only have so much discipline and willpower. That’s why I developed the Endo To Energy framework. Adopting lifestyle changes that require next to no energy, and only going a step further when energy is available.