Endometriosis is a chronic condition that affects 200 million people worldwide and at least 7-15% of women. Characterized by the growth of endometrial-like tissue outside the uterus, it often leads to severe pelvic pain, heavy menstrual periods, and even infertility. One of the most challenging aspects of endometriosis is dealing with flare-ups, where symptoms intensify and, in many cases, disrupt everyday activities. 

The good news is that there are effective strategies to manage and reduce the pain associated with endometriosis flare-ups. In this guide, we’ll explore practical tips and treatments to help you regain control and live a more comfortable life.

woman trying to relieve pain from an endometriosis flare up

But first, what are the symptoms of endometriosis?

Endometriosis symptoms can vary widely from person to person. One person may have extremely painful menstrual cramps, heavy menstrual bleeding, and discomfort during intercourse, while another may have no pain but may experience nausea, bloating, or other IBS-type symptoms. This makes the condition difficult to pinpoint, with an average timeframe of 7-10 years to diagnosis.

Jacqueline Solivan, Rescripted’s VP of Partnerships, describes her endo pain in two ways:   

“Imagine watching someone make a balloon animal, all that twisting and turning...how it looks so tight and like it's about to burst. That’s what my endometriosis feels like!” she explains. On a more regular basis, she says it feels like the pain of a bruise being constantly pushed on. 

Whatever your symptoms may be, they may or may not follow a pattern, according to Endowhat.com. Some endometriosis sufferers have their worst flare-ups around ovulation, while others are in the most pain during the luteal and menstrual phases of their cycle. 

And endometriosis symptoms aren’t just limited to the pelvic region, either. As Jacqueline shares, her flare-ups show up both in her uterus area and her back, with the back pain being the most severe. “It’s literally paralyzing,” she describes. 

So, how can you manage endometriosis flare-ups?

Identifying what triggers your flare-ups is often the first step in managing endometriosis. Common triggers of endo symptoms include: 

  • Menstrual Cycle: Hormonal changes during the menstrual cycle can exacerbate endometriosis symptoms.

  • Diet: Certain foods, especially those high in sugar, caffeine, dairy, or gluten, can trigger inflammation and pain.

  • Stress: Emotional and physical stress can worsen symptoms and lead to flare-ups.

  • Lack of Sleep: Poor sleep quality can increase pain sensitivity and overall discomfort.

  • Physical Activity: While moderate exercise can be beneficial, strenuous activities might provoke pain.

Keeping a symptom diary can help you identify your personal triggers, allowing for better management and prevention of pain and inflammation.

woman using heat therapy to manage the pain of an endometriosis flare up 

Strategies for managing endometriosis pain

When a flare-up does strike, there are several strategies that can provide relief:


  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs like ibuprofen and naproxen can reduce inflammation and alleviate pain. They are most effective when taken at the onset of symptoms.

  • Hormonal therapy: Birth control pills, hormonal IUDs, and other hormonal treatments can help regulate or eliminate menstruation, thus reducing flare-ups. Healthcare providers often tailor these therapies to individual needs.

  • Prescription pain relievers: For severe pain, doctors may prescribe stronger pain medications. It’s important to use these as directed to avoid dependency and side effects.

Heat therapy

Applying heat to the pelvic area can relax muscles and ease cramping. Use a heating pad, warm bath, or hot water bottle for 20-30 minutes as needed.

Pelvic floor physical therapy

A pelvic floor physical therapist can offer exercises and techniques to help relieve pain and improve mobility. They may use manual therapy, biofeedback, and other modalities to target specific areas of discomfort.

Dietary adjustments

Eating a balanced diet rich in anti-inflammatory foods can help manage symptoms. Make sure to incorporate:

  • Omega-3 fatty acids: Found in fish, flaxseeds, and walnuts, these can reduce inflammation.

  • Fruits and vegetables: High in antioxidants, they help fight inflammation.

  • Whole grains: Choose whole grains over refined grains to reduce blood sugar spikes and inflammation.

  • Avoid trigger foods: Limit intake of caffeine, alcohol, red meat, and processed foods.

For Jacqueline, “What has helped the most with flare-ups is my diet and what I put in my body. When I stay away from dairy, refined sugar, and gluten, I feel far less bloated in general (outside of a flare-up), but when I have a flare-up while avoiding those things, it's far milder; I'm not feeling as paralyzed.” 

Stress management

Practices such as yoga, meditation, and deep breathing exercises can reduce stress and improve overall well-being. Cognitive behavioral therapy (CBT) has also been shown to help women cope with chronic pain by changing negative thought patterns and behaviors.

Long-term management and support for endometriosis

Endometriosis is a long-term journey that requires a multi-faceted approach. Here are some additional tips to help you stay empowered and in control: 

Regular medical check-ups

Regular visits to a healthcare provider you trust are essential for monitoring your condition and adjusting treatment plans as needed. Discuss any changes in your symptoms or new treatment options that may be available.

Educate yourself

Staying informed about endometriosis and the latest research can help you make better decisions about your health. Reliable sources include the Endometriosis Foundation of America and the American College of Obstetricians and Gynecologists (ACOG).

woman researching support for endometriosis

Support groups

Connecting with others who understand what you’re going through can be incredibly supportive. Look for local or online support groups, like Rescripted where you can share experiences, tips, and encouragement.

Self-care practices

Incorporate self-care into your daily routine. This can include gentle exercise, adequate sleep, mindfulness practices, and hobbies that bring you joy and relaxation.

Living with endometriosis can feel debilitating, but with the right strategies, you can figure out what works for your body to manage flare-ups and reduce pain. Remember, you are not alone in this journey, and many resources are available to help you navigate the challenges of living with endometriosis. Stay informed, stay empowered, and, most importantly, take care of yourself! 

Kristyn Hodgdon is the Co-Founder and Chief Creative Officer at Rescripted.