It’s Saturday morning. The sun is shining, but it’s a little bit cold, so I’ve got the fire going. I actually slept really well last night despite a couple of wake ups due to children, but here I am, again, waking up exhausted.

So I thought this might be a good time to talk about the ‘f’ word. Fatigue. What does it look like, and what can you do about it?

I’m not talking about your regular tiredness. This is the fatigue caused by chronic illness, and it’s often one of the most overlooked symptoms of endometriosis (although it is extremely common). This kind of fatigue follows you around and makes you exhausted all day, every day. Sometimes you might have a burst of energy that spurs you on to do something great, or get something done. But immediately afterwards, your energy is completely zapped and you have to stop. Often, the burst of energy is only short-lived, at most a few hours but more often only an hour or so.

But you push through anyway. So even though your energy has run out, you continue to push yourself through your daily tasks, often in a very inefficient manner, while getting distracted often and through lots of yawns. And it looks like you’re just a bit tired. But you get to the end of the day, and you still have to feed and bathe the children and put them to bed, and then your sleep doesn’t even get rid of your tiredness, so you wake up in the morning still tired. And you do it all again.

This is the story of my life. It impacts not only functionality in day-to-day living, but it can also affect your mental health and wellbeing, as well as your moods.

First, I want to tell you a bit about how endometriosis causes fatigue. And it’s not straight away, either. It develops over time and gets worse as the disease takes its toll on your body. I’ve suffered endometriosis for more than 20 years. In the beginning, I was ok. I was a bit tired in high school, but I put it down to being busy. And I could push through it. I’m 35 now, and over time, this is getting harder to do.

So why is that? Well there’s the physical aspect of endo. Imagine you have something growing in places it shouldn’t. Naturally, your body will try to get rid of it. Now imagine that it keeps growing and showing up in new places. So your body keeps trying to get rid of it, but it never truly goes away. And your body is using most of its energy to do that. That’s the first reason.

Add to this the pain associated with endo. In the first 15 years for me, I suffered severe cyclic pain that would give me diarrhoea, cause vomiting, chills, cold sweats and an overall ill feeling. The pains were so severe I had to stop what I was doing and could not move until the pain subsided. In primary school, I was able to push through it, but it got worse the older I got, so by high school I had to take time out of class every month when the pain began. Nothing worked to stop it. Imagine how that zaps energy! Thankfully, in my working life, I was very regular, and the pain always seemed to come on a weekend, so I was lucky not having to miss work because of it. Not everyone is that lucky.

I’m fortunate at the moment that I have not had that kind of severe pain since giving birth to my now 7 year old. But I still have pain. Now it’s not cyclic though, it’s all the time, but only mild. Sometimes it’s a dull ache similar to regular period cramps, and sometimes I feel like someone has taken a cheese grater to my insides, which if you have endo, you’ll recognise that feeling from after excision surgery. Just not quite as painful as that. So even the mild pain, being constant, adds to the exhaustion.

Then there’s the iron. If you know anything about endometriosis, you’ll know that periods are typically longer than usual, and far more severe in terms of blood loss, clotting and the like. I won’t gross you out right now, but it’s not uncommon for periods to last up to two weeks of every month. All that blood loss takes iron with it, so anaemia or general low iron levels are very common. Cue more reasons for fatigue.

Then there’s adrenal fatigue. So the basic way to explain this is that, your body is under a lot of stress, so your adrenal glands are working overtime to keep up with demands for stress-reducing hormones. When they can’t keep up, this causes adrenal fatigue. Your body often feels this before it shows up on blood tests, so it’s hard to diagnose early.

So what can we do about it? These are tips for anyone really, I promise you’ll find more energy even if you don’t have endo. First is diet. When you’re already fatigued, it’s really hard to eat well. And I’ve fallen into that trap so many times. Actually, I’m there right now. Not sticking to my diet has made the fatigue worse, and I’m noticing it significantly. So what needs to happen?

Eat lots of greens, lots of fruit and lots of veggies. Avoid gluten, dairy, soy, and fatty meats. Avoid tinned foods. Avoid parabens in cosmetics and go organic as much as possible. This is anti-inflammatory and as such, reduces what your body is trying to eliminate. With less inflammation to work through, your body is able to focus on the endometrial implants themselves and sometimes this even shrinks them.

Get plenty of rest. Give your body the best chance to replenish, even if it feels like it’s not working.

And check your iron levels. Iron tablets are available over the counter, and most chemists stock strong ones for treatment of low iron levels. This is especially important if you experience heavy or prolonged bleeding throughout the month.

I’ll post in more detail another time about the effect of diet in the management of endometriosis, but right now, I need to push through my own mental blocks to get myself back on track. I’ll let you know how that goes.

Happy Saturday!

Jus