Are your days overloaded or is your mind overworked? Your stress increases and your sleep quality decreases? So, your pain is increasing?

I advise you to focus your attention on the link between sleep and endometriosis.

Fatigue is really an undervalued symptom of endometriosis. Just as sleep is too often forgotten in the management of endometriosis. We talk about it (too) little. However, sleep and endometriosis is a duo that can be very wise to consider and address if you want to reduce your endometriosis pain and suffer less from chronic exhaustion. However, sleep is too often forgotten in the management of endometriosis.

Sleep, a natural treatment for endometriosis?

We explain why and how in this article while giving you keys to find a recuperative sleep to relieve your pain.

When your stress increases, your sleep quality decreases

It seems logical… and it’s physiological, because when cortisol increases, melatonin decreases.

Cortisol, a key hormone in the mechanism of stress response, inhibits melatonin. Lamelatonin is often called the sleep hormone because it is a key hormone to help us fall asleep, avoid insomnia and enjoy a recovering sleep. But not only, that’s what we’re going to see.

With an increase in stress in our day, the cortisol level increases. You understand that it becomes problematic if it increases at the end of the day or in the evening because it inhibits melatonin. It can then be difficult for you to fall asleep or have a deep recovering sleep. But melatonin does not only induce sleep. It would also relieve pain, have an anti-inflammatory effect and act as an antioxidant that reduces oxidative stress. It is also now known that oxidative stress and free radicals are responsible for the induction of inflammation.

What raises the level of cortisol?

Cortisol increases to cope with stress. It is a natural adaptive response to stress. In general, cortisol increases in response to stress, whether it is emotional, physical, social, environmental…

I give you some examples:

• A too sweet snack in the evening before bed or at night. This will lead to a decrease in blood sugar in the early hours of the morning. If someone wakes up at night, hypoglycemia may cause an early awakening response. It is also the liver that will have difficulty doing its cleaning work. He may not be able to properly purify the blood and not properly treat the body waste that will accumulate there. According to Chinese medicine, insomnia or an awakening, often between 1 and 3 o’clock in the morning, can be due to the action of the liver which also has an action on your emotions: anger, grudges,…
• Stress in all its forms: physical (anemia, inflammation, blood glucose…), emotional, mental,…
• Anxiety or negative thoughts
• Being overwhelmed with thoughts, things to do,…
• A disrupted circadian rhythm (natural day/night cycle): too much exposure to blue light from screens or artificial and not enough to natural light
• Too intense or prolonged physical exercise (especially during your period) or on the contrary go from physical exercise
• A deficiency or malabsorption of nutrients. Read this article on anti-inflammatory diet for endometriosis.
• Any cause of inflammation (disruptions of the intestinal microbiota, endocrine disruptors, heavy metals, foods that you can’t stand well,…)
• Chronic pain. Try these 5 yoga postures to relieve endometriosis pain. They are also restorative.
• …

As you can see, there are many factors that induce an increase in cortisol. It is therefore crucial to focus on them to reduce their influence when you have endometriosis. We will look for a good quantity and quality of sleep.

Sleep, essential when you suffer from endometriosis

Sleep is essential to restore our energy, allow the repair of our cells and to fight fatigue of course.

Due to pain, our quality of sleep can be undermined1. More tired, our quality of life is impacted, having less energy or even more the strength to do the most banal things of everyday life. Tired, we would also be more sensitive to pain, which in turn would affect the quality of our rest. It’s the vicious circle. And a scientific study2 confirms this to us. She revealed that the quality of sleep was less good and the pain threshold in some parts of the body was lower in the group of women with endometriosis (vs those without endometriosis).

The effect of melatonin on endometriosis pain

Even if the causes of endometriosis are not yet known, it is agreed that it is a multifactorial disease. And inflammation would play a role. Chronic pain is associated with an increase in inflammatory cytokines and other inflammatory markers. In a scientific study3, it was shown that melatonin would improve sleep quality in women and reduce their need to use analgesics. In these women suffering from chronic pelvic pain related to endometriosis, melatonin or sleep hormone reduced daily pain and menstrual pain scores by nearly 40%. Another study4 tells us that melatonin would also have a direct role on endometrial tissue, the tissue that lines our uterus.

Sleep, one of the natural solutions to reduce inflammation and relieve endometriosis pain

It is clear that sleep must be a priority for women with endometriosis.

To improve falling asleep and the quality of their sleep, I often advise women personalized micro-actions or routines that are easy to integrate into their daily lives to align with their natural rhythm, reduce their stress, their mental load, the weight of their emotions,…

Adopt the pillars of naturopathy for a good sleep

Very often, we practice targeted yoga postures, breathing and meditation exercises, a nourishing diet adapted to its constitution (its dosha – in Sanskrit) to compensate for sleep disorders and adopt good habits that promote falling asleep and recuperative sleep. Movements and regular physical activity adapted to your menstrual cycle and condition will also do you the greatest good: oxygenation, mobilization of your body, connection to nature,…

Sleep and endometriosis, essential oils to the rescue

Some essential oils, such as lavender for example or certain synergies, are known for their calming and relaxing properties. (Personally, I use perfectly pure and excellent quality essential oils. Do not hesitate if you want a free 30-minute aroma consultation).

Adapt your lifestyle to promote quality sleep

Other tips complement the recommendations to improve sleep, reduce cortisol levels, and obtain the anti-inflammatory and antioxidant benefits of melatonin for women with endometriosis:

• Reduce or eliminate sugar, alcohol and caffeine… the stimulants
• Expose yourself to outdoor natural light every day for at least 30 to 60 minutes
• Turn off all blue light devices (screens) and Wi-Fi at home before 9 p.m.
• Adopt a personalized soothing sleep routine
• Sleep in a dark and cool room. It is only in the dark that melatonin is secreted into the brain. This hormone reaches its maximum level at 2 a.m. Its production can be slowed down or even completely suppressed by light (often the case with light pollution in our cities)
• Appropriate movements or physical exercise: walking, yoga, dancing,…
• Breathe fresh air to oxygenate all your cells and help detoxification
• Soft and relaxing music in the evening
• A light meal at bedtime, adapted to its own constitution and taken as far away as possible from the time of bedtime (I am in a country where we can have dinner at 5/18 p.m. and I understand why now)
• …

Sleep, a key element of the endometriosis management plan

You have understood it well, do not sacrifice your sleep to finish your movie on Netflix or finalize a project at the last minute, your health will give it back to you.

Your sleep is one of the key elements of a holistic plan to relieve and not aggravate your endometriosis pain. If you feel that you need to be accompanied in a comprehensive and holistic way to sleep better, do not hesitate to make an appointment so that we can discuss the philosophy of my approach and how the support could be adapted to you and your needs.

I wish you a good night’s sleep!

References:

1 Maryam Moradi, Melissa Parker, Anne Sneddon, Violeta Lopez, and David Ellwood (2014), Impact of endometriosis on women’s lives: a qualitative study, BMC Womens Health. 2014; 14: 123. Published online 2014 Oct 4. doi: 10.1186/1472-6874-14-123.

2 Nunes FR, Ferreira JM, & Bahamondes L. (2015) Pain threshold and sleep quality in women with endometriosis, Eur J Pain. 2015 Jan;19(1):15-20. doi: 10.1002/ejp.514. Epub 2014 Apr 14.

3 Schwertner A, Conceição Dos Santos CC, Costa GD, Deitos A, de Souza A, de Souza IC, Torres IL, da Cunha Filho JS, & Caumo W. (2013) Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial, Pain, 154(6), 874-81. do

4 Mosher AA, Tsoulis MW, Lim J, Tan C, Agarwal SK, Leyland NA, & Foster WG. (2019) Melatonin activity and receptor expression in endometrial tissue and endometriosis, Hum Reprod, 34(7),1215-1224. doi: 10.1093/humrep/dez082.