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Fatigue is a common endometriosis symptom that many people find bothersome or even incapacitating. We can have it due to the inflammatory nature of endometriosis, and also because of co-conditions and other factors.

It interrupts activities, routines, plans, and dreams. It can make it impossible to do simple things like take a shower or cook a meal. It can cause you to cancel plans and miss out on your life, constantly needing to rest and recover from a tiredness that doesn’t ever seem to go away.

I’ve struggled with fatigue for 22 years, since I was 17 years old. Excision helped reduce my fatigue, but I still deal with it on most days. Prior to excision, almost daily my eyes would suddenly begin to close and I’d have to lay down wherever I was. I had a yoga mat and pillow under my desk at work and a blanket in my car so that I could nap when my body just couldn’t stay awake anymore.

Since excision, I no longer pass out like this, but I still have to count my spoons. Many activities cause me fatigue after, such as vacuuming, running errands, and recording interviews for my podcast.

What’s helped me is looking at my fatigue from a holistic viewpoint, and trying to figure out the physical, emotional, and even spiritual ways that I am exhausted and drained, and how to address those. There’s also multiple kinds of rest, from physical, creative, social, sensory, spiritual, and more. Understanding these and how my emotional state affects my physical body has helped improve my quality of life. For example, being emotionally burned causes me to lose motivate myself to do anything, even though my body is capable at that time.

Here’s some of the ways I’ve improved my fatigue over the years.

*I recognize that what we each need is individual, and additionally, not all of these are accessible to everyone, but hopefully they can help spark ideas.

Paying attention to how food affects me

Are there certain foods that make you sleepy or crash after eating them?

  • Keeping a food journal can help you notice patterns in how food makes you feel.
  • Working with a registered dietitian can support you in finding the foods that help you feel your best.

For me personally (it’s individual for everyone), those are beans, meals high in carbs, and foods high in added sugars like deserts.

Eating nutrient dense food with enough fat and protein, for my meals whenever I can, has helped a lot in having more energy for my day.

Pacing and prioritizing my activities

Get to know yourself and your activities, and use that info to try and plan your day. 

  • Which ones make you tired afterwards?
  • When do you have the most energy, in the morning, afternoon, or evening?
  • What is most important to you to do today?

For example, I have the most energy in the morning, so that’s when I do the tasks that are the most important to me. Later when energy drains, I can do mundane tasks like washing the dishes or laundry, feeling like a zombie and crawling into bed after.

I also incorporate rest periods into my day. For example, I’ll clean in the morning, watch a movie to rest my mind and body, then go out with friends in the afternoon.

I’ve also learned I don’t have the energy to do it all, so I’ve accepted doing things less often than I want. My house isn’t as clean as I’d like, because I choose to save my precious energy for other tasks.

Putting in disability accommodations at work

These might be more breaks, sitting closer to the bathroom, changing your schedule, working from home, a stool, or a set up to work from bed. 

For me, working from home has been life changing. Prior to that, I only had the energy to go to work and come home. Getting ready, commuting, socializing, having a lack of privacy at work, walking around, being under the bright lights in a cold office, I came home completely and utterly drained.

With work from home, not only do I avoid all those energy drainers, but I can work laying down from bed on the worst days. 

Improving my sleep

Many of us struggle with sleep due to:

  • cortisol dysregulation
  • pain
  • perimenopause/menopause
  • histamine intolerance
  • overstimulation
  • anxiety
  • and more.

Not getting enough sleep can increase our fatigue, affect mental health, cause sugar cravings, and even make us more sensitive to pain.

What might help our sleep?

  • HRT
  • blackout curtains
  • less screens at night or using glasses to block blue light
  • having a wind down routine
  • seeing if sleep is affected by high histamine foods
  • sleeping in a different bed/room from your partner
  • working with therapist or journaling about worrisome thoughts that keep you awake
  • stretching/foam rolling

For more detail, see my page on Sleep.

Improving physical symptoms

This has been two fold. 

Physically, for example, excision lowered my fatigue. Yoga and foam rolling help my body relax, which help me sleep better. 

Emotionally, my fatigue improved because when I got out of survival mode post excision. Excision diminished my symptoms from a 7 or 8 (out of 10) daily to a 3 or 4. Dealing with chronic pain and symptoms is draining, as is feeling unsafe in your own body and the hypervigilance I adapted to try and avoid incapacitating pain.

Addressing my mental health

My emotional state impacts my physical state. Dealing with grief, trauma, and uncertainty is heavy, and that weight is so exhausting. Finding tools, resources, and coping strategies for my mental health has me more revitalized and energized emotionally, which has helped me physically. Such as:

  • journaling
  • letting go of people pleasing
  • finding tools to manage my anxiety
  • joining support groups
  • saying no
  • cutting toxic relationships
  • asking for help
  • an hour in nature
  • finding more joy and beauty in my life through art and music
  • learning ways to manage stress

Checking for other medical problems

These might be thyroid problems, anemia, low testosterone, and others.

For me, going on testosterone has helped immensely with my post-exercise fatigue. Now I’m able to slowly build up strength to recover lost muscle tone, so that I can lift groceries or go up a flight up stairs effortlessly. 

Honoring my fatigue.

I rest a lot. Especially during my period when my fatigue is the worst. When my energy level is zero, I honor that. Guilt free. I get in bed and binge watch movies until I feel able to move again. I take the pressure off myself to be productive, social, or achieve anything outside of work during those hard days.

It didn’t used to be guilt free, but now I understand that I’m not lazy and my value isn’t based on my to-do list. 

Getting out of chronic fight or flight

Stress, and especially chronic stress, can have a detrimental impact on our bodies. I’ve been working on how I can lower my stress, support myself during high stress, and not get stuck in fight or flight. What’s helped me:

  • Qigong
  • regulating my nervous system
  • letting go of perfectionism and other tendencies that put huge amounts of pressure on me
  • replacing my self-critic with self-compassion
  • unlearning my hypervigilance
  • building fear-free relationships with food and sex
  • deep breathing


I don’t want fatigue, I don’t like having it, but ultimately, it is what it is. Fighting against it and wishing it were differently is stressful and draining, which worsens my emotional state which in turn worsens my physical fatigue. If there’s anything I’ve learned over 22 years, it’s that my energy is valuable, and with it being so limited, I want to do with it the things I love, and also the things I need to do (like work and taking care of myself). I no longer want to waste it wishing things were different. Instead, I want to ask myself questions like “How can I support myself? How can I make this challenging situation easier? How can I get closer to my goals?”