Fatigue in endometriosis patients
It is important to note that fatigue is not a typical tired feeling due to a lack of sleep or a full day of work. Rather, endometriosis patients report feeling constant exhaustion. Patients have described this fatigue as being “tranquilized” or having “their eyes go heavy and swollen to the point where they just felt like they cannot do anything.” This fatigue can also serve as a warning sign that a flare-up of pain is approaching.
Why does endometriosis cause fatigue?
The main cause of endometriosis-related fatigue is the body’s effort to eliminate diseased tissue. While the immune system attempts to combat endometriosis, cytokines, also known as inflammatory toxins, are secreted by the tissue. What patients feel to be fatigue is the result of these internal chemicals.
What is the distinction between pain and fatigue in endometriosis patients?
Many patients and their doctors lump fatigue together with pain, but the two are very different symptoms. Fatigue is a constant state of being tired—not sleepy, but physically exhausted. Though pain can accompany fatigue, or even be a primary cause of it, a patient does not necessarily hurt when feeling fatigue.
Why does fatigue often go unnoticed as a symptom of endometriosis?
One reason why patients may not discuss their endometriosis-related fatigue is, similarly to other endometriosis symptoms, the stigma surrounding it. Being "tired" may not receive attention from others and patients may find that they are dismissed, considered "lazy" or "out of shape", or told that “it is all in their head.” This is why it is important to be an advocate for one’s own health. If you find your provider dismissing fatigue, seek care from another professional.
How does endometriosis cause personality changes?
Endometriosis, specifically the pain and fatigue it causes, shapes many individuals' attitudes, states of mind, and personalities. Patients will find themselves having to miss out on the day-to-day activities and events that normally, not only make them happy but also provide a healthy balance in their life. Because the pain and fatigue are real, it affects the brain and can change its functions. It is not uncommon for patients suffering from pain and fatigue to also battle with mental health challenges such as anxiety and depression. These symptoms can cause a feeling of hopelessness that is unique to endometriosis patients.
Patients can also find themselves feeling like they are not allowed to have any outward signs of their pain and suffering. They may give in to the taboos and negative connotations that surround the idea of painful periods that induce constant fatigue, and in turn, may block their pain despite the distress it causes. These patients may continue their day to day activities, while silently suffering throughout the day. However, it is important to stress that symptoms should not be pushed to the side. These symptoms of pain, fatigue, and personality changes are real and your body’s way of saying that something is wrong. It is important to listen and seek proper consultation.
As Lagana et al., “Anxiety and depression in patients with endometriosis: impact and management challenges.” International Journal of Women’s Health, National Institute of Health, Pubmed.gov. May 16th, 2017.https://www.endonews.com/anxiety-and-depression-in-patients-with-endometriosis
- Bowel Endometriosis & IBS, Tamer Seckin, MD