Mensvärk behandlas ofta som något som kvinnor helt enkelt förväntas stå ut med. Budskapet att smärtsamma menstruationer är en del av livet kommer tidigt och ofta, även när smärtan är så svår att den hindrar någon från att arbeta, vila, äta eller röra sig bekvämt. Återkommande, utmattande och störande smärta förtjänar ordentlig uppmärksamhet snarare än att avfärdas, och en tydligare bild av varför den uppstår är en av de mest användbara utgångspunkterna.
Menssmärta och endometrios befinner sig i skärningspunkten mellan flera system samtidigt. Inflammation, prostaglandiners biokemi, nervsystemets kopplingar, hormonsignalering och kroniska stressreaktioner samverkar alla och formar både upplevelsen av smärtan och hur den förändras över tid. Vid endometrios kan detta samspel låsa fast kroppen i en återkommande smärtcykel som påverkar matsmältningen, energinivån, humöret och den dagliga funktionen långt bortom själva menstruationsperioden.
Kort svar: Menssmärta och endometrios är kopplade till varandra genom inflammation, prostaglandiner, nervsystemets känslighet och kroppens kroniska stressreaktioner. Milda kramper under mensen kan vara vanliga, men kraftig smärta är inte normalt. Att förstå varför smärta uppstår är det första steget mot att minska rädslan, beskriva symtomen tydligt och använda metoder som lugnar nervsystemet.
Livsstilen har betydelse för fertiliteten. En studie i BMC Public Health visade att kvinnor med 4–5 hälsosamma vanor hade 59 % lägre risk för infertilitet.
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tar 3 minuter att fylla iFör att förstå mensvärk måste man först förstå smärta i sig. Smärta är inte automatiskt något dåligt. I många situationer har den en skyddande funktion, då den varnar kroppen för fara och hjälper till att förhindra ytterligare skador. Ett sår, en brännskada eller ett kraftigt tryck sänder farosignaler via nervreceptorer, upp genom ryggmärgen och in i hjärnan, som sedan registrerar känslan och hjälper kroppen att reagera snabbt. Systemet är utformat för att reagera snabbt när det upptäcker ett hot.
Smärtsignalerna utgår från ett nätverk av nervfibrer och receptorer i hela kroppen. Dessa receptorer reagerar på olika typer av stimuli, bland annat mekaniskt tryck eller klämning, värme såsom brännskador eller extrem hetta, samt kemiska signaler såsom inflammatoriska ämnen. När ett hot upptäcks skickas signalen vidare till hjärnan, som tolkar vad som händer och avgör hur allvarligt det är.
Det som ofta förbises är hur mycket sammanhanget påverkar den tolkningen. Samma fysiska händelse kan upplevas som mer eller mindre intensiv beroende på tidigare erfarenheter av smärta, trauma eller rädsla kopplad till tidigare smärta, aktuella stressnivåer och om kroppen känner sig lugn eller hotad. Det är därför smärtan kan kännas värre när man är utmattad, stressad, överväldigad eller känslomässigt uttömd. Hjärnan tolkar inte smärta isolerat. Den tolkar den i sammanhanget av hela systemet.
Detta är en av de viktigaste frågorna, och svaret är tydligt. Mensvärk är vanligt, men det är inte normalt när den är betydande. Lätta kramper kan förekomma under menstruationen. Smärta som kräver regelbunden användning av smärtstillande medel, hindrar normal funktion eller går utöver ett milt obehag bör inte avfärdas.
Skillnaden mellan vanligt och normalt är viktig eftersom så många kvinnor får höra att deras smärta är förväntad. Det budskapet fördröjer stöd, fördröjer diagnos och skapar förvirring kring vad kroppen försöker kommunicera. Många som har återuppbyggt sin relation till menssmärta genom nutrition, stöd för nervsystemet och klinisk vård berättar att de har gått från ett stort beroende av smärtstillande medel till att inte behöva några alls, vilket tyder på att svår smärta inte är något som kroppen måste leva med för alltid.
När smärtsamma menstruationer normaliseras slutar människor att ifrågasätta vad som händer. Att ställa rätt frågor tidigare och stödja kroppen med praktisk egenvård vid menstruationssmärta vid sidan av eventuell klinisk vård gör ofta en betydande skillnad för hur upplevelsen utvecklas.
Innehållet är enbart i utbildningssyfte. Det har granskats för vetenskaplig korrekthet, men utgör inte medicinsk rådgivning, diagnos eller behandling. Rådfråga alltid legitimerad vårdpersonal vid medicinska frågor eller beslut om fertilitetsbehandling.
Granskad för vetenskaplig korrekthet av: Dr. Mona Bungum
Senast granskad: maj 2026
Livsstilen har betydelse för fertiliteten. En studie i BMC Public Health visade att kvinnor med 4–5 hälsosamma vanor hade 59 % lägre risk för infertilitet.
Fyll i frågeformuläret och få ett personligt, holistiskt och evidensbaserat program anpassat efter dig.
tar 3 minuter att fylla iTvå kliniska termer hjälper till att beskriva mensvärk mer exakt: primär dysmenorré och sekundär dysmenorré. De är användbara både för att förstå dina egna symtom och för att kunna kommunicera tydligare med vårdpersonal.
Primär dysmenorré avser smärta som uppträder under de första tre dagarna av menstruationen. Det är den typ av smärta som de flesta tänker på när de hör uttrycket ”menssmärta” och den är nära kopplad till själva menstruationsfasen.
Sekundär dysmenorré är annorlunda. Smärtan kan uppstå vid andra tidpunkter under månaden och kan visa sig i flera olika områden eller situationer. Det omfattar smärta vid tarmtömning, smärta vid urinering, smärta kring ägglossningen, smärta vid samlag, ihållande smärta i bäckenet och ihållande ryggsmärta. Detta mönster tyder på något mer komplext än typiska menstruationskramper.
För någon med endometrios är sekundär dysmenorré ofta en del av en mycket bredare bild av kronisk smärta. En komplett guide till endometrios är ofta det tydligaste sättet att förstå hur menstruationssymtomen passar in i den övergripande sjukbilden och vad man kan förvänta sig över tid.
Menssmärta är till stor del kemiskt inducerad smärta. Den drivs av inflammatoriska ämnen i kroppen snarare än av ett sår, en brännskada eller en fysisk skada. De viktigaste ämnena som är inblandade är prostaglandiner, hormonliknande kemikalier som hjälper till att utlösa nedbrytningen och avstötningen av livmoderslemhinnan under menstruationen.
Komplikationen är att inte alla prostaglandiner verkar på samma sätt. Det finns i stort sett två mönster: antiinflammatoriska prostaglandiner, kopplade till omega-3-fettsyror, och proinflammatoriska prostaglandiner, kopplade till omega-6-fettsyror. Varken omega-3 eller omega-6 är i sig skadliga. Problemet är obalansen mellan dem.
I en västerländsk kost är intaget av omega-6 ofta mycket högre än intaget av omega-3, ibland i ett förhållande på omkring 20 till 1, när ett balanserat förhållande skulle ligga närmare 1 till 1. Denna obalans driver kroppen att producera fler proinflammatoriska prostaglandiner. Eftersom livmoderslemhinnan har prostaglandinreceptorer påverkar detta hur starkt livmodern drar ihop sig och hur smärtsam menstruationen blir. Riktade antiinflammatoriska strategier kan direkt förändra denna balans.
Detta är också en del av anledningen till att en strukturerad kost vid endometrios ofta ger märkbara förändringar i smärtan över veckor snarare än dagar. Kroppen reagerar på den biokemiska miljö den utsätts för, och en konsekvent kost påverkar långsamt vad kroppen producerar.
Forskning tyder på att kvinnor med endometrios kan producera upp till fyra gånger så mycket proinflammatoriska prostaglandiner jämfört med kvinnor som inte har smärta. Detta bidrar till att förklara varför menstruationen kan kännas så svår vid endometrios. Vävnaden är redan inflammerad, och kroppen genererar dessutom starkare kemiska smärtsignaler utöver detta.
Det är också anledningen till att antiinflammatorisk nutrition är så viktig vid behandling av endometrios. Kroppen reagerar inte bara på vävnaden. Den reagerar på en inflammatorisk biokemisk miljö som driver på kraftigare sammandragningar, skarpare smärta och ökad känslighet överlag.
Endometrios påverkar mer än bara smärtupplevelsen. Samma inflammatoriska miljö är en del av förklaringen till varför endometrios och infertilitet så ofta hänger ihop, där bäckenmiljön påverkar både menstruationssymtom och den bredare reproduktiva bilden.
Akut smärta och kronisk smärta är inte samma sak. Akut smärta uppstår när något gör ont, kroppen reagerar och därefter följer läkning. Kronisk smärta är annorlunda. Kroppen återgår inte helt till ett säkert tillstånd.
Smärta som varar längre än sex månader och som inte kan lindras fullständigt med medicinsk behandling betraktas i allmänhet som kronisk. Kvinnor med endometrios hamnar ofta i denna kategori. Även när smärtan inte är konstant återkommer den med tiden. Den blir intermittent, återkommande och kopplad till kroppens stressreaktion på sätt som går utöver en enskild smärtattack.
När smärtan återkommer gång på gång börjar nervsystemet att vara i beredskap. Det blir svårare för kroppen att helt lugna ner sig mellan episoderna. Istället för att smidigt återgå till ett avslappnat tillstånd efter att en hotbild har passerat, förblir systemet delvis förberett på nästa smärtattack. En stressig dag, en plötslig skrämselhändelse, höjden vid resor, smärta vid tarmtömning eller spänningar i relationer kan alla påverka smärtupplevelsen. Kroppen reagerar inte längre bara på smärtan. Den förväntar sig den.
En av de viktigaste upptäckterna i den senaste forskningen är att nervfibrer finns i endometrioslesioner, samt i själva endometriet och myometriet. Detta är viktigt eftersom det visar att smärtan vid endometrios varken är inbillad eller överdriven. Det finns verkliga smärtbanor i den drabbade vävnaden.
Hormonbehandling har visat sig minska antalet nervfibrer i lesionerna, vilket ytterligare stöder hur nära sammankopplade smärtkänslighet, hormoner och vävnadsaktivitet är vid endometrios. Det innebär också att smärtupplevelsen och den underliggande biologin är tätt sammankopplade, och att åtgärder som påverkar det ena vanligtvis påverkar det andra.
HPA-axeln står för hypotalamus-, hypofys- och binjureaxeln. Detta system styr hur kroppen reagerar på stress, och vid endometrios är detta viktigt eftersom kroppen ofta utsätts för stress på flera olika sätt samtidigt.
Stress är inte bara emotionell. Den kan också vara fysisk och biokemisk, vilket inkluderar inflammation, kronisk smärta, dålig matsmältning, näringsbrist, ekonomiska påfrestningar, relationsstress, arbetspress och fertilitetsrelaterad stress. Många personer med endometrios utsätts i tysthet för flera av dessa faktorer samtidigt.
Vid långvarig kronisk stress kan HPA-axeln sluta fungera som den ska. Vissa människor producerar för mycket kortisol och andra stresshormoner. Andra går gradvis över till en lägre binjureproduktion och producerar för lite. Oavsett vilket blir systemet mindre motståndskraftigt, och stress och smärta börjar förstärka varandra. Skov uppstår ofta efter känslomässigt svåra händelser, resor, överbelastning eller intensiv utmattning, eftersom kroppen redan är hårt belastad och förlorar sin flexibilitet.
Det mest effektiva sättet att hantera detta är att identifiera specifika stressfaktorer snarare än att behandla stress som ett enda vagt problem. Vissa kan ändras. Andra kan inte det. Men även när en stressfaktor inte kan avlägsnas blir den lättare att hantera om man förstår den. Strukturerade metoder för stresshantering kan integrera dagliga avslappningstekniker i vardagen så att kroppen inte förblir i ett konstant ”kamp-eller-flykt”-läge.
Ett av de tydligaste begreppen när det gäller smärta vid endometrios är återkopplingsslingan. Den förklarar varför smärtan kan kännas så obeveklig och varför det krävs mer än att bara vänta på att inflammationen ska avta av sig själv för att bryta den.
När vävnaden är inflammerad skickar nerverna signaler till hjärnan om att det finns en fara. Hjärnan reagerar på denna fara, vilket ökar kroppens allmänna känsla av hot. Stressreaktionen ökar då inflammationen, vilket i sin tur skickar fler farosignaler, vilket förstärker smärtan ytterligare. Cykeln består av ungefär fem steg som förstärker varandra:
Med tiden dras fler nerver in i processen, fler organ kan påverkas och till och med områden utanför bäckenet kan börja göra ont.
Vissa kvinnor med kronisk endometriosvärk känner smärta ner i benen eller till och med i lederna. Detta är inte alltid ett tecken på en separat sjukdom. Ibland speglar det hur inflammerat och överkänsligt systemet har blivit totalt sett.
Det hjälper också till att förklara symtom som uppblåsthet, hjärndimma, störningar i matsmältningen och utbrett obehag. Kronisk smärta vid endometrios är sällan ett problem som enbart rör livmodern. Det kan utvecklas till ett problem som påverkar hela kroppens nervsystem, där den ursprungliga källan i bäckenet fortfarande finns kvar men inte längre är det enda som systemet reagerar på.
En praktisk och ofta underskattad färdighet är att lära sig beskriva smärta mer exakt. Vagt språk tenderar att ge upphov till vaga svar, både från vårdpersonal och från människor i din omgivning. Exakta beskrivningar gör det lättare för vårdpersonal att förstå upplevelsen och lättare för dig att följa mönster och förbättringar över tid.
Några användbara frågor att återkomma till är:
Att föra en smärtdagbok, även en kort sådan, kan avslöja mönster som är lätta att missa i stunden. Under loppet av veckor blir det tydligare om smärtan förändras i samband med menstruation, stress, mat, sömn, resor, behandling eller känslomässig påfrestning. En dagbok ger också en dokumentation av framstegen, vilket är viktigt eftersom människor ofta glömmer hur långt de har kommit när symtomen förbättras.
En av de mest användbara insikterna inom smärtforskningen är att det att lugna systemet inte bara handlar om att undanröja faror. Det handlar också om att medvetet tillföra trygghet. Om nervsystemet ständigt tar emot farosignaler förblir smärtan förstärkt. Om kroppen börjar ta emot trygghetssignaler regelbundet kan den börja förändras.
Enkla övningar fungerar som trygghetssignaler eftersom de talar till de delar av nervsystemet som reglerar lugnet. Andningsövningar är bland de mest tillgängliga, eftersom andningen är en av de få autonoma funktionerna som medvetet kan påverkas.
Att införliva regelbunden meditation i vardagen är ett annat väl dokumenterat sätt att sänka den grundläggande aktiveringsnivån. Många upplever att fem till tio minuter om dagen ger mer meningsfull förändring än enstaka längre sessioner.
Guidade visualiseringsövningar, inklusive visualisering av en lycklig plats eller affirmationer och visualisering specifikt för endometrios, fungerar på liknande sätt. De använder sinnet för att förse nervsystemet med den typ av information som talar om för det att kroppen är trygg.
Att vistas i naturen, jordningsövningar, matlagning, mindfulness, läsning, djup vila och alla aktiviteter som verkligen känns trygga och vårdande räknas alla in. Dessa avfärdas ofta som valfria eller lyxiga, men forskningen visar att de inte är något extra. När nervsystemet är konstant aktiverat är de en del av läkningsprocessen.
Vagusnerven är den tionde kranialnerven och den längsta i kroppen. Den sträcker sig från hjärnan ner genom kroppen och är kopplad till viktiga organ, däribland lungorna, magen, levern, bukspottkörteln, tarmarna och tjocktarmen. Den är den främsta drivkraften bakom den parasympatiska delen av nervsystemet, även kallad vil- och matsmältningssystemet.
En sund vagal tonus innebär att kroppen smidigt övergår till ett lugnt tillstånd när hotet är borta. Matsmältningen fungerar bättre, det är lättare att återhämta sig från stress och kroppen kan gå in i reparationsläge mer effektivt. Vid kronisk smärta och endometrios störs ofta denna balans, vilket leder till att systemet tillbringar för mycket tid i kamp-eller-flykt-responsen och inte tillräckligt i läget för matsmältning och vila.
Dålig vagal tonus eller dysfunktion i vagusnerven kan yttra sig som dålig matsmältning, instabilt blodsocker, kronisk smärta, ångest, depression, sömnsvårigheter, kronisk trötthet och lätt överstimulering. Vagusnerven kan påverkas av inflammation, trauma, kronisk stress, rygg- eller huvudskador, whiplash, sköldkörteldysfunktion, diabetes och inflammatoriska sjukdomsprocesser. Eftersom endometrios är en inflammatorisk sjukdom passar den naturligt in i denna bild.
Metoder som direkt påverkar vagustonen inkluderar långsam andning, nynnande, exponering för kallt vatten och mild meditation. In ”Shift Your Energy”-meditation är ett exempel på en strukturerad övning utformad för att få systemet att återgå till parasympatisk dominans.
Det tydliga budskapet från forskningen är att smärtlindring vid endometrios inte kan åstadkommas genom en enda åtgärd. Det kräver att flera olika nivåer samverkar.
Fyra nyckelområden återkommer ofta i de mest användbara ramverken:
Rädslan i sig förstärker smärtan. En person som har upplevt upprepade smärtsamma samlag, smärtsamma tarmtömningar eller återkommande smärtattacker i bäckenet kan börja spänna sig i förväg, vilket ökar spänningen och tenderar att förvärra upplevelsen. Att lära sig hur smärta fungerar får inte smärtan att försvinna, men det minskar den emotionella hotbilden kring den.
Inflammation är fortfarande en central drivkraft. Ju mer inflammation kroppen bär på, desto fler smärtsignaler tar nervsystemet emot, vilket är anledningen till att nutrition är så viktigt vid endometrios. Det bredare sambandet mellan stress och fertilitet pekar också tillbaka på samma system, eftersom kronisk stress påverkar både smärtan och den övergripande reproduktiva hälsan.
Strukturella problem spelar också roll. Överspända bäckenmuskler, felaktiga hållningsmönster och fysisk spänning utvecklas ofta parallellt med kronisk smärta. Myofascial release och strukturerad rörelse kan vara till hjälp på detta plan. I grunden för allt detta ligger självvård och självmedkänsla, eftersom kroppen reagerar mycket bättre på vänlighet och konsekvens än på perfektionism eller självkritik.
Här är några av de vanligaste frågorna som människor söker efter när det gäller mensvärk och endometrios. Svaren nedan återspeglar aktuell smärtforskning och klinisk förståelse av endometrios.
Smärtan vid endometrios beror på en kombination av inflammerad vävnad, ökade proinflammatoriska prostaglandiner, nervfibrer som växer inuti lesionerna, ett överkänsligt nervsystem och kroniska stressreaktioner. Dessa faktorer förstärker varandra, vilket är anledningen till att smärtan kan kännas oproportionerlig i förhållande till en enda orsak.
Nej. Milda kramper under mensen är vanliga, men smärta som kräver regelbunden användning av smärtstillande medel, hindrar det dagliga livet eller varar längre än de första dagarna av menstruationen anses inte vara normal. Den bör utredas ordentligt av en läkare istället för att avfärdas.
Primär dysmenorré är smärta som uppträder under de första tre dagarna av menstruationen. Sekundär dysmenorré är smärta som uppträder vid andra tidpunkter under månaden och kan innefatta smärta vid tarmtömning, urinering, samlag eller ägglossning. Sekundär dysmenorré tyder ofta på en underliggande sjukdom, såsom endometrios. Hur orsakar prostaglandiner mensvärk?
Prostaglandiner är hormonliknande ämnen som utlöser nedbrytningen och avstötningen av livmoderslemhinnan. Proinflammatoriska prostaglandiner, som är kopplade till omega-6-fettsyror, driver på kraftigare livmodersammandragningar och förstärker smärtsignalerna. Kvinnor med endometrios producerar ofta betydligt större mängder av dessa.
Ja. Balansen mellan omega-6- och omega-3-fettsyror i kosten påverkar direkt vilken typ av prostaglandiner kroppen producerar. Antiinflammatoriska kostvanor under veckor till månader tenderar att minska inflammation och lindra smärta hos många personer med endometrios.
Kronisk stress aktiverar HPA-axeln, vilket ökar inflammationen och förstärker smärtans återkopplingsloop. Med tiden blir nervsystemet mer känsligt och smärtreaktioner utlöses lättare. Att minska den grundläggande stressaktiveringen mildrar ofta smärtuppblossningarna.
Det är en cykel där inflammation utlöser smärtsignaler, smärtsignalerna ökar hotuppfattningen, hotuppfattningen driver på stress, stress ökar inflammationen och inflammationen ger upphov till mer smärta. Slingan förstärker sig själv och blir svårare att bryta ju längre den pågår.
Det kan den göra. Kronisk endometriosvärk sprider sig ibland till benen, ryggen eller lederna och kan bidra till uppblåsthet, hjärndimma, matsmältningsstörningar och utbrett obehag i kroppen. Detta återspeglar vanligtvis ett överkänsligt nervsystem snarare än separata sjukdomar.
Vagusnerven styr den del av nervsystemet som reglerar vila och matsmältning. En sund vagal tonus främjar lugn, bättre matsmältning och snabbare återhämtning från stress. En svag vagal tonus är förknippad med kronisk smärta, ångest, trötthet och svårigheter att lugna ner sig mellan smärtattacker.
Var specifik när det gäller smärtans karaktär (skarp, molande, skärande, utmattande), var den sitter, när den uppstår och om den är kopplad till specifika aktiviteter såsom tarmtömning, sex, urinering eller ägglossning. En smärtdagbok som förs under några cykler gör ofta mönstren mycket tydligare.
Ja, om de används konsekvent och i kombination med medicinsk vård. Andningsövningar, meditation, visualisering, milda rörelser, antiinflammatorisk nutrition och sömn stöds alla av aktuell smärtforskning. De ersätter inte behandling, men de förändrar på ett meningsfullt sätt hur kroppen reagerar.
För att förstå mensvärk och endometrios måste man börja med att avvisa tanken att svår smärta bara är något man måste stå ut med. Smärtan är verklig, mätbar och formas av en kraftfull kombination av inflammation, prostaglandiners biokemi, nervsystemets kopplingar, stressfysiologi och tidigare erfarenheter. När den bilden blir tydligare blir smärtan mindre mystisk och mindre skrämmande, även om den fortfarande är svår att hantera.
Att minska smärtan handlar inte bara om att jaga ett symptom. Det handlar om att stödja hela det system som ger upphov till upplevelsen. Att identifiera specifika stressfaktorer, beskriva smärtan tydligare, hantera inflammation, lugna nervsystemet och tillföra stadiga trygghetssignaler – allt detta påverkar olika delar av återkopplingsslingan samtidigt. Inget av dem är en enskild bot. Tillsammans är de det som gör att kretsloppet med tiden tappar sitt grepp.
Vägen är sällan snabb eller linjär. Endometrios är ett långvarigt tillstånd, och det tar veckor till månader för de mönster i nervsystemet som utvecklas kring det att mjukas upp. Men vägen finns. Samma kropp som lärde sig att spänna sig kan lära sig att släppa taget. Samma nervsystem som går på högvarv kan lära sig att lugna ner sig. Smärtlindring vid endometrios är ett verkligt, mångfacetterat och pågående projekt, och förståelsen för varför smärtan uppstår är där det börjar.
Om det finns en stillsam lärdom i centrum för allt detta, så är det att smärta som byggts upp under år tenderar att mildras i lager, inte genom en enda åtgärd. Arbetet går långsamt, men effekten ackumuleras. Kroppen är mottaglig, även när själva tillståndet inte försvinner.
00:00:04 So let's get started. So first of all, we're going to talk about understanding pain. So pain in the brain, you know, I want to, I'm going to cover all about how pain works, the science behind these pain signals, you know, is period pain normal? You know, why do you get period pain and then the whole chronic pain and endometriosis and how we can describe and measure this pain to help when we're talking to medical professionals and then what can we do about this? You know, why do you get period pain and then the whole chronic pain and endometriosis and how we can describe and measure this pain to help when we're talking to medical professionals and then what can we do about this? so first of all how does pain work well pain is a really good thing first of all it keeps us alive I mean if you think in a scenario of cutting your finger you know if you burn yourself on the oven or something more you know serious like a serious burn pain is is a good thing it stops us walking further into danger and so it I'll go through in a minute kind of like how you actually walking further into danger and so it I'll go through in a minute kind of like how you actually
00:01:02 cut your finger how that works but it's that pain signal helps to put us into high alert so that we can then seek a way to address that pain and then heal afterwards so it comes from signals in our brain and it comes from our our body as a network you know we have our nervous system we have all these nerve fibers and they carry right through to the skin but also in our organs everywhere and we have these pain receptors and these pain receptors can tell whether we feel organs everywhere and we have these pain receptors and these pain receptors can tell whether we feel pain both mechanical pain um chemical pain um mechanical chemical and then there's one more which i've just forgotten off to my head but there's three three ways that you can feel pain
00:01:46 um so when we injure ourselves these pain signals get sent back to our brain um and then to to make us move away from that okay so this is this is kind of like a basic the basic idea so this is us move away from that okay so this is this is kind of like a basic the basic idea so this is shown here if you cut your finger um for example if you were chopping um a cucumber and you cut your finger open it's like ow and it's instantaneous it's amazing how instantaneous that is and those pain receptors literally send those danger signals via spinal cord up your brain stem and then the pain is registered so your body and it depends of course have you experienced this before it might be a new pain or it might be something where you've cut it before and depending on your
00:02:28 experience depending on whether you've had a traumatic event depending on whether you're experience depending on whether you've had a traumatic event depending on whether you're highly stressed at this particular point in time or whether you're actually very calm will depend on how how you register that pain and how painful it is and that's why you can hear of people who walk across hot coals you know that should be something that's painful but it's because they put themselves in a mind state where they are able to not actually feel that pain response okay um so after you remove yourself from that threat you know you've taken the knife away um so after you remove yourself from that threat you know you've taken the knife away
00:03:02 um or you've you know put your hand under the cool water you stop burning your hand the body then starts to heal goes through this process and that the pain eventually reduces so this is just a very quick and easy way of doing it um so like i said how you're feeling is absolutely you know really really key if you're scared um if you have memories or trauma around something like this this is where pain will increase particularly if it's a repeated repeated element and coming back this is where pain will increase particularly if it's a repeated repeated element and coming back to the three stimuli it's mechanical so like a pinch or a pressure heat that's what i forgot heat and chemical so is period pain normal and the answer is no it is not it is really really common
00:03:47 but it is not normal and I think you all you all know this um or if you don't I'd like you to know this it is not normal to have period pain maybe a twinge but not pain where it's extreme so when this it is not normal to have period pain maybe a twinge but not pain where it's extreme so when you have period pain it's known as dysmenorrhea um there's primary dysmenorrhea and then there's secondary dysmenorrhea primary dysmenorrhea is when you get pain around the first three days your period where secondary dysmenorrhea is around at any point during the month um and it can happen in different areas so you might have pain associated with bowel movements urination around ovulation um during sex ongoing back and pelvic pain so that's known as secondary
00:04:24 around ovulation um during sex ongoing back and pelvic pain so that's known as secondary dysmenorrhea and it is quite useful to know these technical terms because if you're talking to your doctor and if you understand these terms um you know in the future in the past if you you know if you've got relatives who are going through you know a similar journey or who have endometriosis or you think might have endometriosis or got painful periods you're able to advise them of this because i think knowledge is a really key thing around period pain um because even the this because i think knowledge is a really key thing around period pain um because even the medical community just don't know enough about this um during your period you get much you should
00:05:08 get mild cramping nothing that you require a painkiller um you know it's just a slight twinge normal not normal is not the word sorry when you have no period pain you should just have slight cramping that doesn't require any period any painkillers of any sort that is kind of what you're aiming for and it does happen you know many of the clients that I've worked with they've gone you're aiming for and it does happen you know many of the clients that I've worked with they've gone from taking tons to nothing um and it is totally achievable depending on your situation everybody's situation is different and it depends on the layers behind that so the question is why do we get painful periods um so period pain is a chemical induced pain so when we come back to those three
00:05:56 the heat chemical and mechanical it's a chemical induced pain because it's caused by these the heat chemical and mechanical it's a chemical induced pain because it's caused by these inflammatory prostaglandins now you'll see in these two boxes we've got two boxes here where we've got green for good anti-inflammatory prostaglandins known as pge1 um and these that they are made from omega-3 fatty acids whereas bad pro-inflammatory prostaglandins pge2 the building blocks for this is from omega-6 fatty acids now omega-3 omega-6 there's no good pge2 the building blocks for this is from omega-6 fatty acids now omega-3 omega-6 there's no good or bad between them the problem in our society today is that we're imbalanced you want a balance
00:06:40 between omega-3 and omega-6 a one-to-one balance unfortunately with our western style diet most ratios that come up is about 20 to 1 so 20 being omega-6 is being really high it's the amount of omega-3s now as you can see there if you've got a very high amount of omega-6s amount of omega-3s now as you can see there if you've got a very high amount of omega-6s this is going to push you towards having lots of pro-inflammatory prostaglandins not these good anti-inflammatory prostaglandins and the thing is the uterus has prostaglandin receptors in the lining and these are thought to be responsible for the uterine lining contractions okay so prostaglandins are involved in starting the disintegration and shedding of the womb uterine
00:07:24 lining and research has shown that women with endo can have up to four times the amount of bad lining and research has shown that women with endo can have up to four times the amount of bad prostaglandins i.e pg2 compared to those that are not in pain so it's about finding this balance And actually one of the ways that you can see what, you know, your lipid levels, a very basic test. I mean, you can do more, more comprehensive tests, but asking your doctors to test for a lipid panel, particularly including the LDL and HDL. So LDL being bad, we say bad fats, not necessarily bad fats, but sort of the omega-6s, HDL, the omega-3s. So LDL being bad, we say bad fats, not necessarily bad fats, but sort of the omega-6s, HDL, the omega-3s. So you want this to be balanced. You want HDL more than three millimoles per liter and you want LDL below three, ideally around 1.5.
00:08:12 So you actually want it kind of like slightly imbalanced because the HDL is much more protective. So chronic pain and endometriosis. Now, chronic pain is different from just cutting your finger and you heal. chronic pain is classified as pain that lasts longer than six months and cannot be alleviated chronic pain is classified as pain that lasts longer than six months and cannot be alleviated by medical treatment um and women with endometriosis fall into this category okay it's not constant but it's intermittent regular and it continues over time you know with every monthly cycle so it is classified as chronic pain now when you have cut your finger your nervous system responds to that and you can calm down and you can heal but with chronic pain your nervous
00:08:56 system responds to that and you can calm down and you can heal but with chronic pain your nervous system starts not be able to fully relax because you're in this heightened sense of stress okay and this is a really key part to understand because when we come on to the sort of how to help work with reducing pain it is important to register the fact that the nervous system is part of this because you're constantly in pain your nervous system is constantly in this state of sort of fight or flight or very easily triggered and when I say triggered it's like your nervous sort of fight or flight or very easily triggered and when I say triggered it's like your nervous system you might be okay and then you have a stressor at work or I don't know you break when
00:09:37 you're driving very suddenly and you're you know you might feel that tingling at the end of your fingers and you suddenly feel very stressed very quickly anything can trigger you and you can end up having um you know you can end up being bloated you end up being in pain again and that's because your nervous system is just so used to being in this heightened state is very very easy to trigger your nervous system is just so used to being in this heightened state is very very easy to trigger you now they've actually found that there are similar nerve fibers to the rest of your body within the endometriosis lesions the endometrium and the myometrium um and they've also found hormonal therapy so when they've given hormonal therapy to help with endometriosis to get rid of
00:10:21 the pain, this can actually reduce the amount of nerve fibers within the lesions, which I find really interesting. So if you've got a lot of nerve fibers in there, and your nervous system really interesting. So if you've got a lot of nerve fibers in there, and your nervous system is very heightened, and very, very sensitive, and sensitive to inflammation, this is where the inflammation comes in, because pain and inflammation, it's all part of the picture, when you, and I'll talk about this in a minute, it's like a vicious cycle, you're always going to end up in that pain okay um so as i've said here the brains you know the brains of women you know of women with endometriosis you're constantly feeling under threat so your nervous system is just
00:10:56 going to be so sensitive to this extra pain you're not going to feel as relaxed as you should do going to be so sensitive to this extra pain you're not going to feel as relaxed as you should do so this then comes on to something i talk about with many of you is the hypothalamus pituitary adrenal access so hba access now i would say every single one of you when i do a health history has got some issue of dysfunction with your hba access whether that's low or excess adrenal hormone output and this is due to chronic stress now stress we always think of stress as like being hormone output and this is due to chronic stress now stress we always think of stress as like being a stress associated with work or you know an emotional stress but it's not just an emotional
00:11:40 stress stress comes from physical so it can be emotional it can be from a whole variety of things but it can also be from the physical stress so inflammation is stressed um you know chronic pain that is stress on your body if your digestive function is not functioning properly you're not digesting your food properly this is stress on your body because you're not getting those nutrients digesting your food properly this is stress on your body because you're not getting those nutrients to help your liver function to help reduce inflammation all these things and so having dysfunction of the hpa access you're going to constantly be either pumping out too much cortisol or you just haven't got enough to to deal with these stress situations and then this can trigger
00:12:21 pain as well um and make the pain worse and i don't know whether any of you've had like um a stressful situation and then you've had a flare-up afterwards whether you've made this um a stressful situation and then you've had a flare-up afterwards whether you've made this connection between stress because it's very easy to focus on the nutritional side of things but actually the stress side is massive yes we need to feed our body nutrients endometriosis is a nutrient hungry disease um and part of the reason we're not getting the nutrients is because our digestive function I'll come on to this in a bit isn't working properly because our nervous system isn't working properly um I mean I had uh I mean so many flare-ups I can think of I mean
00:12:58 isn't working properly um I mean I had uh I mean so many flare-ups I can think of I mean planes often you know you might not be stressed getting on a plane or the rest of it but even just the altitude you know when you're going up in a plane I've had that where actually I felt quite relaxed um but even just going up the altitude has then caused me to have a flare-up you know and I've ended up with this huge endo belly and I'm like well how did that happen but actually going in a plane going at altitude is a physical stress on your body but then equally but actually going in a plane going at altitude is a physical stress on your body but then equally and I'm sure you've had it where something I mean I mean I remember years ago 20 years ago
00:13:37 um I'd been traveling for a year and I had all these photographs and I've been on my own and I was trying to get them developed and the photo developers completely screwed it up and essentially I just it really just pushed me to the edge I was really stressed anyway from a number of things that had happened during that time and I literally had this huge it was just such a trigger I got that had happened during that time and I literally had this huge it was just such a trigger I got endo bloat like I was nine months and I actually physically fell over I couldn't hold myself up because my nervous system was so it had been wired for so long it didn't know how to relax and it was just triggered by something which actually was fairly small but it was just that
00:14:19 stress point so maybe have a think back have there been times where you've been stressed and you've had a endo flare you've ended up in pain you've ended up with endo belly um you've ended up just had a endo flare you've ended up in pain you've ended up with endo belly um you've ended up just being absolutely exhausted and that's where you've got you know the hpa hpa axis dysfunction you'll pump out that cortisol and if you've had chronic stress for a long time you just can't you know you have low adrenal output you won't have enough cortisol to cope with that so that's why I go on about calming your nervous system so much and supporting your HPA access and that's why it's really important also to identify what your stresses are and sometimes that can be the
00:14:58 really important also to identify what your stresses are and sometimes that can be the hardest thing is trying to understand what is it is it things that you can change sometimes it's things that you can't change and it's not necessarily about having to change those things it's about bringing in techniques so that you can um you can cope with the stresses that are going on around you because our bodies are so clever they should be able to deal with stress and not then push you into an inflammatory into a high pain state and then you experience the chronic pain then push you into an inflammatory into a high pain state and then you experience the chronic pain it's about calming your nervous system which i'll come on to in a minute so more with the chronic
00:15:39 pain and endometriosis the reasons for being stressed as i've said already is like chronic and persistent pain inflammation swelling floating um and excessive bleeding so all sort of coming from the lesions the endo lesions themselves from scar tissue from any you know pelvic pain where you've got scar tissue between organs between like tendons you might have you know a variety you've got scar tissue between organs between like tendons you might have you know a variety of pain issues associated with your pelvic area whether it's also like bladder pain whether it's passing urine passing your bowel movements all of that kind of area but then other stresses associated with the endometriosis and I think this is a big one is the lack of the medical support
00:16:18 and understanding and sometimes you might have amazing support and other times just nobody's listening to you and a lot of that comes with first of all trying to get a diagnosis but then even when you get a diagnosis is the treatment options understanding the treatment options even when you get a diagnosis is the treatment options understanding the treatment options maybe having treatment and then the treatment isn't successful um and just having that lack of a a roadmap or an understanding or support from medical staff that don't necessarily understand the disease and that is a massive massive stress in itself it might seem you know after you get your diagnosis it's a relief but then once you get past that relief there's more stressors
00:16:58 you know like I said before work stressors totally unrelated it could be unrelated to the endometriosis you know like I said before work stressors totally unrelated it could be unrelated to the endometriosis but it could also be you're in pain every month you can't go to work for three or four 10 days you may not be able to work at all as a result and these are stressors and they're ongoing stressors emotional stressors you know strain of relationships due to the endometriosis it could be strained because you know you're not able to have sex comfortably because you get have pain when you have sex and that then affects your relationships you know if you're going through pain when you have sex and that then affects your relationships you know if you're going through
00:17:31 infertility and you're struggling to have a baby that again strains your relationships um so so many things here you know your infertility journey which i said and then of course finances i mean the financial strain of of trying to support your health care whether it's um if you're not able to get insurance or go through the NHS in the UK to, to, you know, support with any operations or support with blood tests. But also then if you are, you know, going down the path, which we, support with blood tests. But also then if you are, you know, going down the path, which we, you know, you're, if you're working with me, then trying to find the, you know, alternative ways to support your body as part of the bigger picture, it is costly. And that can be very begrudging
00:18:13 that having to do that, but it's a stress. So these, so you can see there are so many stresses here but it's about learning these techniques to cope with it and I think that's really important but I think once you identify what your stresses are it's easier to then accept them easier to but I think once you identify what your stresses are it's easier to then accept them easier to understand them easier to kind of go okay that one I can't necessarily deal with but these ones I can so the pain feedback loop your nervous system is creating a feedback loop and your brain is constantly at threat which you know if it's this is with chronic pain it's constantly feeling at threat and it stresses the body it then increases inflammation so as you can see there when the
00:18:57 area is inflamed the nerves send a signal back to the brain saying it's inflamed it's it's area is inflamed the nerves send a signal back to the brain saying it's inflamed it's it's experiencing pain it releases these pain signals and then inflammation is part of like the healing process so when you're healing you get inflammation to heal but in this status because it's chronic you're then increasing your inflammation so it's like reinforcing this feeling of threatened and it worsens the pain signal so you end up in this kind of like you know negative feedback loop going round and round and it's about breaking that cycle and over time um our nerves you know other round and round and it's about breaking that cycle and over time um our nerves you know other
00:19:35 nerves get involved and we're unable to calm down on our pain response resolve the issue we end up getting more nerves more organs and areas other areas become involved you know your digestive system starts to not be able to function properly your liver then gets clogged as part of the picture and because your nervous system isn't necessarily working so all of these interlinked elements and inflammation spreads not just in your pelvic area um many of you may have felt elements and inflammation spreads not just in your pelvic area um many of you may have felt you know your joints hurting and this is where inflammation is spread not just from your pelvic area into you know around your body and this isn't that you've got arthritis it's just that you're
00:20:14 inflamed and if you've had chronic pain for a long time um your nerves are so sensitive um you know many women with endometriosis feel you know horrific pain down their legs as well and it's just your your nerves are just so sensitive and it's any kind of stress can trigger that um it's just your your nerves are just so sensitive and it's any kind of stress can trigger that um you know and as pain continues your brain stops releasing the natural pain relieving chemicals like dopamine so you don't even get these calming feeling you don't get that sort of pain relief and so it's really really important to break this cycle so that you can bring back that sort of um stop the nerves being so sensitive essentially so what can we do about it um one understanding
00:20:57 stop the nerves being so sensitive essentially so what can we do about it um one understanding the pain um is really important because then we can remove the fear around the pain because there's also a lot of fear um you have that emotional trauma around the pain as well i mean one example is painful sex for example you know if you've had painful sex and you've tried it in different ways just every time it's painful you start to then fear having sex which then obviously affects your relationship when you feel guilty um but you also then tense up your nervous system is then relationship when you feel guilty um but you also then tense up your nervous system is then heightened and you're not relaxed and it's no longer a pleasurable experience and then obviously
00:21:39 if you're trying to have a baby it's just you know it really isn't helping the situation so the way that we calm down the pain response is by reducing the danger signals and increasing the safety signals so really it's kind of the best way to go about this and you will have heard me talk about nutrition this way is crowding out it's a bit like initially rather than going right i'm about nutrition this way is crowding out it's a bit like initially rather than going right i'm going to give up gluten and dairy and do that straight away it's like crowd it out by bringing in nourishing foods and this is the same here crowd out those danger signals by bringing in lots of safety signals bringing in and when you start bringing the safety signals the danger
00:22:21 signals start to reduce um it's normally about addressing inflammation so a big part of this is addressing inflammation if there are any structural issues um with regards to pelvic pain is addressing inflammation if there are any structural issues um with regards to pelvic pain if there's muscles that are overtight so using myofascial release and we'll go into this and calming the nervous system so these are like three big things addressing inflammation looking at structural issues and calming the nervous system okay so this is none of this actually brings in nutrition i mean nutrition and supplements are part of it but those are key okay um like i said nutrition i mean nutrition and supplements are part of it but those are key okay um like i said
00:23:01 we need to crowd out the danger signals so one of the other things I think is really important is to when we talk about pain and this is in the the pain management guide which I will put alongside this presentation if you haven't already seen it and it is in the academy as no it's not in the academy actually I just give it out when we come to it so I will put it alongside this is to be able to describe and measure your pain so that you can communicate with your doctor this is to be able to describe and measure your pain so that you can communicate with your doctor your IVF you know with your gynecologist your IVF clinic whether it's your endo you know adeno specialist whoever it is your nutritional therapist you're not working with me or your
00:23:41 acupuncturist whoever it is it is actually really really useful to understand some of the terminology around the pain so that you can describe whether it's jumping whether it's flicking is it sharp is it cutting in is it exhausting is it sickening so here you'll see I've just taken um some from the guide um there's a whole list here this is actually taken from crash 1991 um um some from the guide um there's a whole list here this is actually taken from crash 1991 um as seen in mills and vernon um and i'll put it in that guide you'll see the the link to the reference there as well and i think it's just really good to understand um those pain signals but also in there is actually you'll see um three uh you know three areas of your body is to be able
00:24:26 to mark down where you're getting that pain and that's just useful so that you can like really to mark down where you're getting that pain and that's just useful so that you can like really really pinpoint um you understand it and then it's much much easier to then communicate um but also you can then monitor the differences and changes over time so when you're improving you can look back and go oh yeah because it's it's incredibly easy to forget it's amazing the human body forgets things I mean I was working with um one of you recently and you know it was remembering actually how far you'd come and it was like oh yes I used to feel like that and now I don't I forgot I used how far you'd come and it was like oh yes I used to feel like that and now I don't I forgot I used
00:25:03 to feel like that so actually having some sort of record of like where the pain at its worst when it's like that and you might want to write some notes for yourself and there is space in the guide there's lots of space because it's like a workbook so that you can do that so one of the call to actions that I'd you know recommend is keep a diary occasionally there is kind of like a a month diary here you might be able to see it there's um all the sort of like um feelings of a month diary here you might be able to see it there's um all the sort of like um feelings of pain or areas and then days of the month and you could tick off and put numbers there's a little um you might find that a little bit small but there's uh symbols as well that you can put here
00:25:43 depending on whether it's during your period at any other point of time just to kind of like you can then start seeing patterns because obviously if we're working together and we've done a health history then I try and pull out and tease these things but the more that you understand yourself what is going on the easier it is for you to describe what's going on to other people what is going on the easier it is for you to describe what's going on to other people but also to monitor the improvements and I think this is really important. so calming down the pain response um like i said before safety signals we can see here um some of the safety signals to bring in is breath work it's free it's easy it is one of the biggest
00:26:23 things that you can do and i think often we and i'll come on to it more often we don't put enough significance on this one um meditation yoga being in nature i mean that being in nature and being significance on this one um meditation yoga being in nature i mean that being in nature and being grounded and connected to the earth is huge and again they're they're very they're cheap they're easy they don't cost a lot but sometimes it's about getting ourselves there it's about making a plan it's making commitment to it and I think it's also understanding the significance which is why I wanted to do this masterclass to kind of explain the relevance to the nervous system which I'm going to go into a bit more detail in a minute on the vagus nerve cooking mindfulness
00:26:59 which I'm going to go into a bit more detail in a minute on the vagus nerve cooking mindfulness anything that makes you feel safe safe nurtured calm whether it's reading a book in a swinging chair going to a spa whatever it can be expensive it can be really really cheap it's it's just bringing in and don't I think a lot of time as women we find that these are things that that are looking after ourself and we feel that we don't not deserve it's the wrong thing that that are looking after ourself and we feel that we don't not deserve it's the wrong thing that we don't prioritize our own self-care and actually the doc funnily enough I think it was a couple of years ago um I think in Wales they were starting to actually write prescriptions to go and spend
00:27:48 time in nature and I was like that's fantastic not writing a painkiller but actually writing a prescription spend more time in nature and this will actually you know is part of a healing process And I think because we don't see this as a pill for an ill or anything like this, we don't put it as a priority and it needs to be. And I think because we don't see this as a pill for an ill or anything like this, we don't put it as a priority and it needs to be. So this can then help reduce the danger signal. So you see there the danger signals of feeling unsupported, inflammatory triggers, unresolved trauma, pain and bloating, depression, anxiety, brain fog and endless to do lists. I mean, if you're anything like me, having those to-do lists and then feeling really crappy about yourself because you've just not had the energy, you know, you've got brain fog, you feel like you've crossed nothing off, you know, that triggers you. I mean, if you're anything like me, having those to-do lists and then feeling really crappy about yourself because you've just not had the energy, you know, you've got brain fog, you feel like you've crossed nothing off, you know, that triggers you.
00:28:37 It triggers your nervous system so that, you know, in terms of safety signals, make plans, but be realistic. Maybe you only put one thing on your list. So then it makes you feel safe because you tackle one thing. You don't write 15 things down on there. There might be 15 things, ideas that you can do over the next two or three months and you can tick them off slowly, but you don't have to do them all at once. There might be 15 things, ideas that you can do over the next two or three months and you can tick them off slowly, but you don't have to do them all at once. So, you know, try and reduce those endless lists because then it can reduce this danger signal. So the vagus nerve. So the vagus nerve is part of the nervous system.
00:29:15 It is one of 12 cranial nerves in the body. It's actually the 10th cranial nerve and it is the longest. So it runs in the brain down the spine and it taps into every major organ. As you can see in this figure here, everything from lungs, spleen, pancreas into your small intestine, stomach, liver, colon. As you can see in this figure here, everything from lungs, spleen, pancreas into your small intestine, stomach, liver, colon. It is so important. I mean, it's so, so important. I mean, there are lots of books now actually on the polyvagal theory to do with the vagus nerve, because I think we're now understanding the sheer importance. And the funny thing is the vagus nerve is one of the nerves that underpins, you know, these amazing therapies is the wrong word. And the funny thing is the vagus nerve is one of the nerves that underpins, you know, these amazing therapies is the wrong word.
00:30:02 These amazing Eastern ways of looking, you know, Eastern medicine. So when you look at acupressure, you look at acupuncture, you look at Ayurvedic medicine, they've known about the vagus nerve for thousands of years. They haven't necessarily known how it exactly works, but they have known about it. They've known the importance. And that's why working on various points in your body can tap into the vagus nerve and calm it down. so it controls multiple sensory and motor functions including digestion which is key to so it controls multiple sensory and motor functions including digestion which is key to understand this because this is where the expression rest and digest comes from you know if you're calm you will digest also breathe and feed so again if you're calm your fertility will be turned on
00:30:48 you will have that ability to digest your food so when your vagus nerve is turned on as it were and you're in this rest and digest this is when you're parasympathetic so your body is like split and you're in this rest and digest this is when you're parasympathetic so your body is like split into two it's split into the parasympathetic and the sympathetic well there's the autonomic and the nomic i'm not going to go into that but the parasympathetic is this rest and digest the sympathetic is the fight or flight um which is that stress response and we should be in the parasympathetic we should be in that rest and digest for 80 90 percent of the time and then when we have a stressor then we our nervous system flicks over to our sympathetic nervous system
00:31:24 when we have a stressor then we our nervous system flicks over to our sympathetic nervous system it pumps out cortisol from our adrenals and various other hormones that enable us for our heart to pump faster our eyes dilate we start to sweat we can we get you know loads of blood sugar our blood sugar increases so that we can pump blood sugar around our body so our you know our muscles can move and we can run away from that danger that that's how it works and then when that day just passed you flick back into that rest and digest state now the vagus nerve can be damaged that day just passed you flick back into that rest and digest state now the vagus nerve can be damaged by many things not just damage it can be damaged it can also be known as the vagal tone so it can
00:32:09 just not be very strong um and this can be in terms of damage spine and head injuries particularly including whiplash this is this is a classic one trauma and chronic stress can cause damage to it or cause your tone to be very poor inflammation hyperthyroidism diabetes and then diseases and conditions i mean endometriosis is an inflammatory condition so it comes back to that inflammation conditions i mean endometriosis is an inflammatory condition so it comes back to that inflammation so it affects this vagus nerve um now if you've got poor vagal tone um or it's damaged you'll struggle to stay in this parasympathetic state in this rest and digest state and you'll find that you're you really get stressed very easily you get triggered very very easily and
00:32:56 you may feel wired all the time you may feel actually quite pumped quite um excited by stuff you may feel wired all the time you may feel actually quite pumped quite um excited by stuff and that's when you've just got too much cortisol running around your body and that's great until you're so fatigued you have nothing and then you feel knackered the whole time but anything could trigger you to be stressed and it could be that you suddenly you cry very easily you get bloated you suddenly feel exhausted um very very easily so the other things that then you can struggle with is like i've said is poor digestion your blood sugar management um can go down because with is like i've said is poor digestion your blood sugar management um can go down because
00:33:31 your pancreas is not functioning properly and this kind of then again affects your digestion because your digestive enzymes chronic pain um you can end up with more chronic pain it can end up causing autoimmunity conditions. And again, if your vagal tone is not very good, depression, anxiety, sleep difficulties, chronic fatigue, I mean, go on. The importance of having good vagal tone is really important, but also to understand if you've actually got some damage
00:33:59 to your vagus nerve or physical obstructions. to your vagus nerve or physical obstructions. And I will come on to how we can tell that in a minute.
