Many of the fibroid and endometriosis patients I see in my medical practice complain of major stress along with their physical symptoms. My personal impression as a physician who has worked with women patients for close to 20 years is that stress is a significant component of many recurrent and chronic health problems, including fibroids and endometriosis. To discount the effects of lifestyle stress on illness is a grave mistake. If the physician ignores stress as a contributing factor, the patient never receives the tools or insight necessary to modify her habits and behavior to better support good health and well-being.
Research studies have confirmed the negative effects of stress on many different diseases. On the physiological level, stress increases the cortisone output from the adrenal glands, impairs immune function, elevates blood pressure and heart rate, and affects hormonal balance. In women with fibroids and endometriosis, stress may negatively affect hormonal balance and muscle tone, upsetting the estrogen and progesterone balance and triggering excessive output of adrenal stress hormones. This can impair the body’s ability to limit the scarring and inflammation caused by the endometrial implants. Growth in the size of fibroid tumors is also seen during times of stress.
Stress in fibroid and endometriosis patients can arise over such issues as job security and performance, money worries, relationship problems with family and friends, overwork, and a host of other common problems. In addition, women with fibroids and endometriosis have specific stress due to the diseases themselves, including concerns about their health and about the painful symptoms that are disrupting their lives and well-being. The infertility that can result from fibroids and endometriosis is a particularly upsetting problem for women who are trying to start a family. The pain during intercourse that is also common in women with endometriosis can disrupt a healthy sexual relationship, causing anguish and discord.
A variety of stress management techniques can help women suffering from fibroids and endometriosis. Some women find counseling or psychotherapy to be effective, while others depend heavily on the support of family and friends. Many women find it helpful to rethink their way of handling stressful situations and to implement lifestyle changes. Practicing stress reduction techniques like meditation and deep breathing exercises on a regular basis also helps them handle stress more effectively, as does a program of physical exercise. Whatever methods you decide to practice, I urge you to look at your stress level carefully and make every effort to handle emotionally charged issues as calmly as possible.
The stress management exercises described in this chapter are a very important part of the fibroid and endometriosis self help program I recommend to my patients. For many women, the intensity of menstrual pain and cramps varies from month to month, depending on many lifestyle factors. My patients frequently tell me their bleeding and cramps are worse when they are more upset. As you begin to anticipate the onset of your menstrual period, I recommend using stress reduction techniques on a daily basis. They can really make a difference. If you break up the tasks of the day with a few minutes of stress reducing exercises, you will feel much more relaxed. With the use of these stress reduction techniques, you can accomplish tasks on time but in a much more relaxed, enjoyable, and health enhancing manner.
Exercises for Relaxation
To help you cope with the emotional stresses that may become magnified if you are suffering from fibroid and endometriosis related symptoms, I recommend a variety of relaxation methods. Focusing, meditation, muscle relaxation, affirmations, and visualizations can each help foster a sense of calm and well-being if practiced on a regular basis. This chapter includes exercises from all of these categories for you to try. Pick those you enjoy most and practice them on a regular basis. I have taught these exercises to women patients for many years and love to practice them myself. Sometimes I recommend that my patients learn these techniques on their own through books and tapes; other times I teach the exercises to patients at my office. My patients have been very enthusiastic about the results they attain through stress reduction exercises. They often tell me that they feel much calmer and happier. They also find their physical health improves. A calm mind seems to have beneficial effects on the body’s physiology and chemistry, restoring the body to a normal condition.
To prepare yourself for the relaxation exercises in this chapter, I suggest taking the following steps:
First Step.Wear loose, comfortable clothes. Find a comfortable position. For many women, this means lying on their backs. You may also do the exercises sitting up. Try to make your spine as straight as possible. Uncross your arms and legs.
Focus your attention on the exercises. Do not allow distracting thoughts to interfere with your concentration. Close your eyes and take a few deep breaths, in and out. This will help remove your thoughts from the problems and tasks of the day and begin to quiet your mind.
Exercise 1: Focusing
If you have fibroid or endometriosis related menstrual cramps and pelvic pain, this focusing exercise takes your attention off your pelvic region and lower part of your body as you focus elsewhere, clearing your mind and breathing deeply. At the end of this exercise, you may find that your discomfort is less severe. This is also a helpful exercise for inducing a sense of peace and calm.
- Sit upright in a comfortable position.
- Hold your watch in the palm of your hand.
- Focus all of your attention on the movements of the second hand of the watch.
- Inhale and exhale as you do this. Continue to concentrate for 30 seconds. Don’t let any other thoughts enter your mind. At the end of this time, notice your breathing. You will probably find that it has slowed down and is calmer. You may also feel a sense of peacefulness and a decrease in any anxiety that you had on beginning this exercise.
Exercise 2: Peaceful Meditation
Many women suffering from fibroids or endometriosis complain of daily life stresses. Stress can lower the pain threshold, increasing muscle tension and discomfort. It can also worsen PMS related irritability and mood swings, which often coexist with fibroids and endometriosis. Simple meditation techniques are a way to combat this stress. Meditation requires you to sit quietly and engage in a simple and repetitive activity. By emptying your mind, you give yourself a rest. The metabolism of your body slows down. Meditating gives your mind a break from tension and worry. It is particularly useful during menstruation, when every little stress is magnified. After meditating you may find your mood greatly improved and your ability to handle everyday stress enhanced.
- Lie or sit in a comfortable position.
- Close your eyes and breathe deeply. Let your breathing be slow and relaxed.
- Focus all of your attention on your breathing. Notice the movement of your chest and abdomen in and out.
- Block out all other thoughts, feelings, and sensations. If you feel your attention wandering, bring it back to your breathing.
- Say the word “rest” as you inhale. Say the word “relax” as you exhale. Draw out the pronunciation of each word so that it lasts for the entire breath: r-r-r-r-e-e-e-e-s-s-s-s-t-t-t-t, r-r-r-e-e-e-l-l-1-a-a-a-x-x-x. Repeating these two words will help you to concentrate.
- Repeat this exercise until you feel very relaxed.
Exercise 3: Healing Meditation
This meditation exercise promotes healing through a series of beautiful and peaceful images you can invoke to create a positive mental state during your premenstrual and menstrual time of the month. (You can use this exercise during your symptom-free time, too.) The premise of a healing meditation is the fact that the mind and body are inextricably linked. When you visualize a beautiful scene in which your body is being healed, you stimulate positive chemical and hormonal changes that help to create this condition. This process can reduce pain, discomfort, and irritability. Likewise, if you visualize a negative scene, such as a fight with a spouse or a boss, the negative mental picture can trigger an output of chemicals in the body that can worsen the symptoms caused by fibroids or endometriosis. The axiom “you are what you think” is literally true. I have seen the power of positive thinking for years in my medical practice. I always tell my patients that healing the body is much harder if the mind is full of upset, angry, or fearful images. Healing meditations, when practiced on a regular basis, can be a powerful therapeutic tool. If you enjoy this form of meditation, try designing your own with images that make you feel good.
- Lie on your back in a comfortable position. Inhale and exhale slowly and deeply.
- Visualize a beautiful green meadow full of lovely fragrant flowers. In the middle of this meadow is a golden temple. See the temple emanating peace and healing.
- Visualize yourself entering this temple. You are the only person inside. It is still and peaceful. As you stand inside this temple, you feel a healing energy fill every pore of your body with a warm golden light. This energy feels like a healing balm that relaxes you totally. All anxiety dissolves and fades from your mind. You feel totally at ease.
- Open your eyes and continue your deep, slow breathing for another minute.
Exercise 4: Discovering Muscle Tension
This and the following exercise help you get in touch with your areas of muscle tension, and then teach you how to release that tension. This is an important sequence for women with fibroids or endometriosis who suffer from recurrent menstrual cramps, low back pain, or abdominal discomfort. Many of these symptoms are due in part to the chronically tight and tense muscles that can accompany both problems. Tense muscles tend to have decreased blood circulation and oxygenation, and may accumulate an excess of waste products like carbon dioxide and lactic acid. Interestingly enough, some women with menstrual cramps and pelvic pain carry tension in these areas throughout the month, even when cramps are absent. They tend to tighten the pelvic and lower abdominal muscles in response to work, relationship, and sexual stresses. Usually, this tensing of the pelvic muscles is an unconscious response that develops over many years and sets up the emotional patterning that triggers cramps. For example, when a woman has uncomfortable feelings about sex or a particular sexual partner, she may tighten these muscles when engaging in or even thinking about sex. Tense muscles also affect a woman’s moods, making her more “uptight” and irritable. Muscular and emotional tension usually coexist. Movement is one effective way of breaking up these habitual patterns of muscle holding and contracting. When muscles are loose and limber, a woman tends to feel more relaxed and in a better mood. Anxiety tends to fade away, replaced by a sense of expansiveness and calm.
- Lie in a comfortable position. Allow your arms to rest comfortably by your sides, palms down, on the surface next to you.
- Now, raise just the right hand and arm and hold it elevated for 15 seconds.
- Notice if your forearm feels tight and tense or if the muscles are soft and pliable.
- Now, let your hand and arm drop down and relax. The arm muscles will relax too.
- As you lie still, notice any other parts of your body that feel tense, any muscles that feel tight and sore. You may notice a constant dull aching in certain muscles. Tense muscles block blood flow and cut off the supply of nutrients to the tissues. In response to the poor oxygenation, the muscle produces lactic acid, which further increases muscular discomfort.
Exercise 5: Progressive Muscle Relaxation
- Lie in a comfortable position. Allow your arms to rest at your sides, palms down, on the surface next to you.
- Inhale and exhale slowly and deeply.
- Clench your hands into fists and hold them tightly for 15 seconds. As you do this, relax the rest of your body. Visualize the tense part contracting, becoming tighter and tighter.
- Then let your hands relax. On relaxing, see a golden light flowing into the entire body, making all your muscles soft and pliable.
- Now, tense and relax the following parts of your body in this order: face, shoulders, back, stomach, pelvis, legs, feet, and toes. Hold each part tensed for 15 seconds and then relax your body for 30 seconds before going on to the next part.
- Finish the exercise by shaking your hands and imagining the remaining tension flowing out of your fingertips.
Exercise 6: Affirmations
Affirmations are positive statements that describe how you want your body to be. They are very important because they align your mind with your body in a positive way. As the healing meditations (exercise 3) achieve this goal through the use of positive images, affirmations do it through the power of suggestion. Your state of health is determined in part by the interaction between your mind and body via the thousands of messages you send yourself each day with your thoughts. You can aggravate your fibroid and endometrial menstrual bleeding and cramps as well as pelvic discomfort with negative thoughts, because when your body believes it is sick, it behaves accordingly. Thus, it is essential to cultivate a positive belief system and a positive body image as part of your healing program. It is not enough to follow an excellent diet and a vigorous exercise routine when you are in the process of healing menstrual cramps. You must also tell your body that it is a well, fully functional system. I have seen people stay ill and sabotage their healing program by sending themselves a barrage of negative messages. Sit in a comfortable position. Repeat the following affirmations. Repeat three times those that are particularly important to you.
- My female system is strong and healthy.
- My hormonal levels are perfectly balanced and regulated.
- My body chemistry is healthy and balanced.
- I go through my monthly menstrual cycle with ease and comfort.
- My menstrual flow self-regulates. I have light to moderate bleeding.
- My body is relaxed and pain-free.
- My vaginal muscles are relaxed and comfortable.
- My cervix and uterus are relaxed and pain-free.
- My uterus is normal in size and shape.
- My menstrual flow leaves my body easily and effortlessly each month.
- My body feels wonderful as I start each monthly period.
- I barely know that my body is getting ready to menstruate.
- I feel wonderful each month before I menstruate.
- My uterus is relaxed and receptive; I welcome my monthly period.
- My low back muscles feel supple and pliable with each menstrual cycle.
- I am relaxed and at ease as my period approaches.
- I desire a well balanced and healthful diet.
- I eat only the foods that are good for my female body.
- It is a real pleasure to take good care of my body.
- I do the level of exercise that keeps my body healthy and supple.
- I handle stress easily and in a relaxed manner.
- I love my body; I feel at ease in my body.
- My body is pain-free and relaxed.
Exercise 7: Visualizations
Visualization exercises help you lay down the mental blueprint for a healthier body. This powerful technique can stimulate positive chemical and hormonal changes in your body to help create the desired outcome. Through positive visualization, you are imaging your body the way you want it to function and be. The body can modify its chemical and hormonal output in response to this technique and move toward a state of improved health. As a result, you may find this technique useful for reducing the symptoms and severity of both fibroids and endometriosis.
Patients with many types of illnesses have used visualization to great benefit. The technique was pioneered by Carl Simonton, M.D., a cancer radiation therapist who used visualization with his patients. Aware that his patients tended to see their cancer as a “big destructive monster,” he had them instead visualize their immune systems as big white knights or white sharks attacking the small and insignificant cancer cells and destroying them (instead of the other way around). In many cases, he saw his patients’ health improve.
This visualization exercise for fibroids and endometriosis uses an “erasure” image that helps you see your fibroids or the endometrial implants melt away and disappear. Simply skip the part of the exercise that does not pertain to your symptoms.
- Sit in a comfortable position.
- Close your eyes. Begin to breathe deeply. Inhale and let the air out slowly. Feel your body begin to relax.
- Imagine that you can look, as if through a magic mirror, deep inside your own body.
- Focus on any areas of your reproductive tract that you sense contain endometrial implants. See any lesions, cysts, or scarring that the endometriosis has caused. You may visualize the actual implants, or you may simply see the endometriosis as discolored areas within your body (colors such as gray or brown are common).
- Next, imagine a large eraser, like the kind used to erase chalk marks, coming into your pelvic area. See this eraser rubbing the areas of endometriosis. See these implants begin to loosen, shrink, and finally disappear.
- Now, look at your female organs. See your uterus and ovaries. They are an attractive pink color. Your uterus is relaxed and supple. Any fibroid tumors are melting away as you look at them. Your uterus is becoming its normal size and shape. Your uterus has good blood circulation. Look at your ovaries. They are extremely healthy and put out just the right levels of hormones. They are shiny and pink and look like two almonds. The fallopian tubes that pick up the eggs and bring them to the uterus are totally open and healthy.
- Look at your abdominal and low back muscles. They are soft and pliable with a healthy muscle tone. They are relaxed and free of tension during your menstrual period. Your abdomen is flat and your fluid balance is perfect in your pelvic area.
- Look at your entire body and enjoy the sense of peace and calm running through your body. You feel wonderful.
- Stop visualizing the scene, and focus on your deep breathing, inhaling and exhaling slowly.
- You open your eyes and feel very good. Visualizing this scene should take a minute or two. Linger on any images that particularly please you.
More Stress Reduction Techniques
The rest of this chapter explains other techniques that I have found useful for relaxing tight and tense muscles. You can also use these methods to induce deep emotional relaxation. Try them for a delightful experience.
For centuries, people have used warm water to relax their muscles and calm their mood. You can create your own “spa” at home by adding relaxing ingredients to the bath water. I have found two recipes extremely useful in relieving muscle pain and tension related to fibroids or endometriosis.
Recipe 1: Alkaline Bath.Run a tub of warm water. Heat will increase your menstrual flow, so keep the water a little cooler if that is a problem. Add one cup of sea salt and one cup of bicarbonate of soda to the tub. As this is a highly alkaline mixture, I recommend using it only once or twice a month. I’ve found it very helpful in reducing cramps and calming anxiety and irritability. Soak for 20 minutes. You will probably feel relaxed and sleepy after this bath. Try it at night before going to sleep. You will probably wake up feeling refreshed and energized the following day. Heat of any kind helps to release muscle tension. You may also want to try a hot water bottle or a heating pad to relieve cramps.
Recipe 2: Hydrogen Peroxide Bath.This is one of my personal favorites. Hydrogen peroxide is a combination of water and oxygen. By adding it to your bath, you “hyperoxygenate” the water. This helps to induce muscle relaxation. Hydrogen peroxide is inexpensive and can be purchased from your local drug store or supermarket. I usually add three pint bottles of the 3 percent solution to a full tub of warm water and soak for up to 30 minutes. If you use the stronger food or technical grade hydrogen peroxide (35 percent strength), add only 6 ounces. With the more concentrated peroxide, be sure to avoid direct contact with your hands or eyes and keep it stored in a cool place, as it is a very powerful oxidizer.
Music can have a tremendously relaxing effect on our minds and bodies. For women with fibroid or endometriosis-related cramps and pain, I recommend slow, quiet music, classical music is particularly good. This type of music can have a pronounced beneficial effect on your physiological functions. It can slow your pulse and heart rate, lower your blood pressure, and decrease your levels of stress hormones. It can also help reduce anxiety and induce sleep for women with cramps. Equally beneficial are nature sounds, such as ocean waves and rainfall; these sounds can also induce a sense of peace and relaxation. I have patients who keep tapes of nature sounds in their car and at home for use when they feel stressed. Play relaxing music often as your menstrual cycle approaches and you are aware of increased levels of emotional and physical tension.
Biofeedback therapy is an effective way to relieve pain of all kinds caused by muscular tension, as well as poor circulation caused by narrowing of the blood vessel diameter. Constriction of the skeletal muscles and the smooth muscle of the blood vessel wall usually occurs on an unconscious basis, so a person is not even aware that it’s happening. A variety of factors, including emotional stress and nutritional or chemical imbalances, can trigger this involuntary muscle tension. This constriction can worsen problems such as fibroids, endometriosis, migraine headaches, and high blood pressure.
Using biofeedback therapy, people learn to recognize when they are tensing their muscles. Once this response is understood, fibroid and endometriosis sufferers can learn to relax their muscles to help relieve the pain. Since muscle relaxation both decreases muscular discomfort and improves blood flow, either factor can be monitored. For relief of cramps, women can learn how to implement biofeedback therapy through a series of training sessions, requiring about 10 to 15 thirty minute office visits with a trained professional. During these sessions, a thermometer is inserted into the vagina like a tampon. The thermometer is connected to a digital readout machine that monitors the woman’s internal temperature. The professional teaches her how to consciously change her vaginal temperature. Even a slight rise in the temperature indicates better blood flow and muscle relaxation in the pelvic area, with a concomitant relief of menstrual pain.
After the training sessions, most women are able to raise their temperature at will and thereby control their own cramps. I went through biofeedback training many years ago and found that it had a significant effect on my level of muscle tension. Many hospitals and university centers have biofeedback units, as do stress management clinics, so it is relatively easy to find a treatment facility that offers this type of therapy.
Putting Your Stress Reduction Program Together
This chapter has introduced many different ways to reset your mind and body to help make menstruation a calm and relaxed time of the month and ease the symptoms of fibroids and endometriosis. Try each exercise at least once. Experiment with them until you find the combination that works for you. Doing all seven exercises will take no longer than 20 to 30 minutes, depending on how much time you wish to spend with each one. Ideally, you should do the exercises at least a few minutes each day. Over time, they will help you gain insight into your negative beliefs and change them into positive new ones. Your ability to cope with stress should improve tremendously.
Benson, R., and M. Klipper. Relaxation Response. New York: Avon, 1976.
Brennan, B. A. Hands of Light. New York: Bantam, 1987.
Davis, M. M., M. Eshelman, and E. Eshelman. The Relaxation and Stress Reduction Workbook. Oakland, CA: New Harbinger Publications, 1982.
Gawain, S. Creative Visualization. San Rafael, CA: New World Publishing, 1978.
Gawain, S. Living in the Light. Mill Valley, CA: Whatever Publishing, 1986.
Kripalu Center for Holistic Health. The Self-Health Guide. Lenox, MA: Kripalu Publications, 1980.
Loehr, J., and J. Migdow. Take a Deep Breath. New York: Villard Books, 1986.
Miller, E. Self-Imagery. Berkeley, CA: Celestial Arts, 1986.
Ornstein, R., and D. Sobel. Healthy Pleasures. Reading, MA: Addison Wesley, 1989.