Endometriosis Fatigue Is Not Laziness

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Full transcript of the original video, lightly edited for readability.

If someone you love has endometriosis and they say that they're tired, it's probably not the type of tired that you're used to feeling. I just canceled on a family dinner and I told everyone it's because I have too much to do at my house. What I wanted to say is that I got a head cold, which flared up my endometriosis. And I'm so bone tired that the thought of taking another step makes me wanna just lay down on the ground. That taking a shower and feeding my animals this morning took up all my energy, and then I had to work eight hours.

And then tonight there's a whole other checklist of things I gotta do to manage my disease to make sure that I feel okay. And that I know well enough by now that if I'm feeling this low of energy and I try to keep going, then I'm gonna ruin my entire next week. And I'm still gonna have to wake up, take a shower, keep going to work, and do all the things I need to do to be a grown up. I don't know why it's so hard for me to just say that to people, but I kind of just feel like, I don't know, they won't believe me or I'll seem dramatic.

So when you hear that someone with Endo is worn down, please don't get mad at us when we cancel. Maybe, like, buy us some fuzzy socks. And bring. Okay, she made a really great point and something that's not really discussed very much. Endometriosis fatigue, it's a real thing. So when someone with endometriosis says their fatigue, it doesn't necessarily mean they're tired. What a lot of people think is that they need a nap or they're being lazy, and that's not at all what most women mean.

What they're truly saying is, my body feels like it's running a flu that I can't escape. It's not sleep sick, achy, foggy. Pretty much. Imagine that you have the flu every single day. Your legs feel like they have sand. Your whole body feels like it's moving through molasses. Even standing feels like they have to pay a toll. Sleep is not enough because the body never really recovers. And there is a reason for that. And we're about to get into that, because the reality is, endometriosis just doesn't hurt.

It's not a pain problem. It's a biochemical signaling problem. And this is something that we've been trying to really spread awareness on. This is something that affects a lot of your body's cells, not just your uterus, not just your intestines. They can be systemic. So let's talk about this. Why do you feel achy? Why do you feel all of these things? Well, it has a lot to do with these, inflammatory mediators like prostaglandins and Spote, PGE2 and PG F2 Alpha right here.

And then you have other cytokines that Are extremely powerful, powerful mediators that you'll find right here. These molecules are not gentle. They are the kind of signals that increase pain and pain sensitivity. It makes it feel like your body is under attack. These are the exact same inflammatory mediators you're actually gonna find when you go through the flu. Right. Because this overall starts to shift into a biochemical warfare. So that's actually one thing you need to kind of be cognizant of.

It's not just, hey, I feel like I'm in the flu. There's an actual down cascade effect when we start to look at things like PGE2 start to negatively affect the. The estrogen. Overall positive feedback loop, right? We have estradiol, we have interlukin 1 beta, and then VEGF. That keeps COX-2 turned up, so it kind of feeds back on each other. It's a self feeding loop. So that means more inflammation, more prostaglandins, more pain, which leads to more local estrogen signaling, which leads to more irritation.

This is why the disease can feel relentless. This is what it means to be fatigue and having endometriosis. And that's something that most people do not realize, because in endometriosis, the chemistry is not just inflammation. The disease as a whole can amplify the entire environment that is the body. Right. We can get really deep into this. How? There's a lot of mechanisms that work through cAMP. And PKA But that's a bit too complex for this type of video. Because when you start to also look at other things, right?

Cause this video is already gonna contain a lot of information. We're gonna talk about activated platelets and how these can drive estrogen production through NF-kappa B and tumor growth factor beta 1. Because they signal and start to increase things like STAR and aromatase. Okay? So that the flare is not just inflammatory. Because why does this matter to, you know, endofog? Because estrogen directly affects the brain. There's estrogen receptors in the brain. Predominantly you'll find estrogen receptor beta. So if you start to get estrogen spikes and then massive dips, your brain is gonna have a hard time learning new things because you start to shift different memory patterns.

So memory retrieval becomes scattered. And then on top of the physical body ailments, it's gonna feel like you got hit with a truck in your days and you're still trying to stumble through your day to day day life. However, let's kind of look into what is known as central sensitization. Sorry, there's too many SS sounds here. You see, because over the months, as the pain keeps repeating, especially over years, cause most women have it for their entire lives, their entire nervous system starts to change as well.

The brain starts to adapt to repeated pain stimuli. So now things that should feel minor can feel major. So a normal touch and I'm sure that women with endometriosis know this. During your ovulation, a touch actually hurts. Your skin feels like paper. Even things like a rough blanket might hurt. Because the system gets more efficient at feeling pain, not less. This is the the nervous system. Like, those pathways just get shortened, you know, point A to point B, boom, you feel that pain signal.

This is what they mean by exhausted and and fatigue. It's not just being tired. Is flu like heaviness is estrogen. Inflammation loops that refuse to calm down. That all of this connects at the end of the day. And so not only is the brain getting rewired for pain, that gets amplified through this inflammatory soup that then pushes estrogen. This estrogen, as we talked about, is also going to affect memory retrieval patterns. Because this is where the endofog starts to come in.

Not only do you have to deal with the chronic pain processing, you also have to deal with the erratic memory. That is going to affect a lot of your overall mental wellness. But if you think that's where it ends there, no. Metabolism also starts to get involved. Estrogen will affect your metabolism. There's certain parts in the hypothalamus that also gonna regulate your body temperature. So when you start to look at endometriosis as a whole, this is not just laziness, this is not being dramatic.

This is what happens when the body literally shifts its entire biochemistry into surviving. And the cool part about all of this is that sleep really cannot fix it. You can sleep a full, uninterrupted eight hours. Again, estrogen and these whole mechanisms that we're going over are still going to affect things in the brain, not just via pain, not just via memory, recollection, but also through the cellular metabolism directly in the hypothalamus. So, all in all, when she cancels dinner, when she says she cannot go, when she says she's wiped out, people need to understand what she's actually saying is, I feel like I have the flu.

I'm having a hard time remembering my keys as well, and I'm also extremely low on energy. So that's what people need to take away from this video. It's not laziness, it's not poor discipline. It is a chronic existence.