Coping with Hot Flashes and Hidden Symptoms of Endometriosis

If you've recently found out about endometriosis, you've probably heard a lot about chronic pelvic pain and heavy periods. But did you know that hot flashes, fatigue, digestive issues and other less common symptoms can also be part of the picture? Let's take a closer look at these symptoms and, more importantly, how you can manage them.

Why Hot Flashes?

Hot flashes are usually associated with menopause, but they can also happen with endometriosis, especially in people undergoing hormone-based treatments. Here’s why: endometriosis can disrupt the normal balance of estrogen and progesterone in your body. In some cases, the condition itself affects ovarian function; in others, hormone therapies used to manage symptoms, like GnRH agonists, intentionally suppress estrogen to mimic menopause.

Estrogen plays a key role in regulating your body’s internal thermostat, which is managed by the hypothalamus in your brain. When estrogen levels drop suddenly or fluctuate wildly, the hypothalamus can misinterpret your body’s temperature, triggering a chain reaction: your blood vessels dilate (causing flushing), your sweat glands kick into overdrive, and you may suddenly feel overheated or even chilled afterward. It’s your body trying to cool itself down, even though the temperature didn’t actually change.

So while hot flashes aren’t a “classic” endometriosis symptom, they can absolutely show up, especially when hormone levels are thrown out of sync.

Read More: 7 Common Symptoms of Endometriosis You Shouldn't Ignore

So, How Can You Handle Hot Flashes?

The good news? There are practical ways to get relief:

• Layer Your Clothing: Wearing several thin layers makes it easier to adjust your temperature quickly. Cotton or breathable fabrics are your best friends here.

• Keep Hydrated: Drinking plenty of water helps cool your body down naturally. Keep a bottle handy and sip regularly.

• Cool Environment: Make sure your living and sleeping spaces are cool, comfortable, and well-ventilated.

• Mindfulness and Breathing Exercises: Simple breathing exercises or mindfulness techniques can calm your body's response. Apps like Headspace or Calm are handy resources to get started.

  
  

Beyond the Heat: Lesser-Known Symptoms of Endometriosis

Hot flashes aren't the only overlooked symptoms of endometriosis. Here are a few other unexpected ones you might experience:

1. Fatigue: You’re not just “tired”, you’re completely wiped out. Endometriosis fatigue isn’t the kind of tiredness a good nap or a strong coffee can fix. It’s persistent, sometimes debilitating exhaustion that can hang over you for days, even when you’ve technically “rested.”

   
   

   So what’s behind it? Several things, actually. First, chronic inflammation caused by endometrial-like tissue growing outside the uterus puts your immune system in a constant state of alert. That ongoing inflammatory response can drain your energy reserves, much like having the flu that never quite goes away. Add to that the physical toll of chronic pain, pain that keeps you up at night, wears on your nerves, and makes everyday tasks feel like mountains.

   
   

   On top of that, hormonal imbalances often seen in endometriosis can disrupt sleep cycles and energy regulation. And if you're losing blood heavily during your period, you may also be dealing with low iron levels or anemia, which only worsens the exhaustion.

   
   

   This kind of fatigue doesn’t just affect your body, it seeps into every part of life. It can make it harder to concentrate at work, follow through on plans, or even feel present in conversations. Managing it isn’t just about getting more sleep, it often involves pacing your activities, learning when to rest (even when you feel like you "should" push through), eating in a way that supports your energy, and advocating for yourself when you need space to recover.

   
   

   It’s not laziness. It’s not in your head. It’s a very real part of what makes endometriosis so much more than “just bad periods.”

   
   

2. Digestive Issues: Endometriosis doesn’t just stick to reproductive symptoms, it can also seriously mess with your gut. In fact, many people are misdiagnosed with IBS (Irritable Bowel Syndrome) before anyone considers endometriosis as the real culprit. That’s because endo can cause gastrointestinal symptoms that closely mimic IBS: bloating, constipation, diarrhoea, gas, and nausea.

   
   

   Why does this happen? A few reasons. For one, endometrial-like tissue can grow on or near the bowel, rectum, or intestines, especially in cases of deep infiltrating endometriosis. This tissue responds to hormonal changes just like it would inside the uterus, which means it can swell, bleed, and cause inflammation in the digestive tract during your cycle. That inflammation can lead to cramping, irregular bowel movements, and intense bloating, often dubbed the “endo belly,” which can make you look several months pregnant by the end of the day.

   
   

   Some people find relief by making gentle dietary changes. Cutting back on common triggers like dairy, gluten, red meat, or ultra-processed foods can sometimes reduce bloating and discomfort. An anti-inflammatory approach, focusing on whole foods, fiber, and healthy fats, may also help soothe symptoms. That said, what works for one person might not work for another, and restrictive dieting can do more harm than good if it’s not done thoughtfully.

   
   

3. Mood Swings: Feeling emotionally up-and-down with endometriosis? You’re not alone, and, you’re not overreacting. Mood swings, anxiety, low moods, or even sudden irritability are all common experiences for people living with endometriosis. It’s not just about dealing with chronic pain (though that’s a major factor); it’s also about how endometriosis impacts your hormones, your nervous system, and your sense of control over your own body.

   
   

   Let’s break it down. Hormonal fluctuations, especially shifts in estrogen and progesterone, can influence mood-regulating neurotransmitters like serotonin and dopamine. When these hormones swing wildly (as they often do with endo), your mood can follow suit. Some people describe it like PMS dialed up to 100, with emotional crashes that hit hard and linger.

   
   

   There’s also the mental toll of being dismissed or misdiagnosed by healthcare providers, which can chip away at your self-confidence and trust in the system.

   
   

   So what can help? A lot of people find that talking therapies, like cognitive behavioural therapy (CBT), counselling, or even peer support groups, can make a big difference. Sometimes just having space to vent, process, or reframe your thoughts helps lighten the emotional load. Gentle physical activity like yoga, stretching, or walking can also help regulate stress hormones and calm the nervous system. It's not about "fixing" your feelings, it's about giving your mind and body tools to cope.

When to Talk to Your Doctor

If your symptoms, like hot flashes, fatigue, or digestive problems, are disrupting your life, don’t wait it out. A timely conversation with your doctor can open doors to better management strategies or treatments that suit your specific situation. Remember, your experience is valid, and seeking help isn't just okay; it's important.

Further Reading: Meal Planning for Endometriosis: A Guide to Reducing Symptoms

You're Not Alone in This

Navigating endometriosis can feel isolating at times, especially when dealing with symptoms that aren't widely discussed. But remember, millions of people worldwide understand exactly what you're going through. Online forums, local support groups, and resources like Endometriosis UK can connect you with others who "get it." It can feel surprisingly comforting to talk with others experiencing similar challenges.

Keep an Eye on Your Symptoms

Tracking your symptoms, no matter how minor they seem, can provide valuable insights. Simple apps or even just keeping a daily note can help you and your doctor spot patterns, making management strategies more effective.