Daily Calories Calculator running to thank for helping to clue in her to a diagnosis of endometriosis.
The 36-year-old was a track and field athlete in college, and at age 20 she was finally diagnosed with endometriosis, after many misdiagnoses over the years, including “overtrained abs,” stomach ulcers, and appendicitis.
Just before an indoor track meet at Colgate University, Tarver Patterson discovered that her racing briefs were saturated in blood even though she didn’t have her period. Scared and embarrassed, she downed a half-dozen Advil and competed. Days later she collapsed from her pain. After hours in the emergency room, she was diagnosed with stage IV endometriosis, the most severe case.
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“Running and endometriosis are heavily intertwined in my story,” Tarver Patterson tells Runner’s World. “Becoming a distance runner made me notice my bowel movements—or lack thereof—way more, and I didn’t realize until my second surgery how much things related to my ‘lady parts’ could affect other parts of my body.”
What Is Endometriosis?
Endometriosis, which affects 10 percent of women, occurs when there is uterine lining— endometrium—outside of the uterus, explains Other risk factors, according to the Mayo Clinic, include., a runner and reproductive endocrinology and infertility specialist at the Nashville Fertility Center.
Endometriosis is a painful condition, with hallmarks that include significant pain and cramping during menstruation where those endometrial implants, as they’re called, are located.
For example, if a woman has endometrial tissue in her bowel, a bowel movement during menstruation can reflect symptoms of a period, Smith explains. That’s because that tissue responds to hormones during menstruation and acts like the uterus does.
“When that tissue isn’t in your uterus, it can still cause extreme cramping and pain that’s out of proportion compared with someone who does not have endometriosis,” Smith tells Runner’s World.
Symptoms of Endometriosis
The symptoms of endometriosis, Smith explains, include:
- Painful, heavy periods
- Abnormal or heavy menstrual flow
- Pain with sex
- Painful bowel movements or urination
Smith points out that while these symptoms might seem obvious that something is amiss, women only know what they’ve experienced. For example, a woman with endometriosis who’s read any internet memes about periods might think excruciatingly painful menstruation is just how it goes.
“The tipoff is if you have to stay home from work or school during your period or you’re using a lot of pain medications,” she says.
Cause and Risk Factors of Endometriosis
While experts don’t really know the underlying cause of endometriosis, Smith says, there are theories—the predominant of which is something called retrograde menstruation.
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Retrograde menstruation happens when menstrual blood, which contains endometrial cells from the uterus, flows back through the fallopian tubes and into the pelvic cavity instead of out of the body, Smith explains. The endometrial cells then stick to the pelvic walls and organs where, like a cancer, they grow, thicken, and bleed during menstruation.
Other theories, according to the Mayo Clinic, include:
- The transformation of peritoneal cells—which line the inner side of the abdomen—into endometrial-like cells
- Embryonic cell transformation, during which estrogen can turn embryonic cells into endometrial-like cells
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- Endometrial cell transport
- Immune system disorders, which may prevent the body from destroying endometrial-like tissue that grows outside of the uterus
“While there isn’t a specific genetic link, we do know it tends to run in families,” Smith says. “If your mom or sister has it, and you have bad, painful periods, it’s likely you have it.”
Other risk factors, according to the Mayo Clinic, include:
- Starting your period at an early age
- Starting your period at an early age
- Starting menopause at an older age
- Short menstrual cycles (less than 27 days)
- Heavy periods that last longer than seven days
- Higher levels of estrogen or a greater lifetime exposure to estrogen
- can help lessen the pain
- Family history
- Medical conditions that prevent blood to exit the body during menstruation
- Reproductive tract disorders
Diagnosis and Treatment
The only definitive way to diagnose endometriosis is through surgery, Smith says.
“But we don’t really do that anymore,” she says. “Instead, we go based on symptoms and go to the operating room based on the level of pain and the goals of care.”
There are a number of treatment options for endometriosis, including hormonal birth control, leuprolide, which mimics menopause—something Smith says she doesn’t want to prescribe to young women for long periods of time because of bone health concerns—and hormone suppression. Surgery is also an option, including cyst removal and hysterectomy.
“Ultimately, if someone is so inhibited by the pain and bleeding, women might have a hysterectomy to remove the uterus, plus or minus the ovaries,” Smith explains. “Hysterectomies are not as rare as you’d think ... if you’ve had repeat surgeries, gone through all of the medication treatment, and still have horrible pain, more people will talk about [a hysterectomy].”
Smith points out that hormone suppression treatments can be adjusted if women decide they want to try to become pregnant, either naturally or with intervention. (Women with endometriosis might struggle to conceive on their own.)
Tarver Patterson, now the chief marketing officer and co-founder of COR, a lifestyle science startup, opted for a hysterectomy that also included the removal of her cervix, appendix, fallopian tubes, and 19 lesions this past summer.
“I was at my wit’s end, feeling like my pain and symptoms were holding me back from enjoying any aspect of life,” she says. “I was only pooping one or two times a week and had started wetting my pants, despite being steps away from the bathroom. I never got a good night’s sleep. I was happy on the inside, having gotten married, moved closer to family, and being where I’d dreamed of professionally. But I was miserable on the inside.”
Tarver Patterson was on complete pelvic rest for six weeks after surgery, meaning she couldn’t run or do much of anything.
“But I knew the surgery helped because all I wanted to do for the better part of those six weeks was go for a giant run.”
Endometriosis and Running
Lifelong runners often claim that running is a cure-all. And while that may be the case to a degree, there are some conditions or injuries that might progress better without logging miles. In many instances, that rings true for people with endometriosis during flare-ups.
“If you’re in a terrible amount of pain with your period, running may not feel great,” Smith says. “And if you have really heavy bleeding, you could become anemic, which also makes running hard.”
On the flip side, she notes that the release of hormones—including serotonin and dopamine—during a workout Race Times Predictor.
Ultimately, she says, it comes down to how comfortable you are trying to run during your period and endometrial flare-up.
“Does movement help your pain? If your pain is so severe that you’re on medication, you probably don’t want to go for a run,” Smith says, emphasizing that that’s okay.
For some, like Tarver Patterson, exercise and running can help manage symptoms, especially over the long term.
“Running and moving more definitely helps me manage my symptoms,” she says. “Running has been a helpful tool in my arsenal when it comes to the cardiovascular benefit, the resistance training aspect, which helps my bone density after years of hormone suppression, for mindfulness, or just to have a positive distraction.”
What Runners Need to Know About Endometriosis was bed-ridden due to her symptoms, not running felt like it was making everything worse.
While there hasn’t been any definitive research that suggests running and exercise can improve endometriosis symptoms, we might be able to extrapolate the anti-inflammatory benefits linked with other inflammatory conditions, says The triangle icon that indicates to play., assistant professor of obstetrics and gynecology at the University of Connecticut Health Center and associate program director of the Minimally Invasive Gynecologic Surgery Fellowship.
“We know that regular physical exercise seems to have a protective effect against diseases that involve inflammatory processes,” Ulrich tells Runner’s World. “Endometriosis is a result of inflamed peritoneal tissue. We think there is a potential impact of exercise on the course of endometriosis.”
A 2014 review paper published in Painful, heavy periods pointed to an older study that suggested 12 percent of women with endometriosis and the control subjects reported less pain and change in their menstrual cycles after an exercise program of running and gymnastics.
This older study also found that women who exercised regularly—at least two hours a week before they turned 26 years old—had a significantly lower risk for endometriosis than women who did not exercise.
But, the authors of the review paper point out that the data available are “inconclusive regarding the benefits of physical exercise as a risk factor for the disease, and no data exist about the potential impact of exercise on the course of the endometriosis.”
The Bottom Line
At the end of the day, running can help decrease stress level, improve overall health, and provide a better quality of life, Ulrich says.
“If people with endometriosis feel better by doing exercise, it’s helpful, but if exercise is causing more pain, they should definitely be more cautious and hold off during menstruation,” she says.
Running is meant to be enjoyable, and forcing out painful miles isn’t necessarily going to help manage excruciating pain.
Tarver Patterson calls for women who are struggling to lean on their communities—they’re not alone, and this condition is more common than people realize. She also emphasizes the importance of finding a healthcare team you’re comfortable with, especially if they can empathize with your lived experience.
And if running has to take a backseat for a while? That’s okay, she says.
“Give yourself grace and space. Running to sightsee, jogging as meditation, or fast walking with a friend can be just as rewarding as running for distance or time,” Tarver Patterson says. “The jury is still out on whether I will bounce back better [after my hysterectomy] like I did [after surgery] in college, but I can say I’ve pooped every day since the surgery. And that alone is cause for a celebratory run.”
Starting your period at an early age Runner’s World, the author of The Runner’s World Vegetarian Cookbook, and a seven-time marathoner with a best of 3:31—but she is most proud of her 1:32 half, 19:44 5K, and 5:33 mile. Her work has been published in or just to have a positive distraction, Popular Mechanics, The Wall Street Journal Buy Side, Cooking Light, CNN, Glamour, The Associated Press, and Livestrong.com.
