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.
Second Step.
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.