Endo Belly: What Are the Causes and How to Manage it

Hitting you around the time of your menstrual cycle, endo belly can have you questioning your pregnancy status by the end of the day. A painful burden on your mental health and physical appearance, this condition is seen with a diagnosis of endometriosis. The diagnosis of endometriosis is often delayed because some of its symptoms, like pelvic pain and infertility, may also be a symptom of other conditions.

Key takeaways:
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    This symptom of endometriosis can resemble those symptoms seen with other pelvic conditions.
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    Endo belly is distinguishable from typical bloating because it happens in a cyclical pattern, with tight and painful skin.
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    Surgery, such as laparoscopy, can treat severe symptoms; however, there may be a recurrence of condition.

What is endo belly?

Endo belly is a term used for the severe bloating that accompanies endometriosis. Also known as endo belly pooch, this bloating can be so intense for some women that it looks like they are in the early stages of pregnancy, making clothes tighter and more uncomfortable.

Knowing whether you have an endo belly or it is another condition can be challenging. Endo belly can come on suddenly to the point that you look about three months pregnant by the end of the day. Due to this extreme abdominal distention, your skin may be tender if touched. Along with severe bloating, you might experience constipation, gas, nausea, or even diarrhea.

An endo belly is not something that stays all month long. This symptom may last anywhere from a few days up to a couple of weeks depending on the severity of endometriosis.

Is it endo belly or bloating?

It's important to understand that the bloating associated with endo belly is different than your typical menstrual bloating. Endo belly might not be present when you first wake up, and you will notice as the day goes on that your belly has grown significantly, almost to the size of a pregnant belly.

Endo belly is also mainly in the lower abdomen rather than all over the belly, as with typical menstrual bloating. Another difference from typical bloating is that your belly is hard to the touch.

What causes endo belly?

Endo belly is a symptom of a disease called endometriosis. Tissue similar to that found in the uterus's lining develops outside the uterus in unexpected places. These tissue deposits are usually called lesions. When it is time to have a menstrual cycle, these lesions will act like the lining of the uterus and start shedding and bleeding.

Endo belly usually results from:

  • Inflammation. Endometriosis causes the surrounding areas to become angry and inflamed. With inflammation comes pain and many other cells trying to combat that injury, leaving your with swelling and bloating;
  • Constipation. If the lesions develop on the bowel, you may experience constipation and bloating;
  • Alterations in the gut microbiome. More research is necessary; however, endometriosis could affect the gut microbiota and influence the symptoms of this condition, including bloating;
  • Estrogen might be to blame. High levels of estrogen can cause water retention and bloating. Unfortunately, there is a high level of estrogen production in endometriosis.

Symptoms of endo belly

Some women usually feel sharp abdominal pain. The abdomen can also become very distended, which increases pain. The skin becomes tight, and there may even be some tenderness.

Endo belly symptoms will follow the flow of your menstrual cycle, which means that you will begin to experience the debilitating symptoms a couple of days before the start of your period.

Other symptoms may include:

  • Nausea and vomiting;
  • Pain after eating;
  • Constipation;
  • Gas;
  • Inability to button pants by the end of the day;
  • Constant pressure;
  • Diarrhea.

How to treat endo belly?

To treat endo belly, you need to manage the endometriosis diagnosis. Since there is currently no cure for endometriosis, clinicians focus therapy on managing the symptoms. For severe cases, your doctor may recommend surgery to help ease the pain.

Hormonal medication

The lesions that are responsible for endometriosis act like the tissue found in the uterus lining, responding to the hormone changes that occur during the menstrual cycle. These types of hormonal treatments will stop the ovaries from producing certain hormones. They will help to minimize the lesions' activity, which will help decrease the pain.

Medications for treatment are typically the following:

  • Oral contraceptives (birth control pills);
  • Progesterone and progestin-only pills (no estrogen);
  • Danazol;
  • Gonadotropin-releasing hormone (GnRH) medications.

OTC medication

Over-the-counter medications will focus on helping to relieve the pain that you experience, similar to intense menstrual cramping. These medications help to reduce inflammation and are from non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin). Another choice of NSAID is naproxen sodium (Aleve).


Surgery may relieve severe endometriosis pain, though it does not cure it. Laparoscopy is a safe and minimally invasive surgery that a surgeon can do while you are under anesthesia.

The surgeon will make minor cuts into your abdomen and insert a laparoscope to see the lesions during this procedure. The surgeon will then decide to remove the lesions, or they may choose to use heat to seal the blood vessels without the need for stitches.

A more extensive surgery called a laparotomy might be needed if the lesions are too small to be seen in the laparoscopy. Major abdominal surgery, such as a laparotomy, is typically reserved as a last resort.

Depending on the number of endometriosis lesions or the tissue damage, the surgeon may need to remove the uterus, ovaries, and fallopian tubes.

How to deflate endo belly naturally

Some women have reported benefits from changing lifestyle routines and found these remedies help to relieve belly-bloating naturally. Discussing treatments with your doctor is always important; however, you can generally try the methods discussed below.

Change up your diet

Increase foods that may help decrease inflammation. Add more omega-3 polyunsaturated fatty acids, such as a fish oil supplement. These omega-3s are in nuts and seeds like flaxseed and walnuts, plant oils like canola and flaxseed oil, and certain fortified foods such as certain brands of eggs and yogurts.

Avoid foods known to cause stomach issues, such as irritable bowel syndrome (IBS). These will be items like caffeine, alcohol, processed foods, fatty foods, high fructose, carbonated beverages, and foods containing wheat.

Yoga or Pilates

Both activities can help strengthen your core (abdominal) muscles. Also, it's understandable that this severe bloating can cause harm to your mental well-being. Yoga can help to improve stress hormones and mental states.


Stress and anxiety can have a negative effect on our digestive health, and meditation can help to lessen both. Through the act of deep breathing, oxygen levels in our blood rise during meditation which can help to facilitate the actual digestion process.


Pelvic physiotherapy may help to improve symptoms dramatically. This therapy uses stretches and massaging to help increase blood flow to the pelvic region. A pelvic physiotherapist can tailor these stretching exercises to target the gut to help relieve bloating and constipation.

What else can cause a bloated belly?

There could be other possible reasons besides endometriosis for a bloated belly. Talking with your doctor and being open and honest about your symptoms will help them to make a correct diagnosis and also help to order the proper tests needed.

Other causes for a bloated belly could be:

  • Small intestinal bacterial overgrowth;
  • Lactose or fructose intolerance;
  • Celiac disease;
  • Pancreatic insufficiency;
  • Gastric obstruction;
  • Gastroparesis;
  • Ascites;
  • Irritable bowel syndrome;
  • Pelvic floor dysfunction.



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