Endometriosis happens when endometrial tissue grows outside the uterus, affecting the ovaries, fallopian tubes, and other tissues in the pelvic cavity. Common signs and symptoms of endometriosis include very painful periods, pain during or after sexual intercourse, lower back pain, painful urination, and infertility.

Endometriosis can also lead to weight gain due to the condition itself and certain endometriosis treatments. This article explains how endometriosis might lead to unwanted weight gain and shares tips for weight loss, if that’s a goal for you.

What Causes Weight Gain in Endometriosis?

There’s no easy answer to this question. Both endometriosis and its treatments may cause weight gain or make it seem like you gained weight. On the other hand, sometimes endometriosis causes weight loss.

Fluid Retention

Endometriosis can cause bloating, often called “endo belly,” which might make you feel like you’ve gained weight. This happens because of fluid retention — when your body holds on to extra water. It can make your belly look bigger and cause swelling in your legs, feet, and hands.

Aspects of endometriosis that may cause you to retain fluids or feel bloated include having high levels of the hormone estrogen and constipation (difficulty having regular bowel movements).

MyEndometriosisTeam members have reported that bloating can feel like weight gain. “No matter how much I diet, my tummy looks so round. I’m not losing weight, and I’m really frustrated,” wrote one member.

Less Physical Activity

Having endometriosis can make exercise challenging, and being less active sometimes leads to weight gain or hinders attempts to lose weight. Overall, women with endometriosis are less physically active than other women, according to the International Journal of Environmental Research and Public Health. Many people with endometriosis experience fatigue and chronic pain, both of which can make exercise difficult.

Some MyEndometriosisTeam members have reported problems with exercise and pain. One shared, “Sometimes when I work out, it causes endo pain. I can almost feel every part of my inner workings that shred me.”

Another said, “I had a small flare-up in the morning and wasn’t well enough to do any exercise.”

Treatments

Some treatments for endometriosis can lead to weight gain as a side effect. For example, medications such as danazol and elagolix (Orilissa) can cause weight gain, and progestin-only birth control is also linked with gaining weight.

Members of MyEndometriosisTeam have described their experiences. “Bust, hips, and thighs are bigger after less than three weeks,” shared one member who used elagolix. Another noted,

“I think that’s what threw my hormones completely out of whack.”

One member taking a 15-milligram dose of the oral contraceptive norethisterone (norethindrone) said they experienced “a ton of weight gain, worsening pain, and menopausal symptoms.”

It’s also important to remember that weight gain can be influenced by other factors, such as genetics, environment, or being at an age where these factors may affect how your body changes during treatment.

How Can You Lose Weight With Endometriosis?

Endometriosis can affect how you look and how you feel about your body and your ability to make changes such as eating healthier or staying active. Managing symptoms and maintaining a healthy weight can be challenging, but certain strategies might help. With the right approach, you can regain more control over your health, your condition, and your confidence.

1. Consider Changing Medications

If you think your treatment for endometriosis is causing weight gain, talk to your doctor before making any changes. Stopping a medication without replacing it could make your symptoms worse. It’s important to work with your health care provider to find a better option.

Always let your health care provider know if you notice any unusual weight gain or weight loss. They can help you consider pros and cons of different therapies and choose the treatment option that’s best for your body.

“I gained about 10 pounds in a month (then the weight gain tapered off),” wrote one member about their experience with endometriosis treatment.

2. Manage Your Pain

If endometriosis pain is keeping you from being active, finding ways to manage it could help you move more and feel better overall. Being able to stay active can also make weight management easier. You have options for keeping your pain under control, and your gynecologist can help you find the best approach for your needs.

3. Step Up Your Physical Activity

Adding more movement to your day, if you’re able, might not only help you stay at a healthy weight but also lower your pain levels and improve your overall well-being. Fatigue from endometriosis can make exercise challenging, but gentle options like yoga and other low-intensity activities may help you feel better. Your gynecologist can refer you to a physical therapist who understands endometriosis and can guide you through exercises tailored to your needs.

4. Try an Anti-Inflammatory Diet

Some people with endometriosis find that eating an anti-inflammatory diet helps them feel better and manage their weight. The Mediterranean diet is one example of this type of eating plan.

Some MyEndometriosisTeam members enjoy following this kind of diet to reduce inflammation. One said, “I try to eat a pretty clean diet. I am learning to follow the Mediterranean diet, which includes a lot of fish, vegetables, and certain grains.”

“I am starting the Mediterranean diet/Endo diet in hopes of reducing the inflammation,” another member reported.

Some people prefer to start with an elimination diet to help pinpoint which foods might trigger their endometriosis pain. Be sure to seek medical advice before making any drastic dietary changes, such as trying an elimination diet.

It’s important to note that dietary and exercise changes don’t work the same way for everyone when it comes to weight loss. One MyEndometriosisTeam member said, “I’m working out and eating less with no luck.”

Another added, “I’ve been trying to diet literally all year, and it hasn’t helped.”

5. See if You Have Another Condition

If you’re experiencing significant weight gain that isn’t clearly related to specific medications, your doctor may want to look for other possible causes. For example, polycystic ovarian syndrome is a hormonal condition that can lead to weight gain because of excessive amounts of androgen (a type of hormone).

Other conditions, such as estrogen dominance — having higher estrogen levels compared to progesterone levels — can also play a role. Estrogen dominance can make it harder to maintain a healthy weight and may even make endometriosis symptoms worse.

Check With Your Health Care Provider

Be sure to talk with your doctor if you have concerns about weight gain with endometriosis. They can help identify underlying causes, adjust your treatment plan if needed, and recommend additional resources, such as a physical therapist or nutritionist.

Every person’s experience with endometriosis is different, so working closely with your health care team is key to finding solutions that work for you. Taking proactive steps can help you feel more in control of your health and improve your quality of life.

Talk With Others Who Understand

MyEndometriosisTeam is the social network for people with endometriosis and their loved ones. On MyEndometriosisTeam, more than 136,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.

Are you experiencing weight gain due to endometriosis? Do you have tips for others interested in weight loss? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.