Showing Up For Myself Post Surgery (Part 1)

My pain got better after surgery, and that part was real. Not long after, though, I found myself testing the waters, going back to habits I already knew better than to touch. More cookies and sweets than I care to admit. Extra sugar cubes in my tea. Pizzas and pastas. None of it felt like a big deal at the time.

Then, as the days before my period arrived, my body reminded me, not gently, that I still have endometriosis and adenomyosis, and it hadn't forgotten either. That's when I understood something surgery alone couldn't tell me. Surgery fixed what was happening structurally, but staying consistent is what keeps that relief going. Skip it, and I end up back in that same week wondering why.

Why Consistency Matters More Than the Surgery Itself

You probably already know most of this. You've likely had your own version of that stretch, a few days without a flare, or a period milder than you're used to, and then things came roaring back before you could even enjoy it.

Looking back, there are a handful of things I've had to stay consistent with to keep endometriosis symptoms manageable: blood sugar, gut and liver support, movement, sleep, and what I've come to call the pause. The pause is where I start, since it's the one that makes room for the rest to actually work.

The Pause

Once you've experienced the pain of your uterus fused to your colon due to endo, a lot of things stop mattering the way they used to. You stop saying yes to things that harm you, because in the middle of a flare, those things can't save you. They never could. That's what got me back to checking in with myself throughout the day instead of pushing through it. Prioritizing myself that way used to feel selfish, and I've had to unlearn that.

Yogic breathwork was where I started. Not the twenty-minutes-with-a-candle-lit version, though that has its place too. The version I actually use is remembering to breathe in the middle of a stressful work moment, instead of holding my breath and pushing through it. Taking an actual pause instead of powering past whatever just spiked my stress.

The other piece is giving myself larger chunks of time, sometimes during the day, sometimes across the week, to do genuinely nothing. No scrolling. No phone calls. Just quiet, a walk in the park, or getting into bed earlier than I need to so I actually have time to unwind before I try to sleep. Otherwise I'm carrying the day's anxiety straight into the night with me, and my body never gets the signal that it's safe to let go.

I check in with my body while I do it. Where am I holding tension. My jaw. My neck. My belly. My pelvic floor. Just noticing it and breathing into it, slowly and correctly, has relieved mild cramps more than once, no supplement or heating pad involved, just pausing and steadying my breath until my body could stand down.

I don't think that's a coincidence. A regulated nervous system is what lets everything else do its job. You can't repair from a stressed out, shallow breathing place, no matter how good your supplements or meal prep are.

Managing endo already feels like a full time job on top of an actual full time job. Cooking anti-inflammatory meals. Staying on top of supplements and herbal remedies. Doing yoga. Keeping structure in place so the healthy choice is the easy one. The pause is what I start from, because starting regulated is the only way I've found to hold the rest of it without falling apart by Wednesday.

The pause calms things down, but what I put in my body matters just as much.

Blood Sugar and Gut Health for Endometriosis

That stretch wasn't really about the cookies themselves. Blood sugar spikes and crashes drive inflammation, and that inflammation doesn't stay where the sugar was processed. It shows up in the same pathways feeding endo pain. A few weeks of extra sugar and pasta doesn't ruin anything overnight, but it adds up quietly until the days before your period, when your body has nowhere left to hide it.

Now I build my meals around nutrient dense foods, higher in protein and fiber, instead of just carbs and hoping for the best. Protein and fiber slow down how fast sugar hits the bloodstream in the first place, which means fewer of those spikes and crashes to manage before they even start.

Gut health is tied to estrogen the same way. A lot of estrogen clearance happens there, and when gut bacteria are out of balance, estrogen gets reabsorbed instead of cleared. That means more circulating estrogen, more fuel for endo tissue. I notice it most in how differently my body handles the same trigger foods, depending on whether my gut has had a good month or a rough one. Our Nourish page has anti-inflammatory recipes that make this easier to sustain.

Supplements for Endometriosis, and Why Normal Labs Don't Mean Stop

If your last labs came back low in iron or vitamin D and you corrected it, the temptation is to stop taking what fixed it once the number looks normal. I get it, a normal result feels like a finish line. But a normal number just means the support worked, not that the need went away. With endo, inflammation keeps pulling on iron in a way that doesn't stop just because a lab result did. Vitamin D works the same way, it's actively involved in regulating inflammation, not something you take until you hit a target and move on. Stop the support, and the number tends to drift right back down, usually before you even notice, until the next set of labs tells you what your body already knew.

That same pattern showed up for me with the liver and gut, once I understood how connected they actually are. They work as one clearance system, not two. The liver metabolizes estrogen, the gut clears it out, and when either one is overtaxed, estrogen recirculates back into the body instead of leaving it.

NAC and milk thistle support the liver side of that system. I added them once I understood specifically what they were doing, and staying consistent with them isn't any different than the iron or vitamin D story above, the benefit fades the moment I let it slide.

A high quality probiotic matters a lot on the gut side of that same system. Gut bacteria balance is what actually determines whether estrogen gets cleared out or reabsorbed in the first place, which is why this isn't the place to grab whatever's cheapest off the shelf. Together, the probiotic, the NAC, and the milk thistle are a big part of why my month runs smoothly instead of building toward that same rough week before my period.

Alcohol and refined sugar overtax that whole system faster than almost anything else, which is exactly what weeks of extra sugar and dessert did to mine. I have removed alcohol completely from my life in the past 18 months. Within 24 hours of consuming just a few sips of alcohol or too much refined sugar, my flares send me into another dimension. It's simply not worth it.

None of that matters much, though, if I'm not also moving my body enough for any of it to circulate.

Movement and Lymphatic Flow

I can tell when I've gone more than a couple of days without hip openers. I get restless. A little more irritated than the situation calls for. It's not subtle once you know to look for it.

A lot of that comes down to sitting. I have a full time job on top of everything else, which means hours at a desk most days, and sitting that long promotes pelvic congestion, blood and lymph pooling in the pelvis instead of moving through it the way they're supposed to.

The pelvic cavity depends on movement to keep that flow going. Lymph has no pump of its own. It moves because you move, and a desk chair isn't moving anything.

So I've had to build in getting up throughout the day, even if it's just a few minutes at a time. Walking to refill my water. Taking a call standing up instead of sitting through it. Anything that gets me off the chair between meetings, since it doesn't have to be a workout to count. The point is breaking up the hours of stillness, not swapping them for a different kind of stillness on a break.

This is also why yoga, pilates, and light cardio do more for me here than staying stationary ever will. Hip openers specifically work into a part of the body that holds a lot of tension for those of us with endo, so skipping them for even a few days shows up fast, in how my body feels and in my mood.

By the time I'm restless like that, I've usually let my sleep slide too, and that's not a coincidence.

Sleep and Nervous System Regulation

I used to treat sleep as the first thing I'd sacrifice when the day got long, like it was the most flexible item on the list. Work ran late, so sleep got pushed back. Instagram scrolling needed one more hour, so sleep got pushed back. Somewhere along the way it became the one habit I assumed could stretch to fit whatever was left of my day.

It's actually the opposite. Nothing else on this list works without it.

Deep sleep is when the glymphatic system does its clearing, flushing out what built up in the brain and nervous system over the day. That process is tied closely to nervous system regulation, which for those of us managing chronic pain isn't optional. It's the difference between waking up steadier or waking up already behind. This is part of why I protect the wind-down time I mentioned earlier, getting into bed before I technically need to, because falling asleep still keyed up doesn't give my body the same chance to actually do this work.

A night or two of good sleep and I can feel the difference by the next afternoon. Clearer headed. A calmer nervous system. Better able to manage whatever the day throws at me, on top of everything else I'm already doing to support my body through endo.

Why It's All Connected

The pause, blood sugar, gut, liver, movement, sleep aren't separate items, they're one loop, and I've felt every seam of it. The stretch of extra sweets showed up in my blood sugar. Skipping hip openers because I'd been sitting at a desk all day showed up in my mood. Letting my wind-down time slide showed up the next afternoon, foggier, with less patience for whatever the day was already asking of me.

None of it happens in isolation. A rough night makes the next day harder to regulate. That makes it easier to reach for the sugar I said I'd minimize, which pulls on the same liver and gut system already working to clear estrogen. One slip doesn't undo anything on its own. A pattern of them, without something in place to catch it, adds up exactly the way it did for me during that stretch.

None of this was new information for you. The hard part was never knowing it. The hard part is doing all of it, every day, for months, especially on the weeks nothing hurts yet. That's what part two is about.

Continued in Part 2: Why This Is So Hard to Manage Alone →

Written by Monique, founder of Maisha Haus, certified yoga instructor, and someone who has lived with endometriosis and adenomyosis. Maisha Haus is one-on-one endo coaching that starts with deeper lab work.

This post reflects my personal experience managing endometriosis and adenomyosis, not medical advice. For diagnosis or treatment, please consult a licensed provider, or explore The Maisha Circle for vetted specialists.

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