Can Drinking Water and Staying Hydrated Help Ease Symptoms of Endometriosis?

 We are all aware of the importance of staying hydrated by drinking water, but is it particularly crucial for individuals with endometriosis? Let’s explore how adequate hydration could hold added significance for those of us dealing with this condition. Water is our life source, we are made up of approximately 60% water and need it to stay alive, function optimally, absorb nutrients and generally just… thrive. Understanding the significance of water, let's now examine some specific symptoms that some people with endo experience and how water can play a role in either aiding or reducing them.

Common Endo Symptom: Sore Joints & Inflammation

Many people with endo experience sore joints chronically or periodically. Both the cartilage in our joints, and the synovial fluid (the thick fluid that sits between our joints to cushion them and reduce friction) require water. Synovial fluid needs water to be produced, while cartilage is composed of around 80% water.1 Hydrated joints contribute to better joint health, by ensuring adequate lubrication and facilitating the transportation of nutrients between cells. Although hydration won't cure joint pain, as the underlying cause probably isn't a lack of fluid, staying hydrated can prevent pain worsening due to dehydration. Even mild dehydration can exacerbate joint pain. Water can aid the reduction of inflammation by flushing toxins and irritants out of our body, thereby reducing the body's need to induce inflammation to combat them. Those with endo may experience inflammation-related side effects in many ways ranging from acne to body pains. Providing your body with the necessary tools to facilitate efficient cleansing can help minimise these effects.

Common Endo Symptom:  Headaches, Fatigue, Muscle Cramps, Nausea

Water is required to maintain fluid balance, which is the equilibrium between water in and water out of our body. Waste products are continuously eliminated from our bodies through various processes including breathing out carbon dioxide, but the majority of waste is expelled through urine and faeces. It’s important to continually replenish the water that is flushed out in our urine to ensure optimal fluid balance.

Fluid balance is partly regulated by electrolytes or minerals which must be maintained in perfect balance with the amount of water in our body. We lose electrolytes when we exercise, sweat, vomit, urinate or have diarrhoea. Maintaining the right electrolyte balance ensures our bodies work effectively. Fluid and electrolyte balance is regulated through a couple of different mechanisms, but importantly via the kidneys, whose role is to filter the body of waste. The kidneys work most effectively in an abundance of water so that they can effectively filter the blood to create urine. Kidneys determine how much water we lose when we urinate. If we are dehydrated so must cut back on the amount of water lost, it produces a more concentrated urine, the kind that is yellow or darker, which can wear on the kidney tissues.2 Our kidneys do many important things for us so keeping them happy and healthy is vitally important - drinking water helps to protect them.

When fluid balance and electrolyte balance is disrupted, it can cause headaches, fatigue, muscle cramps, nausea. These are common symptoms in endometriosis. You can help prevent these symptoms by adequately replacing lost fluids in the body. If you sweat a lot, particularly from strenuous exercise, replenishing electrolytes is important, so eating a snack can help maintain this balance. Electrolytes are found in various foods including nuts, fruit, dairy, vegetables, white meat, shellfish, beans, and good-old salt. While your endo symptoms are unlikely to be directly caused by dehydration, ensuring adequate hydration is a good place to start to avoid triggering them further.

Common Endo Symptom: Difficulty Concentrating

Blood, comprised of 90% water, carries oxygen and nutrients to every part of the body, allowing cells to receive the nutrients and oxygen needed for survival. One of those areas is the brain; despite it consisting of just 2% of our body mass, it uses around 20% of our oxygen and is made from about 80% water.3,4 Every chemical reaction in our brain requires water, so even a small reduction in hydration can impair brain function causing confusion, fatigue and making it difficult for you to concentrate. Prolonged dehydration can lead to problems with thinking and reasoning. Maintaining hydration keeps the oxygen and nutrients flowing around the body and to our brains, whilst ensuring our brain is hydrated enough to remain mentally sharp.

Common Endo Symptom: Bowel Problems

The bowel needs water to work properly; part of the intestine’s role is to absorb water and nutrients from waste matter so that it can harden and form a solid stool. Drinking enough fluid ensures your poops are soft and easier to pass. When your body lacks sufficient water, it continues to absorb moisture from your bowels causing dry stools that are hard to pass, so dehydration can contribute to constipation. Acid reflux can also be heightened by dehydration when corrosive stomach acid comes back up the oesophagus and possibly into your mouth. Many people with endometriosis deal with this symptom. Sipping on water throughout the day won’t cure acid reflux, but it can help clear the acid from the oesophagus whilst helping food in your stomach move to your bowels, both of which can improve symptoms.

Common Endo Symptom: Urinary Tract Infection

Another common symptom of endo are UTIs, otherwise known as a water infection. Although it’s not caused by a lack of water, staying hydrated can ensure that you pee regularly throughout the day. This may help flush the bacteria that entered the urethra helping to clear it and possibly help with prevention.

Whilst water is not a magic pill for any of these symptoms, it might be able to help. Water is essential for everyone so it's good to look at your intake as part of a healthy diet. In the UK we are recommended to drink on average eight to ten glasses of fluid each day, or 1.5-2 litres a day. If you exercise this should increase to match the level of exercise and water lost. If you really struggle to get your water intake, remember it doesn't have to be plain water. You can still get the benefits of hydration through sparkling water, coconut water, herbal tea, squash, or you can add fruit to your water such as cucumber or lemons. Tea and coffee also count towards your fluid intake each day, but it’s not a good habit to rely on these as part of your fluid intake. Finding strategies to implement more fluid in your day will be individual to you. Some like to try and get a large glass of water in the morning and before bed to ensure at least two glasses are ticked off each day. Some prefer to fill a large reusable bottle to drink throughout the day, helping to monitor their intake. Personally, I drink herbal tea all day on a cycle. I have developed this habit so strongly that now I rarely can sit at a desk or watch tv without having a drink beside me. I know that method doesn't suit everyone's lifestyles, so finding what works for you is what matters.

You may have heard online about Celtic Sea Salt, famed for its trace amounts of healthy minerals such as magnesium, calcium and potassium. Adding a small pinch of Celtic Salt under your tongue once a day before drinking water can help balance electrolyte levels and promote better hydration. Effectively it improves the water absorption by the body meaning you are getting more out of your water. I am yet to try this, so if any of you have please leave your opinions in the comments.

If you are interested in Celtic Sea Salt, you can purchase it on amazon: https://amzn.to/3z6hDsr

1 - Shiguetomi-Medina JM, Ramirez-Gl JL, Stødkilde-Jørgensen H, Möller‐Madsen B. Systematized water content calculation in cartilage using T1-mapping MR estimations: design and validation of a mathematical model. Journal of Orthopaedics and Traumatology. 2016;18(3):217-220. doi:10.1007/s10195-016-0433-8

2 - Popkin BM, D’Anci KE, Rosenberg IH. Water, hydration, and health. Nutrition Reviews. 2010;68(8):439-458. doi:10.1111/j.1753-4887.2010.00304.x

3 - Raichle ME, Gusnard DA. Appraising the brain’s energy budget. Proceedings of the National Academy of Sciences of the United States of America. 2002;99(16):10237-10239. doi:10.1073/pnas.172399499

4 - MacAulay N. Molecular mechanisms of brain water transport. Nature Reviews Neuroscience. 2021;22(6):326-344. doi:10.1038/s41583-021-00454-8