Living with endometriosis can involve more than managing physical symptoms. Pain may interrupt work, relationships, exercise, sleep, travel, and plans that once felt predictable.
Medical care remains central to treating endometriosis. But alongside appropriate treatment, some patients may find value in ideas that help them navigate uncertainty, frustration, and the emotional burden of living with a chronic condition.
Several concepts associated with Japanese culture offer an interesting perspective. They do not treat endometriosis or replace medical care. Instead, they can provide simple ways of thinking about the parts of the journey that medicine alone may not address.
Japanese concepts centered on acceptance, small steps, mindfulness, and living in the present may offer supportive perspectives for navigating life with endometriosis.
1. Shōganai: Accept What You Cannot Control
Shōganai is commonly understood as recognizing that some circumstances cannot be changed.
For someone living with endometriosis, uncertainty can be particularly difficult. You may not be able to control when symptoms appear, how quickly a treatment works, or whether a particular day becomes more painful than expected.
Acceptance does not mean ignoring symptoms or accepting inadequate care.
It means separating what you cannot control from what you can influence.
You can document your symptoms, prepare questions for appointments, seek another medical opinion when appropriate, learn about treatment options, and advocate for your needs.
Sometimes conserving energy for those decisions is more useful than fighting circumstances you cannot immediately change.
2. Kaizen: Take One Small Step
Kaizen is associated with continuous improvement through small changes.
Endometriosis can make patients feel as though they need to solve several problems simultaneously: pain, appointments, medications, fertility concerns, work responsibilities, and decisions about treatment.
Instead of trying to solve everything today, identify the next useful step.
It might be scheduling an appointment, keeping a symptom diary for the next month, gathering previous imaging reports, or writing down three questions for your doctor.
A small step does not have to solve the entire problem to move you forward.
3. Wabi-Sabi: Make Room for Imperfection
Wabi-sabi is often associated with recognizing imperfection and impermanence as natural parts of life.
That perspective can be meaningful when illness disrupts expectations.
Perhaps you planned to exercise but needed to rest. Maybe pain changed your weekend plans. You may have needed help with something you normally handle yourself.
Living well with endometriosis does not require managing every difficult day perfectly.
Adjusting your plans, asking for help, or giving your body time to recover is not the same as giving up.
4. Shoshin: Keep a Beginner’s Mind
Shoshin, or “beginner’s mind”, encourages approaching something with openness rather than assuming that you already know the outcome.
This can be particularly useful when navigating endometriosis care.
A treatment that did not help does not necessarily mean that every treatment will fail. A previous normal ultrasound does not necessarily exclude endometriosis. And another patient’s experience does not determine what your experience will be.
Endometriosis varies considerably between patients.
Remaining curious can mean asking new questions, reconsidering previous assumptions, and discussing different options with your healthcare team when symptoms persist.
5. Shinrin-Yoku: Spend Time in Nature
Shinrin-yoku, often translated as “forest bathing”, refers to intentionally spending time immersed in nature.
Walking through a park or sitting quietly in a garden will not remove endometriosis lesions or replace medical treatment.
But living with persistent symptoms can be mentally exhausting. Gentle time outdoors may provide an opportunity to slow down, redirect attention, and support general well-being.
For someone experiencing significant pain, even sitting outside for a short period may be more realistic than taking a long walk.
The goal is not to turn nature into another treatment obligation. It is simply to create space away from the demands of illness when possible.
6. Ichigo Ichie: Come Back to the Present
Ichigo ichie expresses the idea that each encounter or moment is unique and will not occur in exactly the same way again.
Endometriosis can make thinking about the future difficult.
Will the pain become worse? Will treatment work? Will I need surgery? Could endometriosis affect my fertility?
These can be legitimate medical questions, and some deserve careful discussion with an endometriosis specialist.
But not every future question can be answered today.
Sometimes the most useful approach is to return to the information you currently have and determine what decision needs to be made next.
7. Zazen: Observe Your Thoughts Without Following Every One
Zazen is a form of seated meditation associated with Zen practice.
Persistent pain and uncertainty can generate frightening thoughts. A new symptom may immediately lead someone to imagine the worst possible explanation.
Mindfulness practices can help some people notice a thought without automatically treating it as a fact.
That does not mean dismissing physical symptoms.
New, persistent, severe, or worsening symptoms deserve appropriate medical attention. Mindfulness may support emotional well-being, but it should not be used to explain away symptoms that require evaluation.
Japanese Wisdom Is Not a Substitute for Endometriosis Treatment
There is an important distinction between coping with endometriosis and treating endometriosis.
Mindfulness, acceptance, time in nature, and other supportive practices may help some people manage the emotional demands of chronic illness. They do not remove endometriosis lesions, endometriomas, fibrosis, or established pelvic adhesions.
Endometriosis treatment may involve pain management, hormonal therapy, supportive care, fertility treatment, surgery, or a combination of approaches depending on the patient’s symptoms and goals.
The right approach is different for every patient.
Moving Forward One Step at a Time
Living with endometriosis can involve uncertainty, but you do not need to answer every question at once.
There may be things you cannot control. There may also be meaningful decisions you can make today.
At New York Gynecology Surgery & Endometriosis (NYGSE), we look at the complete clinical picture, including symptoms, previous treatments, imaging findings, fertility goals, and how endometriosis affects daily life, to determine what further evaluation or treatment may be appropriate.
References
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- Culley, L., Law, C., Hudson, N., Denny, E., Mitchell, H., Baumgarten, M., & Raine-Fenning, N. (2013). The social and psychological impact of endometriosis on women’s lives: A critical narrative review. Human Reproduction Update, 19(6), 625–639. https://doi.org/10.1093/humupd/dmt027
- Hansen, M. M., Jones, R., & Tocchini, K. (2017). Shinrin-yoku (forest bathing) and nature therapy: A state-of-the-art review. International Journal of Environmental Research and Public Health, 14(8), 851. https://doi.org/10.3390/ijerph14080851
- Missmer, S. A., Tu, F. F., Agarwal, S. K., Chapron, C., Soliman, A. M., Chiuve, S., Eichner, S., Flores-Caldera, I., Horne, A. W., Kimball, A. B., Laufer, M. R., Leyland, N., Singh, S. S., Taylor, H. S., & As-Sanie, S. (2021). Impact of endometriosis on life-course potential: A narrative review. International Journal of General Medicine, 14, 9–25. https://doi.org/10.2147/IJGM.S261139
