Endometriosis Surgery Recovery Timeline: Week-by-Week Insights

What you can expect in the first four weeks after laparoscopic surgery for endometriosis

Recovery from endometriosis surgery is about more than wound healing. It’s a complex process of physical, emotional, and hormonal adjustment- especially in the first few weeks. In this blog, we break down what the post-surgery journey often looks like, based on feedback from participants in our 8-week program and current best-practice care.

Week 1: Rest, Regulation, and Reassurance

The first few days post-surgery are often spent managing:

• Fatigue and drowsiness (from anaesthesia and pain meds)

• Bloating and shoulder tip pain, especially from the gas used during laparoscopy

• Emotional vulnerability- it's common to feel teary or low, even if surgery went well

Clinical Tips:

1. Nervous System Regulation
   Try short breathing exercises like box breathing (inhale for 4, hold for 4, exhale for 4) or body scans to help settle the nervous system and improve sleep quality.

2. Movement for Gas Pain Relief
   Gentle rocking, pelvic tilts in bed, or walking short laps around the house can ease gas pain and support circulation.

3. Validate Emotional Changes
   Remind patients that feelings of sadness, fear, or fragility are valid and often pass. Encourage them to rest and seek support if needed.

Week 2: Gentle Movement and Listening In

As the pain starts to ease and wounds begin to heal, many people feel ready to:

• Take short walks or increase household activities

• Notice digestive changes or bowel discomfort, especially if the surgery involved deep infiltrating endometriosis

• Start feeling impatient or uncertain about “how much is too much”- this is COMMON!

Clinical Tips:

1. Start Graded Movement
   Increase or introduce gentle exercises like walking, stretching, and continue breathing exercises.

2. Digestive Support
   Encourage fibre, fluids, and gentle stretching to support bowel movements and reduce abdominal tension. Rotational exercises can help if you find you are sitting or lying for long periods. Simply turn to look over your left or right shoulder, rotating until you feel a gentle stretch.

3. Pacing Education
   Start learning activity pacing- alternating rest and movement- to avoid post-activity flare-ups.

Week 3: Reconnection and Flare Awareness

This is when some people start:

• Feeling well enough to re-engage in social or work activities, you may return to work this week OR you may not- both are ok!

• Experiencing energy fluctuations or delayed flares (often due to overdoing it)

• Worrying about whether ongoing pain means surgery "didn’t work"

Clinical Tips:

1. Flare-Up Framing
   Educate that flares can be part of healing and don’t mean the surgery failed. Reframe them as information, not setbacks.

2. Energy Tracking
   Introduce simple tools like energy journals or mood/pain trackers to help patients recognise patterns. Utilise the spoon theory, being more conscious of how you spend your “spoons” to best make use of your energy.

3. Mind-Body Strategies
   Add grounding tools like gentle yoga, mindfulness, or guided audio to help reconnect with your body in safe, supported ways.

Week 4: Rebuilding Confidence

By now, many participants are:

• Gaining clarity around their physical limits and energy needs

• Interested in returning to exercise, sex, or work- but unsure how to do it safely

• Reflecting on the emotional and identity shifts post-surgery

Clinical Tips:

1. Support Graded Return to Activity
   Provide guidance for resuming work, walking programs, or low-impact exercise (like mat Pilates or the gym) in a stepwise way.

2. Pelvic Floor Check-In
   Recommend pelvic health physio review (if appropriate) to address scar healing, return to exercise, pelvic floor engagement, and intimacy concerns.

3. Emotional Integration
   Encourage reflection on the whole journey- what’s shifted physically, emotionally, and socially. This can help with long-term adjustment and goal setting.

Final Thoughts

Every endometriosis surgery recovery is different. There’s no “perfect” timeline- but understanding the patterns we often see can help patients feel less alone and more prepared.

At Matilda, our digital program offers:

• Weekly movement videos delivered by Pelvic Health Physiotherapists and Yoga/Pilates Instructors

• Guided mindfulness from a Clinical Psychologist experienced in the endometriosis space

• Peer support calls guided by clinicians

• Clinical education on pain, fatigue, bowel health, sex, and more

If you're preparing for surgery or supporting someone who is, consider structured recovery support as a key part of your plan- not an afterthought.

👉 Want access to Matilda’s 8-week program? Learn more at https://www.matilda.health/join-now