If you follow my work, you’ll know that over the years I’ve made a gradual move to self-employment to help me lead a lifestyle that suits my body and allows me to manage endometriosis. While this way of living has obvious benefits, it’s no walk in the park, and I’ve been struggling deeply with loneliness.

My boyfriend and I moved away from London, where we both grew up, and while we’ve gotten to know some of the locals, due to difficult personal circumstances, we’ve not been able to dedicate the time we’d like to develop friendships in our new area. My boyfriend continues to work in London and care for a sick parent back home, which for me has meant few new friends, less contact with old friends, and days and nights alone without my partner.

While I’ve not seen a return of the crippling periods I once had, I’ve noticed a slight increase in my pain levels in the first two days of menstruation, from about a zero or 1 on the pain scale to about a 3. Additionally, I’ve started having some premenstrual pain, which I’ve never really had before. This is quite unusual for my pain pattern. I’ve also had a cold for over three months and seem to have continuing health issues. On top of that, my mental health has suffered, specifically with depression and anxious moods.

Some of this could be related to the stress we’ve endured in our personal lives lately, and my reaction has been to not eat entirely with endometriosis in mind. However, I am still one of the healthiest people I know in terms of diet. Let’s just say it’s unlikely my ill health is a result of a lack of vitamins. But I do believe it could be a combination of the previously mentioned factors, coupled with the impact of my experience with social isolation.

Recently, my curiosity was peaked while studying for my Women’s Health Coaching certificate, when I discovered how pivotal social relationships are to our health. I’ve written about the effects of isolation before, but with much more of a focus on mental health. However, the research I’ve read suggests the impact goes even further than this, particularly in terms of our experience with pain, inflammation, and disease risk.

Consider our history. In her new book, Integrative Women’s Health Institute founder Jessica Drummond explains that our female ancestors would do their gathering in packs and raise their children together. Being together was instinctive and essential to survival when we were at risk of the elements, other tribes, and wild animals. It was about protecting the group and keeping safe.

So, the theory is that when we’re alone, our brain goes into a state of heightened anxiety – it thinks we are at risk of danger. This leads us to experience increased intensity when we feel pain, as our body is alert to any warnings of danger or harm, and our brain takes our circumstances and surroundings into consideration.

Jessica explains that while it’s not a conscious decision, the intensity of pain we experience is a decision made by the brain based on numerous factors, including our personal safety — which extends to our environment, social connections (or lack thereof), history of trauma, and the quality of our relationships.

Additionally, social isolation has been found to increase the risk of inflammation in adolescence by the same degree as lack of exercise. Further evidence now shows that maltreatment — essentially negative relationships — in childhood increases the chances of a heightened stress response, and therefore, heightened inflammation in the body. People who experienced adversity in early life are more likely to experience inflammatory-related diseases as they develop and age.

Other studies have linked that lower levels of social integration and low-quality relationships with higher mortality rates, age-related diseases, and various health risks, whereas quality social relationships protect the health and enhance longevity.

What does this mean for endometriosis? While there are no studies that I know of linking endometriosis directly to social isolation or poor quality relationships, there’s plenty of evidence showing how the quality of our social interactions can affect our experience of pain, our rates of inflammation, and our risk of disease. As endometriosis is an inflammatory chronic pain disease, it makes sense to me that our support network not only affects how we feel about living with endometriosis but also how we experience endometriosis.

If you’re currently experiencing isolation, I encourage you to seek support, either through online communities or physical meetups. They exist, and support is out there.

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