Endometriosis is a complex inflammatory disease in which tissue that is similar to the kind that lines the uterus, grows outside the uterus. More on this here

There is an important connection between histamine and endometriosis. 

What are histamines?⁠

Chemicals that are stored in immune cells known as Mast Cells.⁠

When Mast Cells are triggered, they release histamine, which helps regulate the immune response.⁠

In people with endometriosis, mast cells are present in much higher quantities in the endometriotic tissue, than in healthy tissue of those who don’t have endometriosis.⁠

Endo and Immune Response

There’s a correlation between an abnormal immune response (specifically a hyperimmune response) and endometriosis.⁠

This triggers production of histamine.⁠

If you have endo, the goal is to calm the immune response.⁠

Which is why as part of your treatment plan, it may be beneficial to experiment with avoiding histamine triggers. ⁠

Such as these top histamine producing foods:⁠

  • Fermented, cured, or soured foods, such as yogurt, lunch meat, pickles, sauerkraut and sour cream⁠
  • Aged cheeses, such as cheddar and goat cheese⁠
  • Alcoholic beverages, especially wine and beer⁠
  • Smoked fish⁠

The endo and gut health connection

Endo is massively connected to gut health.⁠

There is now substantial evidence that the health of the intestinal bacteria play a critical role in the development and progression of endometriosis. ⁠

Animal studies show the composition of the microbiota is altered in endometriosis, and the condition is linked to higher levels of gram-negative bacteria or Lipopolysaccharides (LPS for short). ⁠

What the heck are those? ⁠

Endotoxins, released from the outer cell walls of pathogenic bacteria (e.g. E. coli or salmonella, which I’m sure you’re familiar with). ⁠

A few studies have even found antibiotics to slow endometriosis progression, possibly due to the effect on certain bacteria in the microbiome. (PMID: 36693853, 37315109⁠).

Check out these two articles to learn more about those studies:

This is likely why those with endometriosis tend to experience such a wide array of gastrointestinal symptoms and conditions.⁠

One of the most common GI conditions that accompanies endometriosis is:⁠

Small Intestine Bacterial Overgrowth or SIBO. ⁠

Endo can infiltrate the bowel and alter the intestinal motility and the bacterial population, causing SIBO. ⁠

A significant number of IBS cases are linked to SIBO.⁠

This is why many people are diagnosed with IBS before getting an actual endometriosis diagnosis. 

It’s also been shown that LPS triggers macrophages (a type of white blood cell) to release inflammatory substances like cytokines in the pelvis that promote growth of endometriosis lesions. ⁠

Finally, the combination of LPS and estradiol promotes further pelvic inflammation and can worsen endo.⁠

The good news? 

We now know that we can begin to address endo by addressing the health of the gut and immune system.  

Head over to this article to discover some of the natural solutions for endometriosis.

Endo resources 

General Endometriosis Information:

Endometriosis Foundation of America (EndoFound): strives to increase disease recognition, provide advocacy, facilitate expert surgical training, and fund landmark endometriosis research.

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Endo Black: Advocating for African American women & WOC affected by endo.

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Jenneh Rishe: The Endometriosis Coalition, a 501c3 Non-profit fighting for awareness & promoting reliable education for endometriosis.

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Doctors & Surgeons:

Center for Endometriosis Care: Center of Expertise in Endometriosis serving the global community since 1991.

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Dr. Andrea Vidali:

World-renowned expert in the field of Robotic Excision Endometriosis Surgery.

Website | Instagram


Jessica Duffin/This Endo Life: Living + thriving with endometriosis. Certified Women’s Health Coach specializing in endo + SIBO, endo belly and more. Creator of the Endo Foundations Course.

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Dr. Jessica Drummond: CEO of The Integrative Women’s Health Institute and Outsmart Endo Program, keynote speaker and bestselling author of Outsmart Endometriosis.  

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Lizzie Alexander: Endowarrior who had symptoms for 25 years. As a women’s health coach her specific focus is on how to thrive and conceive with endometriosis.

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Cindy Dabrowska: Dietitian & endowarrior who helps women improve endo pain, endo belly & infertility without restrictive diets.

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April Summerford – Holistic Endo Coach: Amazing endo support group and map of endo specialists.

Website | Instagram


Heal Endo by Katie Edmonds

Beating Endo by Dr. Iris Orbuch and Dr. Amy Stein

Outsmart Endometriosis by Jessica Drummond

My book, Fix Your Period (pay special attention to the gut protocol!) 

Podcast Roundup:

Using advanced ultrasound techniques to diagnose endometriosis with Dr. Mathew Leonardi

Does Everyone With Endometriosis Need Surgery? With Katie Edmonds

Your Chronic Illness Doesn’t Define Who You Are with Jenneh Rishe

Viewing Endometriosis As A Uniquely Traumatic Condition with Kat Smith

The Truth About The Pill, Lupron and Endometriosis with Dr. Jessica Drummond

How Endometriosis Impacts Mental Health with Jessica Murnane

When It’s Not Just Endo – The Connection Between SIBO, IBS, IC and Endometriosis with Jessica Duffin