I first heard about endometriosis about 15 years ago when a doctor suggested I might have it. At the time I had debilitatingly painful periods that made me want to curl up into a ball under my desk each month. In fact, under my desk or on the couch in the production office (I used to be a freelance production coordinator on TV commercials in my former life), was where my production manager would often find me!
This doctor was clearly ahead of the game, but there wasn’t much she could offer me besides the pill. I’d been there, done that, so the pill was not an option for me at that point. In fact, in the five years I was on it, it had just masked all the symptoms I’d been experiencing, and now I felt like I was back to square one. Ugh.
I’ll share further down what I did instead of succumbing to the pharmaceutical push (because as you can imagine, that was certainly not the last time it was offered as a panacea for all my period woes).
Alarming Endometriosis stats
Endometriosis is estimated to affect approximately one in ten women of reproductive age, which is approximately 176 million women in the world.
Studies have shown a delay from 3 to 11 years between the onset of symptoms and the final diagnosis of endometriosis. With an average of 9.28 years before receiving a proper diagnosis!!  (Um, hello! This is just not okay. Women’s health concerns need to be taken way more seriously. But don’t get me started on gender bias in medical care…I think a post on the topic is in order).
Up to 30% – 50% of women with endometriosis may experience infertility. Sadly, it’s one of the top 3 causes of infertility.
One study found the prevalence of endometriosis in adolescent girls to be close to 50%, whereas others estimate the number to be roughly 70%. This is happening to young girls, and we have to intervene as early as possible.
What is Endometriosis?
Endometriosis is an inflammatory disease in which tissue that is similar to the kind of tissue that grows in the uterus grows outside of the uterus (instead of just on the inside). This tissue responds to the hormone fluctuations that govern the menstrual cycle in the same way it would if it were in the uterus, building up each month before the period (to prepare for possible implantation of a fertilized egg), and then breaking down when the body signals that it’s time to shed this lining.
Endometriosis is typically non-cancerous and can cause A LOT of pain. It’s believed to affect at least 1 in 10 premenopausal women worldwide
This tissue can develop into growths and lesions throughout the body, which are commonly found on organs in and around the pelvis like the fallopian tubes, the surface of the uterus, and the lining of the pelvic cavity. Endometriosis can also spread further into the abdomen though, affecting the intestines, the bladder, and the rectum. In rare cases it can even be present in the lungs!
When your uterine lining builds and sheds each month, it leaves the body through the vaginal opening. The endometrial tissue outside the uterus has nowhere to go but into the abdomen and pelvis. Over time, this monthly shedding leads to the formation of scar tissue and adhesions around the endometriotic tissue, which can cause a whole host of other issues – chronic inflammation, an abnormal immune response and even more scarring.
So yes, you guessed it – symptoms can worsen over time for many women. However, there are countless women (20-25% of them to be exact) who don’t even realize they have endometriosis until they are trying to conceive and lesions are found.
The symptoms of Endometriosis
Depending on the location and severity of the endometriosis lesions, symptoms can vary quite a bit. Since the endometriosis tissue is estrogen-responsive just like the endometrial lining of the uterus, symptoms often correlate with the menstrual cycles. Women most often experience:
Pelvic pain, usually with menstruation, but some women may experience pain throughout the entire month
Severe cramping during menstruation can disrupt life for 1 or more days, and don’t typically go away with anti-inflammatories
Periods that last longer than 7 days
Heavy to very heavy menstrual flow
Bowel and urinary disorders that include painful urination or IBS-like symptoms. These conditions include vulvodynia, interstitial cystitis and pelvic floor dysfunction
Nausea or vomiting, especially during menstruation
Depression and anxiety
Pain or bleeding during sex
Spotting or irregular bleeding outside of your period, and
Causes of Endometriosis
Currently, endometriosis is rather poorly understood by the western medical community, and they have been slow to catch up to the latest findings on this condition.
Researchers have concluded that endometriosis has almost all the hallmarks of an autoimmune disease, and has been found to occur in conjunction with other autoimmune conditions like multiple sclerosis, rheumatoid arthritis and inflammatory bowel diseases (including Crohn’s and ulcerative colitis) .
So this means there is definitely a connection between endometriosis and overall inflammation. Digging even deeper, inflammation is connected to our gut function and liver health (the liver’s ability to detox effectively), because gut and liver health play an important role in autoimmunity and the development of autoimmune disease.
Additionally, researchers seem to agree that hormonal imbalance is at the root of this painful condition, with excess estrogen being at the forefront. I think it would be more accurate to say that hormonal imbalance exacerbates this condition, rather than causes it.
Genetics also play a role as it’s been found that women who have a close relative with the condition are 7 to 10 times more likely to get endometriosis. In female twins, there is a likelihood that both will get the condition, especially if they are identical.[6,7] Other factors that have been linked to the development of endometriosis include alcohol use, which can increase estrogen in the body and decrease the liver’s detoxification function, and low body weight.[8,9]
There has been a longstanding belief that something known as retrograde menstruation is also a cause of endometriosis. Normally, menstrual blood should flow from the uterus out of the body, but instead of the blood flowing out of the body through the vagina, the endometrial lining flows backwards through the fallopian tubes and into the abdomen. Here’s the thing, retrograde menstruation is associated with endometriosis, but not every woman who experiences retrograde menstruation has endometriosis. So, if you experience retrograde menstruation, it does not automatically mean you have endometriosis.
How Is Endometriosis Diagnosed?
Endometriosis is difficult to diagnose. According to the study Invasive and non-invasive methods for the diagnosis of endometriosis, “imaging has limited utility in the diagnosis of endometriosis, as it lacks adequate resolution to identify adhesions or superficial peritoneal implants. Ultrasound is cheap and easy to perform, but user-dependent; MRI is more accurate but considerably more expensive. A CT scan of the pelvis does not visualize pelvic organs well, so it is not useful in the diagnosis of endometriosis. An important role for the CT scan with contrast is to detect ureteral involvement and possible renal insufficiency.”
Exploratory laparoscopy surgery is the only fully viable method to detect it. Because there is not a great non-invasive alternative for diagnosis, women can wait for up to ten years to get a proper diagnosis! What often happens instead of a diagnosis is women are prescribed pain medication and antidepressants, and sent on their way.
Is there a cure for Endometriosis?
There is currently no known cure for endometriosis, but there is a lot that can be done. I break it down into three components.
#1. According to the top endometriosis clinicians, the most important first step once endometriosis has been confirmed, is to find a SKILLED excision surgeon to remove the endometrial lesions and any scar tissue. While this surgery isn’t necessary for relieving pain in every case, it is one of the best ways to stop the progression of the disease and preserve your future fertility.
A good surgeon can usually remove everything in one go, but there are instances where multiple excision surgeries are required – usually if a woman has had previous surgeries or if the disease has had a lot of time to progress. In addition, hormonal suppression is used in conjunction with surgery (Lupron is one such drug that is used, but I do not recommend it).
#2. Additionally, women with endometriosis should also see a Pelvic Physical Therapist before, and after surgery to provide the best possible outcome for their recovery.
#3. I’m not an expert on surgery or hormonal suppression (so I can’t speak extensively about it), but I am an expert on nutrition and lifestyle adjustments, which is the third component of a well-rounded approach to endometriosis. 🙂
Many women who suffer from this condition have been able to mitigate its symptoms by addressing inflammation and strengthening their immune system. A natural approach that removes endocrine disruptors, and detoxifies excess estrogen has been extremely helpful in my practice.
Making the case for optimal gut health if you have Endometriosis
The health of the GI tract is connected to endometriosis. Here are two reasons why…
Lipopolysaccharides & Leaky Gut
Lipopolysaccharides (or LPS) are endotoxins that come from the outer cell walls of unfriendly bacteria, also known as gram-negative bacteria. When the GI tract is out of balance and a person has leaky gut, LPS can travel across the gut barrier and enter the body. These toxins can have far-reaching effects – particularly on the immune system.
In combination with estradiol, LPS can promote pelvic inflammation and worsen endometriosis. One study found that 80% of women with endometriosis have SIBO, and another suggested that the health of the intestinal bacteria played a critical role in the development and progression of endometriosis.[11,12]
Additionally, endometriosis can directly affect the GI tract, so it goes both ways. Prostaglandins, which are released during menstruation by the uterus and the endometrial lesions, affect the smooth muscle of the bowel and cause symptoms such as intestinal cramping and diarrhea. The endometrial cells can even invade through the wall of the intestines. This interferes with the gut’s ability to keep waste products moving, resulting in SIBO, yeast overgrowth, and bacterial imbalance, all of which will only worsen endometriosis as I just said.
Histamines are chemicals that are stored in immune cells known as Mast Cells, and are involved in nerve transmission and immune response regulation. When Mast Cells are triggered, they release histamines.
When a person has a histamine sensitivity, certain foods or environmental stimulants can cause a host of symptoms including: flushing, sneezing, itching, hives, headaches, wheezing, swelling, anxiety and difficulty sleeping.
Interestingly, in women with endometriosis, mast cells are present in much higher quantities in the endometriotic tissue, than in healthy tissue of women who don’t have endometriosis. It appears there is a correlation between an abnormal immune response, specifically a hyperimmune response and women with endometriosis. This means that clients with endometriosis definitely need to experiment with avoiding histamine triggers.
While genetics and food allergies certainly play a role in histamine sensitivity, gut dysbiosis makes things much worse. People with leaky gut or small intestine bacterial overgrowth are much more prone to histamine sensitivity.
Solutions For Managing Endo Naturally
I never did the laparoscopic surgery to determine if I had endo, but I did a complete overhaul of my life in order to get my period pain under control. It wasn’t easy – I changed careers, upgraded my diet, lifestyle, and supplement regimen, and even moved to a place that made me happier!
And that brings me to my TOP SEVEN recommendations to help YOU manage endometriosis naturally.
#1 Curcumin (a powerful ingredient in turmeric)
In addition to being an incredible anti-inflammatory/brain boosting/cancer-preventing powerhouse, curcumin also prevents the growth of endometriosis cells by inhibiting the production of the hormone estradiol. I recommend making a turmeric paste like this one and adding it to meals, soups and smoothies every day.
Try limiting intake or cutting these out completely for 4 weeks to see if there is a reduction in your symptoms.
Fermented, cured, or soured foods, such as yogurt, luncheon meat, pickles, and sour cream
Aged cheeses, such as cheddar and goat cheese, and smoked fish
Citrus fruit and dried fruits such as apricots and raisins
Alcoholic beverages, especially wine and beer
Certain nuts, including walnuts, peanuts, and cashews
Avocados, eggplant, spinach, tomatoes, chocolate, and dairy
I am also a big fan of quercetin, a flavonoid which works like an all natural anti-histamine – stabilizing the effects of histamines released from mast cells. It also doubles as a leaky gut and pain reliever. I like Pure Encapsulations Quercetin and recommend 500mg a day for 8-12 weeks.
#4 Blood sugar balancing for the win
If your blood sugar is consistently unstable, then it’s contributing to inflammation in your body. Long-term inflammation = pain. The goal is to eat a balance of protein, carbs, fat and fiber so your blood sugar doesn’t spike and crash all day long. This translates to more stable energy (no crashes mid-morning or mid-afternoon), more stable moods less drama, better sleep, beautiful skin and hair (yes sugar messes these up too), and waaaay better periods! Read my blog post about it and get my Blood Sugar Balancing Protocol here.
#6 Support your liver’s ability to process estrogen
Each day eat 1-2 cups of cooked cruciferous veggies like broccoli, kale, collards, cabbage, and brussels sprouts, which are nutrient powerhouses that will help support the liver’s estrogen detoxification capacity. You can up your detox game by including the following supplements….
Di-indole methane (DIM), and Sulforaphane Glucosinolate (SGS) are cruciferous vegetable extracts that are helpful in cases of estrogen dominance. DIM supports phase 1 liver detoxification, and SGS supports phase 2. Start with SGS for 28 days, and then move onto the DIM. I like Thorne Research Crucera SGS. The standard recommendation is to take 100 milligrams every other day for 28 days. I like Designs for Health DIM Evail, and it’s typically recommended to take 200-400 milligrams a day for 28 days
#7 Avoid exposure to damaging chemicals and xenoestrogens
Poly-chlorinated and brominated chemicals, like PCBs and flame retardants, are harmful to the liver. These are present in drinking water and many foods. Other environmental toxins such as BPA and other plastic softeners like phthalates can artificially increase estrogen levels. Dioxins, which are bleach byproducts should also be avoided because they contribute to endometriosis progression.
Information in this post and on this web site is provided for informational purposes only. The information is a result of practice experience and research by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem.
Rogers PA, et al. Priorities for endometriosis research: recommendations from an international consensus workshop. Reprod Sci 2009;16(4):335-46.; Adamson GD, et al. Creating solutions in endometriosis: global collaboration through the World Endometriosis Research Foundation. J of Endometriosis 2010;2(1):3-6