Understanding Endometriosis
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March is Endometriosis Awareness month. Endometriosis affects an estimated 1 in 10 women during their reproductive years (ie. usually between the ages of 15 to 49), which is approximately 190 million women worldwide according to the World Health Organization's recent estimates and according to the American Society for Reproductive Medicine affects 24 to 50% of women who experience infertility. Unfortunately, endometriosis remains a condition that isn't fully understood by conventional medicine. Because of that, women and people with a uterus are suffering on a daily basis without understanding the nature of the condition or how to find relief.
If you are among these individuals, you know how debilitating, frustrating, and scary it is to experience pain throughout the month. We want to give you some background on endometriosis and ways to deeply heal using both evidence-based and natural modalities.
What is endometriosis?
Endometriosis occurs when endometrial-like tissue, which is normally found in the uterus, grows in places outside the uterus—places where it shouldn't be like on the ovaries or fallopian tubes, even on the abdomen or other organs. Recent research has clarified that this tissue is similar to but not identical to the endometrium that lines the uterus, explaining why it responds differently to hormones and treatment.
Because this tissue responds to hormonal fluctuations (especially estrogen) that are activated during the menstrual cycle, the pain associated with endometriosis will often follow the same cycle as your period. When you menstruate, these endometrial-like tissues may also bleed, regardless of where they are in the body. The blood causes irritation and inflammation, which results in pain and scar tissue formation.
The number one symptom people with endometriosis report is pain — with their period, with sex, with bowel movements or urination, as well as constipation, nausea, and for some, constant pelvic pain.
Recent studies have also highlighted the significant impact endometriosis can have on fertility, with approximately 30-50% of individuals with endometriosis experiencing fertility challenges.
What causes endometriosis?
There are multiple theories about the causes of endometriosis, though none have been conclusively proven. These include:
“Reverse menstruation" (where menstrual tissue flows backward through the fallopian tubes and attaches to organs in the lower abdomen)
Genetic predisposition: a family history of mothers or sisters that have endometriosis are at a higher risk for developing endometriosis.
Immune system factors that may stimulate endometriosis growth.
Estrogen excess fuels endometriosis development. Therefore, reducing exposure to both excess estrogen and xenohormones (environmental chemicals that disrupt natural hormone balance) is an important consideration for management of the condition.
The latest research also reveals that endometriosis isn't just a reproductive disorder but a complex, systemic inflammatory condition that can affect multiple body systems, which explains why many patients experience fatigue, gastrointestinal issues, and other systemic symptoms.
Some symptoms include:
Heavy menstruation with pain, large clots, long or abnormal length of cycles
Lower abdominal pain, back pain, burning pain
Frequent or constant pain all month long
Painful sexual intercourse
Pain during bowel movement or urination
Dysmenorrhea
Ovarian swelling
Swollen abdomen
Infertility
Some women may experience bleeding after intercourse, bowel movements, or urination
Excerpt by Hethir Rodriguez
How Does Endometriosis Affect Fertility?
Endometriosis is an estrogen dominant condition. When there is too much estrogen in the system, it causes hormonal imbalance. Proper hormonal balance is essential for healthy fertility.
Endometriosis also creates a situation of “congestion” where there are excess tissues growing in the uterus (as well as other areas of the body) which may make it harder for an embryo to attach properly for implantation (Case-control study from Yale University IVF-ET program).
Every month, the excess tissues bleed, which cause inflammation to occur and scar tissue to begin adhering to the uterus, fallopian tubes, the ovaries, and other organs. Amongst holistic healthcare practitioners, internal damage from endometriosis is known and referred to as chronic pelvic “congestion”. If endometrial cells attach to the ovaries or fallopian tubes this may alter normal ovulatory function or cause the fallopian tubes to become blocked.
As if that was not enough, some researchers suggest that the woman’s body may form antibodies against the misplaced endometrial tissue. The same antibodies may attack the uterine lining and cause miscarriages (up to three times the normal rate).
There are four stages of progression with endometriosis. As the disease progresses, fertility is negatively impacted in different ways. Stage I is considered the mildest, while Stage IV is considered the most severe and the most devastating to not only reproductive health, but the entire surrounding organs and tissues of the uterus.
I also align with Alissa Vitt’s mind-body perspective when it comes to endometriosis.
Excerpt by Alissa Vitti
The Feminist Mind-Body Connection
Think about your female reproductive organs — uterus, ovaries, a vagina — acting as a “low heart” and as such holding many of your unconscious, deeper emotions that the “high heart” is not yet ready to process. The emotions are held here, only to be released once a person has processed the source of these held feelings.
There’s actually a deeply feminist history to the mind-body connection and how it relates to the female experience. A student of psychologist Carl Jung, Marion Woodman, developed a concept of “feminine psychology.” Her work details how unconsciously held emotions, feelings, and thoughts can affect the female body. It’s important to note that as science progresses we are seeing more and more empirical evidence to support and back up this perspective. Woodman investigated how women feel about their bodies. Many of us are brought up to be fearful and distrustful of our bodies, and she believed this has a significant impact on our health. She believed that the unprocessed trauma experienced by many women – as the result of individually experienced acts of abuse and violence, and as the result of cultural oppression – could manifest itself in physical symptoms, especially those relating specifically to female biology.
If you have endo, there is reason to have hope. Implementing lifestyle strategies that reduce inflammation, strengthen immune function, support liver health, and balance hormones can significantly reduce symptoms and enhance quality of life.
A Natural Endometriosis Support Plan May Include:
Relaxation techniques and exercise to reduce stress
Nutrition and lifestyle changes to support pain, reduce inflammation response and promote estrogen metabolism
Herbal pain support
Support for reducing excess estrogen
Supplementation for hormone balance
Reducing adhesions and future growth
Natural progesterone supplementation
Foods to help boost immune function
Garlic
Ginger
Dark leafy greens
Leeks
Mushrooms and medicinal ones like reishi, shiitake, and cordyceps
Berries
Seeds (like flax, chia, and pumpkin)
Fiber-Rich Food for Hormone Detox
Vegetables, fruits, legumes, beans, whole grains, seeds, and nuts. They contain skins, and flesh that are fiber rich.
Foods for Liver Support
Artichokes
Beets
Burdock root
Cabbage
Kale
Lemon & Lime
Dandelion greens
A nourishing endometriosis smoothie to reduce inflammation? Get it HERE.
Reducing environmental exposures
Minimize plastic use: Especially avoid heating food in plastic containers, which can release endocrine-disrupting chemicals.
Choose clean personal care products: Look for products free of parabens, phthalates, and synthetic fragrances.
Filter water: Consider using a quality water filter to reduce exposure to potential hormone-disrupting chemicals.
Choose organic when possible: Especially for the "dirty dozen" fruits and vegetables with the highest pesticide residues.
Research has highlighted the connection between gut health and endometriosis. Supporting your nutrition with the foods above and regulating your bowel movements can bring drastic relief. If you need 1x1 support, reach out here.
When to seek medical care
Natural approaches can complement conventional treatment, but working with healthcare providers who specialize in endometriosis is essential for comprehensive care. Recent advances in laparoscopic excision surgery, medication options, and multidisciplinary pain management have significantly improved outcomes for many patients. Don't delay seeking professional medical attention if:
You experience pelvic pain that disrupts your work, social life, or daily routines
You find that standard pain medications provide little to no relief
Your symptoms worsen over time despite self-care measures
You're having difficulty conceiving after trying for 6-12 months
You notice blood in your urine or stool, or have recurring digestive issues
You experience extreme fatigue that doesn't improve with rest
You have painful intercourse that affects your intimate relationships
Remember that early diagnosis can help prevent disease progression and preserve fertility. Many patients benefit from seeing specialists at endometriosis centers where gynecologists work alongside pain specialists, physical therapists, and integrative medicine practitioners.
Finding community and support
One of the most significant developments in recent years has been the growth of endometriosis awareness and support communities. Connecting with others who understand your experience can be incredibly validating and provide valuable insights on managing the condition. Online and in-person support groups offer resources, emotional support, and advocacy opportunities.
Remember, endometriosis, as well as any other hormonal imbalance, is by no means your fault. The historical lack of education, research in women's health, and societal conditioning has left many feeling disconnected and ignored. However, with growing awareness and research, there is increasing hope for better understanding and more effective approaches to managing this complex condition.
Your experience is valid, your pain is real, and you deserve compassionate, comprehensive care that addresses all aspects of this condition.
For information on endometriosis excision expert guidance, including getting financial support for this procedure, follow our good friend Nicole Notar at Endo-Excision For All.
References:
Hethir Rodriguez: https://natural-fertility-info.com/endometriosis
Alissa Vitti: https://floliving.com/blog/a-functional-medicine-approach-to-endometriosis
