Endometriosis is one of the most common gynaecological conditions, affecting approximately 10 – 15% of all women. It occurs when tissue similar to the lining of the womb (the endometrium) grows outside of the uterus, potentially creating pain, inflammation and infertility. The tissue can grow along the fallopian tubes, ovaries, in the pelvis, around the bowel and bladder, and even the lungs, heart, armpits, knees and eyes! The tissue is hormone sensitive meaning it swells and bleeds along with a menstrual cycle, and as there is nowhere for the blood to go, inflammation and scar tissue can occur.
Endometriosis can be very tricky to detect, with it taking an average of 8 years to fully diagnose. Whilst scans may possibly show endometrial growths, it’s usually only accurately diagnosed via a laparoscopy, which may come with it’s own issues. It is very common for women to be diagnosed with IBS long before endometriosis is even considered.
Symptoms of Endometriosis
- Extremely painful periods (dysmenorrhoea)
- Painful intercourse
- Painful ovulation
- Chronic pelvic, abdominal or back pain
- Heavy or irregular periods
- Gastrointestinal issues
Medical Management of Endometriosis
The medical management of the condition is usually based around 3 options: Hormone treatment, surgical excision, and pain management.
Whilst these can all help with short- term pain, they may come with their own risks and re-growth of lesions are fairly common. This is why supporting the body with diet and lifestyle changes can be extremely useful in the management of endometriosis.
Endometriosis involves a high degree of inflammation, which in turn can lead to a cascade of immune reactions throughout the body. Therefore, removing certain foods that can trigger these issues is vital. Top inflammatory foods include: gluten, dairy and sugar, so eliminating these from the diet is a crucial first step.
Supplements to aid this process include turmeric and omega 3. The active component in turmeric, curcumin, has been shown to be effective at inducing apoptosis (cell death) and one study has referred to it as an “anti-endometriotic agent”. It is also a known anti-inflammatory, helping with pain management. Omega 3 has also been shown to have anti-inflammatory effects in the body and may reduce symptoms of dysmenorrhea (painful periods)
Another step in the healing process focuses on the gut, as this is where nutrients are absorbed and where sneaky pathogens may be hiding that further generate inflammation and immune reactions. A stool test is always advised if digestive symptoms are present, and interestingly, the yeast candida albicans is frequently associated with endometriosis, which ultimately needs to be dealt with before moving forward.
Removing trigger foods, as above, is vital for gut healing, together with herbs like berberine and grapefruit seed, which can help combat pathogens. Zinc is extremely useful in repairing leaky gut, which is common across various autoimmune conditions, and it is also a vital nutrient for the immune system. Probiotics can additionally help rebalance the microbiome, and lactobacillus gasseri in particular has been shown to help with the immune process in endometriosis.
Supporting Detoxification & Hormone Balance
Detoxification is essential to pull excess oestrogen from the body, which may be relevant in oestrogen dominant cases of endometriosis.
Sadly, there are so many chemicals in our environment these days that are known to have endocrine- disrupting effects and can wreck havoc with our body. Things like plastics (BPA specifically), skincare and beauty products, canned foods, feminine hygiene products, cleaning products, and pesticides, can actually mimic our own hormones, and can be extremely difficult to eliminate from the body.
It’s always best to use natural products on your body and in the home, use stainless steel pans when cooking, store food in glass containers, and eat organic foods to avoid increasing your toxic load unnecessarily. This can therefore taken the burden off the liver, enabling it to remove natural hormones safely and more efficiently.
Consuming fresh vegetables, especially leafy greens can help the liver detoxify. Some supplements can also aid this process. N-acetylcysteine (NAC) is an amazing antioxidant and can help with oestrogen detoxification. One particular study has shown some very promising results of endometriosis symptom reduction after 3 months, so it’s one to keep a close eye on!
B vitamins are also involved with detoxification in a process called methylation. Deficiencies have been associated with menstrual issues, fertility, and mood issues so it’s always recommended to up your B’s as the first port of call.
Oestrogen may also build up due to low progesterone, so using herbs to boost this hormone can be helpful, plus progesterone has been found to inhibit the growth of endometrial cells. Herbs can include agnus castus (chaste berry/ vitex), but also adaptogens that can support adrenal health.
Endometriosis is a condition with many layers, involving various systems in the body. It can take time to balance each of these in turn, but working through each stage with a practitioner can be hugely beneficial.
One thing to be aware of is that it can take 3 months on a protocol to notice a change in any menstrual issues, and with endometriosis you may be looking at between 6 months and a year to notice a reduction in endometrial tissues.
- Autoimmunity: https://www.ncbi.nlm.nih.gov/pubmed/22330229
- Curcumin: https://www.ncbi.nlm.nih.gov/pubmed/22227273
- Zinc: https://www.ncbi.nlm.nih.gov/pubmed/25864256
- Gluten free: https://www.ncbi.nlm.nih.gov/pubmed/23334113
- NAC: https://www.hindawi.com/journals/ecam/2013/240702/abs/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2708809/
- Bacteria https://www.ncbi.nlm.nih.gov/pubmed/25205755
- Probiotics: https://www.ncbi.nlm.nih.gov/pubmed/21153437
- Dysmenorrhea http://onlinelibrary.wiley.com/doi/10.1016/j.ijgo.2011.11.019/full
- Alternative strategies review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422563/pdf/ijwh-9-281.pdf