Endometriosis: How To Help Chronic Symptoms

The amount of women dealing with endometriosis is just astounding to me, but even more so is the care (or lack of) that exists around it. The standard of care includes birth control, pain meds, and surgery. While perhaps those can be beneficial, they do nothing to solve the problem at the root- they're just bandaids.

While endo primarily affects the pelvic region, there’s growing recognition of extrapelvic endometriosis, where this tissue is found in other parts of the body, such as the intestines, lungs, and even the brain. From a functional medicine perspective, understanding the root causes and systemic connections of endometriosis is key to managing and potentially alleviating symptoms. Because yes, even with surgery, issues can come back.

The Functional Medicine Approach

When it comes to endometriosis, functional medicine can offer a ton of insights into how hormonal imbalances, immune dysfunction, inflammation, and lifestyle factors contribute to the condition. There are four clinical areas I like to focus on with my clients (I'll add in a bonus 5th, which is nervous system regulation):

1. Hormonal Imbalance: Endometriosis is estrogen-dependent, meaning the growth and inflammation associated with the condition are fueled by estrogen. This means that beyond focusing on just the hormone piece, we must also support liver detoxification, improve gut health, and manage stress to reduce estrogen dominance. Hormones are chemical messengers- they're responding to the environment, which means it's the environment that needs to be "fixed."

2. Immune System Dysfunction: There is evidence to suggest that women with endometriosis have altered immune responses, which may allow endometrial tissue to implant and grow outside the uterus. 

3. Inflammation: Chronic inflammation is a key driver of endometriosis symptoms. It's important to reduce inflammation by identifying and removing potential triggers, such as pathogenic overgrowth, environmental toxins, and stress. Anti-inflammatory diets rich in omega-3 fatty acids, antioxidants, and phytonutrients are often recommended (I prefer to use food when possible).

4. Gut Health Connection: The gut plays a crucial role in hormone regulation, immune function, and inflammation—all of which are relevant to endometriosis. Dysbiosis, or an imbalance in gut bacteria, can contribute to estrogen dominance and systemic inflammation. For my endo clients, I always run a comprehensive stool test. Not just to look at potential overgrowth, but also to see how well estrogen detoxification is happening, among other factors.

Need help on your gut healing journey? Download my free ebook HERE.

What About Extrapelvic Endometriosis?

Extrapelvic endometriosis, where endometrial-like tissue is found outside the pelvic region, is also quite common but misunderstood. When this tissue grows in the intestines, for example, it can cause symptoms like bloating, pain, and altered bowel habits, which are often mistaken for IBS. The presence of endometrial tissue in other organs like the lungs or brain can lead to a range of other symptoms, making diagnosis challenging.

The Gut-Endo Connection: How the Gut Influences Endometriosis

The gut’s connection to endometriosis is multifaceted, which is a big reason why I run stool tests for clients. Here are a few key pieces to note:

1. Estrobolome and Estrogen Metabolism: The estrobolome, a collection of gut bacteria, plays a critical role in metabolizing estrogen. If the gut is imbalanced, this can lead to recirculation of estrogen, contributing to estrogen dominance and worsening endometriosis symptoms.

2. Leaky Gut and Systemic Inflammation: Intestinal permeability, often referred to as “leaky gut,” can allow toxins, bacteria, and undigested food particles to enter the bloodstream, triggering systemic inflammation. This inflammation can exacerbate endometriosis symptoms and contribute to the spread of endometrial-like tissue outside the uterus.

3. Gut-Brain Axis: Stress and emotional health are closely linked to gut health. The gut-brain axis, a bidirectional communication pathway between the gut and the brain, means that stress can directly impact gut function, potentially worsening endometriosis symptoms. 

Managing endometriosis requires a multifaceted approach that addresses the root causes and systemic connections. Here are some strategies that I often recommend to clients:

1. Focus on an anti-inflammatory diet rich in whole foods, fiber, healthy fats, and protein. Foods high in omega-3 fatty acids (like fish and flaxseeds) and antioxidants (like berries and leafy greens) can help balance hormones and reduce inflammation.

2. Enhancing liver function to process and eliminate excess estrogen is crucial. This can be supported through foods like cruciferous vegetables (broccoli, cauliflower), green tea, and spices like turmeric.

3. A healthy gut microbiome is essential for managing endometriosis. This includes incorporating probiotics (fermented foods) and prebiotics into the diet, avoiding processed foods, and addressing any underlying gut infections or imbalances.

4. Chronic stress can exacerbate endometriosis by increasing inflammation and disrupting hormonal balance. Mind-body practices such as prayer, meditation, and deep breathing exercises are often recommended, and I also utilize somatic movement and hypnosis with my clients.

Endo can be a debilitating condition, but truly, it doesn't need to be life-long. There is help out there, but unfortunately for many it doesn't come from Western medicine. Because of this, I offer private consulting and also a very affordable monthly membership for women who are motivated to make changes. You can learn more about that HERE.