The endometrium is normally found in the uterus, forming the uterine lining.  It is expelled and rebuilt each month during the menstrual cycle.  Endometriosis is a condition where this endometrial tissue grows outside the uterus.   This displaced endometrial tissue is most commonly found on the ovaries, in the fallopian tubes, the outer wall of the uterus and ligaments of the uterus and ovaries as well as in the bowel, the ureters or the bladder.  However, endometriosis can in fact occur anywhere within the body.

The displaced endometrial tissue responds and performs in the same way as the endometrium within the uterus.  It builds up in the lead up to ovulation and then breaks down and bleeds during menstruation.  This bleeding can trigger inflammation and pain and over time can lead to scarring, known as adhesions.

Endometriosis has a significant impact on fertility and is a causative factor in 25 – 50% of fertility issues in women.

The cause of endometriosis is largely unknown and symptoms can vary greatly.  Most common symptoms of endometriosis include

  • Severe period pain (or pain may last all month long)
  • Heavy bleeding and/or clotting
  • Abnormally long or short cycles
  • PMS (Pre-menstrual syndrome)
  • PMT (Pre-menstrual tension)
  • Lower abdominal pain or back pain
  • Abdominal swelling
  • Painful intercourse
  • Difficulty falling pregnant
  • Infertility

These symptoms are fairly general and can occur without the presence of displaced endometrial tissue.  For this reason many women are not aware they have endometriosis until it is discovered during unrelated surgery or when they have difficulty trying to fall pregnant.   Fortunately a new Australian Government initiative has provided more funding for research into endometriosis which hopes to aid early diagnosis and treatment.

Endometriosis appears to have a genetic connection being commonly seen in family members.  Endometriosis is also associated with a relative estrogen to progesterone excess, meaning the ratio or estrogen in the body is high in relation to progesterone levels.

 

Endometriosis and fertility

Mild endometriosis may have little, if any, impact on fertility. However, more severe endometriosis can significantly impair your ability to fall pregnant.

The displaced endometrial tissue can damage internal organs including the fallopian tubes, ovaries and uterus.  Build up of scarring can hinder or block the passage of the egg and sperm making fertilization difficult or impossible.  Scarring on the uterus may prevent a fertilized egg from implanting.  If endometriosis is present on the ovaries, eggs may be damaged resulting in decreased ovarian reserve and reduced egg quality and quantity.  The continual bleeding of displaced endometrial tissue also increases inflammation and congestion within the body.  This inflammation can also effect the immune system, hindering healthy development.

 

Natural Treatment

Support estrogen clearance

Estrogen excess is a common factor in endometriosis.  Healthy estrogen clearance requires healthy functioning of the cytochrome P450 (CYP450) family of enzymes in phase I detoxification as well as phase II detoxification processes within the liver.  Herbal and nutritional support can help improve detoxification pathways, supporting healthy hormonal clearance to reduce the estrogen dominance.

Reduce Inflammation

An anti-inflammatory diet combined with nutritional and herbal support help to reduce the inflammation associated with endometriosis.

Regulate the immune system

Endometriosis has been found to be linked to immune issues including the development of autoimmune conditions.  70% of the immune system starts in the gut.  Pre and probiotics can help support immune regulation alongside nutritional and herbal immune support.

 

Diet

Foods to increase

To help ease the congestion and inflammation associated with endometriosis your diet should focus on

  • Fresh, organic fruits and vegetables
    • Fruits and vegetables should form the bulk of your diet. Eating organic where possible maximises the availability of essential nutrients and helps reduce inflammation due to the lack of chemical intervention.
  • Cruciferous vegetables
    • Cruciferous vegetables such as broccoli, kale, cauliflower, bok choy, brussel sprouts, cabbage, collards greens and mustard greens are particularly beneficial for women with endometriosis as they contain a nutrient known as diindolymethane which supports hormone balance by assisting in the breakdown of estrogen.
  • High fibre
    • Fibre further supports detoxification pathways supporting the excretion of excess estrogen
  • Oily fish, nuts, seeds and other sources of essential fatty acids
    • Essential fatty acids help reduce the inflammation and pain associated with endometriosis

 

Foods to decrease

It’s important to avoid foods that have been shown to exacerbate inflammation and congestion, these include

  • Wheat and gluten
    • High wheat intake is linked with increased pain in endometriosis. Gluten sensitivity, intolerance and celiac disease have also been found to be more common in women with endometriosis.
  • Dairy
    • Dairy can contribute to congestion within the body, with popular homogenised, pasteurised cow’s milk being one of the hardest dairy products to digest and most congestive. The best forms of dairy to consume are organic natural yogurts and where possible choose milk alternatives such as almond, rice or oat milk (soy milk is not recommended due to it’s estrogenic properties).
  • Red meat
    • Red meat can exacerbate inflammation so should be limited to 3 times per week or less. Ideally meat should be organic.  Studies also suggest minimising ham and pork intake.
  • Toxins
    • Toxins of all forms increase the load on detoxification pathways, contributing to increased congestion and inflammation. To help minimise your toxic load you should
      • Eat organic
      • Use organic body products and make-up
      • Use eco-friendly, low chemical detergents and cleaning products
      • Use natural feminine hygiene products
      • Avoid all exposure to pesticides, herbicides and synthetic fertilisers
      • Avoid storing food in plastic (even BPA free plastic), opt for glass alternatives wherever possible.

Lifestyle

  • Exercise
    • Regular exercise is highly recommended to support overall health, weight and further support detoxification pathways.  Aim for 30mins – 1 hour of exercise at least 5 times per week.
  • Stress
    • Stress increases cortisol levels in the body which further exacerbates inflammation and immune regulation.  If chronic stress is a factor, steps should be taken to eliminate the stress or employ coping strategies such as meditation, yoga or counselling.