Endometriosis

What is endometriosis?

Endometriosis is an inflammatory disease that affects roughly 10% of women, in which tissue similar to endometrial tissue or the uterine lining is found OUTSIDE of the uterus, often on or around the ovaries, fallopian tubes, bladder and bowel. Lesions have even been reported on the brain and lungs. 


These lesions are hormone sensitive, so these lesions enlarge and bleed with each menstrual cycle. When these extra-uterine lesions bleed, the blood is trapped as it cannot leave the body like it normally would during a menstrual bleed. This creates further inflammation and adhesions, or scar tissue that binds pelvic structures together. Because of these adhesions, endometriosis can cause structural problems, like the bowel sticking to reproductive organs causing digestive problems, or distortion of the uterus/fallopian tubes/ovaries themselves, contributing to infertility. 





Some symptoms of endometriosis include:

  • Severe pain not alleviated by ibuprofen, that can occur during a menstrual bleed but also between periods, and is so severe that you may vomit. This pain is not just limited to the uterus, but also the bladder, bowel, legs or throughout the pelvis. Although sometimes endometriosis presents with no pain at all. 

  • Bladder issues: painful urination, frequency and urgency. 

  • Bowel issues: constipation, diarrhoea and painful bowel movements. 

  • Bloating, headaches, nausea, fever.

  • Intermenstrual bleeding.

  • Infertility and miscarriages.  

  • Heavy menstruation and subsequent anemia.

  • Depression and anxiety. 



There are several theories around the development of endometriosis. Genetics plays a big factor. Older theories include:

  • Retrograde menstruation, or the backflow of menstrual blood, although every woman has some level of this and not every woman has endometriosis. 

  • ‘Oestrogen dominance’ or elevated oestrogen levels, however oestrogen dominance doesn’t cause endometriosis but it does worsen the condition.  

More recent theories include: 

  • Immune dysfunction: high levels of cytokines including Il-8 & TNF-a promote endometrial cell proliferation adhesion and angiogenesis, or blood supply to the lesions. Endometriosis shares similarities with other autoimmune conditions including rheumatoid arthritis, Crohn’s disease and psoriasis. 

  • Bacterial contamination hypothesis: “bad bacteria” can translocate or move from the gut to the pelvis. Research has shown that women with endometriosis have a high level of gram-negative bacteria in the pelvic microbiome.  These bacteria contain the toxin LPS (lipopolysaccharide), which promotes the onset and progression of lesions. This movement of bacteria is likely to occur in cases of increased intestinal permeability or “leaky gut” and small intestinal bacterial overgrowth (SIBO). This bacterial contamination activates the immune response. 

  • Gut dysbiosis: Women with endometriosis have been shown to have elevated levels of the following bacteria in the gastrointestinal microbiome:

    • Enterobacteriaceae

    • Streptococcus

    • E.coli

    • Gardnerella

Diagnosis of endometriosis

Definitive diagnosis can only be achieved by laparoscopy, not an ultrasound. Conventional treatment of endometriosis consists of keyhole surgery to remove these lesions. This surgery can vary from conservative to radical. Surgery can relieve pain and improve fertility, however surgery can also cause further adhesions or scar tissue. The recurrence following surgery is 21% after 2 years, and 40-50% after 5 years. Other conventional treatments include oral hormonal birth control pills which shut down ovarian function to suppress oestrogen levels and synthetic progestins to suppress the growth of endometrial lesions. 



Naturopathic treatment of endometriosis

Naturopathy can help endometriosis sufferers, although the condition cannot be cured as such. Naturopathic treatment includes the prescription of various nutrients and herbs with treatment aimed at:

  • Modifying the microbiome to improve good bacteria and reduce harmful LPS-excreting bacteria 

  • Healing the gut lining to prevent further translocation of harmful bacteria  

  • Supporting the immune system to reduce inflammation 

  • Supporting clearance of oestrogen and boosting progesterone 

  • Symptomatic support to reduce pain 


There are nutritional measures that can be introduced to help with endometriosis, including:

  • Avoiding dairy: the casein protein found in milk can form the inflammatory opiate casomorphin or BCM7, which stimulates inflammatory cytokines and mast cells. This affects periods as the uterine lining is dense with mast cells. 

  • Avoiding gluten: because of the link with gluten, inflammation and autoimmune conditions. A high percentage of endometriosis patients also carry the genotype for coeliac’s disease. Research shows that endometriosis improves after 12 months on a gluten free diet. 

  • Increase dietary antioxidants.

  • Increase consumption of cruciferous vegetables.

  • Increase dietary fibre.

There are important environmental and lifestyle factors that must be addressed with endometriosis, including:

  • Limiting endocrine disrupting chemicals, like dioxin found in conventional menstrual products (cotton tampons and pads). Always opt for organic cotton menstrual products, menstrual cups or washable period underwear. 

  • Limit xenoestrogen exposure, found in plastics pesticides, additives and personal care products. 

  • Exercise has been shown to reduce oestrogen production and increase oestrogen metabolism. 

There are many nutrients and herbs that can be game changers when it comes to supporting endometriosis and reducing pain. If you require help with endometriosis, get in touch to see how naturopathy can help you.

Hayley Brass