Endometriosis is a very common condition for many women. In fact, it's estimated that 200 million people worldwide are living with this condition. Here, we'll discuss the condition, how it works and the symptoms you can expect. But we'll also go further and look at natural treatments for endometriosis.
What is Endometriosis?
Endometriosis is the growth of endometrial-like tissue in irregular areas of the body. Endometrial tissue is normally only found lining the uterus, but in this condition endometrial-like implants are found in fallopian tubes, ovaries, intestines and other tissues.
While the endometriosis implants have similarities to the endometrial lining (what you shed during your period) they are in fact different tissues. When you look at them under a microscope, endometrial lesions tend to have more fibrous tissue and cysts, unlike the lining of your uterus.
Endometriosis is a chronic condition that impacts people of any age, race, and gender. It can have significant impacts on people's quality of life and in severe cases, it is outright debilitating.
The number one symptom women with endometriosis report is pain — with their period, with sex, with ovulation, with urination, with bowel movements and for some women, their pelvic pain is constant.
Because the endometrial implants respond to the same hormones that result in your period, these tissues also bleed when you have your period, regardless of where it is in the body. The blood causes irritation and inflammation, which results in a whole lot of pain and scar tissue. Overtime, adhesions begin to form in the reproductive organs, intestines, bladder, and other organs.
These lesions can also make their own hormones, which can compound the issue women with endometriosis face.
But not all women are symptomatic. In fact, 20-25% of women with endometriosis are without symptoms, which makes getting an early diagnosis more difficult. And endometriosis symptoms can look different for each person, which is why it can be misdiagnosed as irritable bowel syndrome (IBS) or interstitial cystitis.
How Common is Endometriosis?
Endometriosis is estimated to affect 1 in 10 people born with a uterus. It is possible that this number is underestimates the true number of people living with endometriosis given that symptoms can be dismissed making it so some people struggle for a decade to get diagnosed. While the focus of this article is on women who have been assigned female at birth, it is important to note that endometriosis can affect all bodies. It may be rare, but endometriosis has been found in cis men.
Is Endometriosis More Common in White Women?
Medicine has historically perpetuated the idea that endometriosis is “a disease of white women,” this is actually incorrect. Because of this, many Black and Hispanic women have had their pain dismissed, diagnosis delayed, and received inadequate treatment. Endometriosis affects all races, ethnicities, and bodies.
How is Endometriosis Diagnosed?
The definitive diagnosis of endometriosis is made via surgery, specifically laparoscopy. Endometriosis cannot be diagnosed with an ultrasound or other imaging.
During the diagnosis, excision surgery (removal of tissue) can also be performed, which is why it is important to find a skilled and experienced surgeon to perform the surgery. Excision surgery can reduce pain in some cases.
Unfortunately, because surgery is expensive and invasive, some doctors will hesitate in making the recommendation, which can further delay diagnosis.
In some cases, a doctor will treat endometriosis presumptively with birth control pills and NSAIDS. If the patient's symptoms improve then they will assume it is endometriosis. This approach, however, is not considered a definitive diagnosis of endometriosis and it is important to note that other conditions will respond to these same treatments. While it is important for you to get relief from your symptoms, it is equally important that your provider accurately diagnose your condition.
What Causes Endometriosis?
Sadly, endometriosis research is underfunded making the condition's cause unknown. While science is not exactly sure of the cause of endometriosis, research suggests correlations between the condition and the following:
Environmental Toxins and Endometriosis
We are not entirely sure what causes endometriosis, but some experts have begun to question the role of environmental toxins in the disease. Chemicals like dioxins and polychlorinated biphenyls (PCBs) are thought to increase the risk of endometriosis by altering cytokines, immune function, hormones and growth factors.
Estrogen Dominance and Endometriosis
We also know that endometriosis is estrogen dependent, which is a hormone that is sensitive to environmental endocrine disruptors. It may be possible that the effect of environmental toxins on hormone balance contributes to disease progression.
Endometriosis does have a relationship to estrogen dominance and getting estrogen back in balance is one of the keys to treatment. We now understand that endometrial lesions can produce their own estrogen, which further lends to the symptoms of this condition.
Read more on Detoxing Your Hormone for Better Hormones.
Is Endometriosis Autoimmune?
One theory as to the cause of endometriosis is that it may be autoimmune. As I explain in my book, Beyond the Pill, most autoimmune diseases have an estrogen dominance component, but it appears that the immune system may be driving the condition.
Research has identified tissue-specific antibodies and inflammatory cytokines, which are present with endometriosis. Or in other words, the immune system is definitely involved. This is why treatment focus needs to include reduction of inflammation.
One thing we know about autoimmune disease is that intestinal hyperpermeability (commonly referred to as leaky gut) is a risk factor and present in those who develop autoimmune disorders. Leaky gut is also commonly caused by the use of NSAIDS and birth control pill—two commonly used groups of drugs.
Leaky Gut, Autoimmune Disease and Endometriosis
The analogy I use with my patients is the recipe for autoimmune disease. The recipe has 3 ingredients — intestinal hyperpermeability (aka leaky gut), a triggering event and the right genes.
When intestinal hyperpermeability is present, large proteins, which should be kept within the intestine, are allowed to escape. Your immune system doesn’t take kindly to strange proteins wandering through the body and so it attacks. With 70-80% of your immune system present in the gut, it is easy to see how these proteins can cause a big issue for your immune system and your body.
Chronic stress, food sensitivities/ allergies, bacterial infections, parasites, viral infections, antibiotics, and some drugs (including NSAIDs and hormonal birth control) can cause a breakdown of your gut’s integrity at the cellular level.
This is how food sensitivities develop and is at the heart of autoimmune disease.
It's concerning that the pill is one of the main treatments for women with endometriosis when it has the ability to cause leaky gut and reduce microbial diversity. These two things alone can drive estrogen dominance and autoimmunity. I go into detail about this in Beyond the Pill and provide solutions to help women with endo support their health if they do choose to use birth control. You can learn more about Leaky Gut here.
While there are concerning aspects of using the pill to treat endometriosis, it is important to also acknowledge that for some women, it does bring symptom relief. While there is no definitive evidence to demonstrate that it slows the progression of the disease, there are many women who report reduction in pain when taking the pill continuously.
Without the stimulation of their own hormones, the lesions may not continue to create inflammation and pain. If you're reading this and thinking, “the pill did nothing for my pain,” then I want to acknowledge your experience as well. Because while it may work for some, for others it has no effect or they feel it makes their symptoms worse.
Natural Treatments for Endometriosis
Women with endometriosis are given little treatment options by their conventional doctors — painkillers, hormone therapy like birth control, surgeries, and a hysterectomy are all aimed at managing symptoms. And while they can offer short-term symptom relief, these therapies have many side effects. It's important to have options and to recognize that the best treatment for you will need to be tailored to your needs.
There is no shame in doing whatever it takes to feel your best.
As an integrative doctor, who focuses on educating and empowering women with practical tools, I have helped many women successfully manage their endometriosis symptoms without the need for medications. In many cases, we partner with endometriosis specialists, including experienced excision surgeons, physical therapists, and mental health workers.
By utilizing natural endometriosis treatment we can alleviate the discomfort that keeps you from being able to enjoy life and engage in activities that would ultimately help you address your body's needs. You do not have to go 100% natural in your treatment and in fact, I'd encourage you to take the best that medicine has to offer to help you feel better.
9 Natural Treatments for Endometriosis
We’ve got two major priorities here: 1. Getting you out of pain. 2. Minimizing or eliminating the need for pain medications.
Healing endometriosis naturally is about making sure you're comfortable in your body, but also have the energy, the stamina, and the motivation to do the self care it takes to heal. And yes, you can heal, but there are several factors to consider.
Endometriosis is a lifelong condition in which there is no cure. While you can heal your body, you cannot eliminate endometriosis for good.
Endometriosis is a complex condition, which means you'll likely do best from a team approach. Building a team of providers who listen to and support you is crucial in supporting your health.
Natural therapies don't have to be used alone. You can combine them with surgery, medications, or any treatment you wish to help you get the relief you need. It is always important to discuss the treatment you're employing with your provider.
Remember, NSAIDs perpetuate leaky gut, plus they suppress ovulation, which leads to estrogen dominance. Easy to see why we want to ditch those. But you may need to leverage them while you address other areas of your health. There is no shame in keeping yourself out of pain so you have the energy to address the other areas of your life.
You need a partner who understands how to support you with short-term and long-term solutions and who knows how to dig to find your root cause.
While we don't know the one cause of endometriosis, we can still do a full body assessment to identify your particular triggers and the areas of your body that need to be addressed. For example, if we know endometriosis is inherently inflammatory, we will want to assess gut health. The majority of your immune system lives there and can be an additional source of inflammation.
Healing is possible.
Part of the healing process includes getting necessary lab testing and exploring your unique journey to identify what may have triggered your condition and what you must do to heal.
We recommend lab testing on an individualized basis in my clinic. In the case of treating endometriosis naturally, we always investigate hormones and gut health.
Read more about the Autoimmune Hormone Connection.
Consider the following endometriosis natural treatments to help you get relief:
Melatonin has been shown in the research to help reduce menstrual pain, pain with sex, and pain with urination or having a bowel movement. While the research suggests higher doses are needed, I recommend my patients start with a lower dose around 3 mg and increase overtime if needed. Your provider should be able to help guide you in the best dose for you.
For now, boost your own melatonin and naturally treat your endometriosis:
- Wear amber glasses 2 hours before bed.
- Sleep in a completely dark room
- Eat pineapple, bananas, and oranges as they may increase melatonin levels
For women with endometriosis, pycnogenol (an extract from pine bark) has been shown to offer a 33% reduction in pain symptoms when taken at 30 mg twice daily.
For solutions to menstrual and pelvic pain read Natural Remedies for PMS & Cramps.
In one study it was found that turmeric was able to inhibit the growth of endometriosis cells by suppressing the production of estradiol. In another study, turmeric was shown to inhibit growth of endometriosis via down regulation of vascular endothelial growth factor.
Turmeric also has anti-inflammatory properties, which may improve symptoms of endometriosis such as pain. You can read more about the benefits of turmeric here.
4. Physical Therapy
In our clinic, we also partner with Physical Therapists—because how you move in your body every day is incredibly important in your healing. Most women with endometriosis don’t even recognize how the way they walk and move their body may have changed since the disease began. Muscle imbalances can result from your body compensating and avoiding pain and can it can make symptoms worse.
Getting an evaluation by a physical therapist is an important part of your holistic approach to endometriosis.
Depending on a woman's history or her symptoms, we may also prescribe sessions with a bodyworker. Bodyworkers can help resolve the pelvic and abdominal adhesions that are common, as a natural treatment for endometriosis.
5. Pelvic Floor Care
Taking a therapeutic approach to pelvic health that integrates myofascial pelvic floor therapy can be highly beneficial for any chronic pelvic pain syndrome, including endometriosis. It is not uncommon for pelvic floor muscles to be tight, have trigger points, and be in need of some TLC. A pelvic floor physical therapist that specializes in endometriosis can offer you specific support for your condition.
6. Support Elimination of Estrogen
As explained above, estrogen can play a pivotal role in the pain cycle of endometriosis. Because of the ability to make its own estrogen and the inflammatory nature of the condition, endometriosis has been linked to estrogen dominance.
While estrogen is a beneficial hormone, excess levels of it can be problematic. Supporting estrogen metabolism, that is the breakdown of estrogen and removal from the body, is a natural approach you can take daily.
Estrogen is processed through the liver via phase 1 and phase 2 liver detox. Nutrients like DIM, B vitamins, magnesium, vitamin C, and bioflavonoids found in plants can help support this process.
Once the estrogen is packaged up by the liver it is sent out to the kidneys and bowels to be excreted. Drinking plenty of water can help your kidneys do their job. Consuming a fiber rich diet can support your gut in eliminating estrogen.
Read this article for more tips on addressing estrogen dominance.
7. Dietary Changes
An anti-inflammatory elimination diet coupled with gut healing therapies can make a serious impact on your pain and periods.
I typically have patients increase their consumption of certain spices and foods. Turmeric, ginger, garlic, onions, fermented foods, cooked cruciferous vegetables like broccoli or cauliflower, and consume lots of leafy greens. This not only supports detox, but also supports the body in lowering inflammation.
Food intolerances are common in endometriosis, which is why it is important to understand which foods are and aren't working for you in this moment. There's no “bad food” when it comes to endometriosis. There's just the foods that don't work for you. And certainly, you shouldn't have to eat an incredibly restrictive diet to manage your endo.
What I recommend to my patients is an elimination diet where we focus on brining in nutrient dense foods while avoiding potential triggers. After about 3-4 weeks we slowly reintroduce foods to determine if any are an issue for them.
While diet is certainly an important component, I caution anyone from thinking diet alone will completely manage their endometriosis symptoms.
8. Stress Reduction
Stress makes pain worse and it leads to hormone imbalances. It can be the cause of low progesterone, which leaves estrogen unchecked to stimulate tissues. Stress can also mess with our periods.
Try meditating for 5 minutes a day for 30 days and see how you feel. If you want to really up your meditation game and reap the benefits at a faster pace, consider the Muse meditation device.
Engaging in both stress reducing activities and short HIIT sessions can help with balancing your hormones and your immune system. Try alternating gentler activities like walking, gentle yoga, pilates, Qi Gong and Tai Chi with 7-15 minute HIIT sessions 2-3 times per week. In this article I explain how to workout with your menstrual cycle, which can help you get started.
Keep in mind that if you have adrenal or other health issues you’ll need to modify your exercise to best suit your body’s needs. This is one of those times it can help to talk with an expert. My good friend Steph Gaudreau is an excellent resource if you’re looking to keep it safe with exercise while treating endometriosis naturally. Plus, she also has endometriosis and is one of the strongest women I know…and she lives a pain free life.
Individualized Root Cause Resolution as a Natural Treatment for Endometriosis
What we know is women with endometriosis are likely to have estrogen dominance, immune system dysfunction, and a need for detoxification support. But each person is an individual when it comes to healing endometriosis. Sometimes we need to spend more time healing the gut and the liver before the estrogen will balance. Other times we have to focus heavily on clearing infections and reducing stress to gain traction in healing. In my clinical experience, it is different for each woman.
This is where digging in and investigating comes in. Having necessary lab testing, along with a thorough evaluation of your story is essential to understanding your individualized needs.
Natural Treatment for Endometriosis Case Study:
When Elle first came to see me for her debilitatingly painful periods she was also experiencing some pretty serious digestive issues that were the result of her non-stop ibuprofen use. At 36, she had already gone through multiple surgeries, which offered only temporary relief.
For about a week and a half every month she'd find herself alone. She was missing family events, work meetings, and social events with her friends. Her endometrial pain was causing her to feel isolated and it was taking a toll on her mood and her life.
Elle was diagnosed with endometriosis just after she turned 33. She is one in ten women who are diagnosed with this condition, although the number may be higher due to undiagnosed cases.
Like Elle, many women use NSAIDs, like Ibuprofen and Motrin, to cope with the pain, Unfortunately, these are often not enough and can cause damage of their own. And pain killers do little to treat the other symptoms that often accompany endometriosis, like chronic fatigue, bloating, constipation, diarrhea, low back pain, ovarian mass, heavy periods, and urinary issues.
The above list shows many of the steps taken to help Elle manage her endometriosis:
As for Elle… I'm happy to report she is no longer at the mercy of endometrial pain and she is living a much fuller life thanks to the strategies discussed in this article.
Are you a woman living with endometriosis? What have you tried that has helped? Leave a comment below to share with us.
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