Notes on Endometriosis

What causes endometriosis?

Endometriosis is a common hormone imbalance, affecting up to 10-15% of females. It is caused by rogue uterine cells (uterine implants) growing outside of the uterus in abnormal locations, most commonly in the fallopian tubes, ovaries and pelvis. However, they have the potential to grow anywhere in the body, including the eyes. These oestrogen-regulated cells are programmed to ‘menstruate’ at the same time as a period takes place in the uterus which means a period bleed wherever those cells are located.

This can mean a painful, sometimes agonising time as the bleed causes irritation and inflammation in your body  as it attempts to deal with this abnormal process. This long-term hormonal condition can be life changing for sufferers, affecting mood, weight and sometimes fertility. I was recently speaking with wellness mentor Jasmin Harsono who has had endometriosis since her teens and said that endometriosis can be ‘a scary and lonely place’ (read her full story here) Many people with this condition suffer for years before receiving a diagnosis, which can be very confusing and difficult.

What are the main symptoms of endometriosis and does it cause infertility?

Excessive bleeding during and between periods, dysmenorrhea (painful periods), pelvic pain, dyspareunia (painful intercourse) are some of the classic symptoms. There are 4 stages of endometriosis diagnosis and stage 4 can sometimes impact fertility.

What are the risk factors for getting this and is endometriosis hereditary?

Genetics play a major role in determining whether you have endometriosis, so it’s commonly seen in families.  The origins of endometriosis are still unclear, but there are indications that impaired immunity, diets low in vegetables/fruit, diets high in red meat, saturated fat and a lack of exercise are at play. Other factors may be triggers and mediators for endometriosis and these include intrauterine devices (coils), endocrine disruptors; prenatal exposure to endocrine disruptors, poor liver function, dioxin, parabens, Bisphenol-A exposure and oestrogen dominance. Interestingly, a number of studies have suggested an association between naturally red hair and increased incidence of endometriosis.

How is endometriosis diagnosed?

Endometriosis can be investigated through blood tests, pelvic examination or ultrasound but the gold standard for diagnosis, is laparoscopy, which involves a tiny camera being inserted into your abdomen, then taking a biopsy. This determines the amount of endometriosis you have and where it is located.

Endometriosis Treatment

Medical approaches often involve things that work to suppress some of the symptoms using oral contraceptives to raise progesterone to inhibit menstruation. Hysterectomy is a last resort but happens more than might be necessary, forcing young women into early menopause and infertility.

Living with endometriosis and natural ways of managing symptoms?

The functional medicine approaches to managing endometriosis aim to bring hormonal balance back to the body through diet and lifestyle, rather than mask or suppress symptoms with drugs. We are all genetically different so no one plan fits all, however the basics of any endometriosis plan would involve improving oestrogen metabolism, which is central to helping to manage this oestrogen-sensitive disorder.

Functional hormone testing can help to monitor hormone levels and behaviour if your hormones are being used correctly and not floating around the body in excess. Weight is also an important part of treatment as adipose fat can contribute to excess oestrogen and therefore a low sugar and low saturated fat diet will be a first step in the plan.

Supporting the liver, our major hormone detoxification organ, is vital to reduce the recirculation of hormones, which can lead to oestrogen dominance. Gut bacteria is also integral in supporting the liver’s hormone removal processes, so probiotics may be helpful. Supplements such methylfolate (highly absorbable folic acid) that can help support healthy methylation (liver detoxification) may also be useful to help detoxify oestrogen.

What is your key advice to anyone experiences some of the symptoms?

Get a diagnosis. If endometriosis is present and your symptoms are relatively manageable, do some research and start on an endometriosis diet and lifestyle plan to manage symptoms better or prevent them from worsening over time. If you are still suffering, see a nutritionist to get a more personalised diet and lifestyle plan and see how you go before deciding on hormone therapy. Your body has an incredible ability to self heal and if you symptoms are tolerable, adopting a natural approach should be your first port of call regardless.