Endometriosis is a condition that impacts thousands of menstruating women worldwide. Approximately 10 to 15% of menstruating women between the ages of 24 to 40 are affected. This disease involves the growth of uterine lining (also known as endometrial tissue) outside of the uterus. Women with endometriosis generally experience a triad of symptoms that include painful periods, pain with sexual intercourse, and/or infertility. Other symptoms may include heavy or irregular bleeding, nausea/vomiting, and bloating. Individuals may experience pain within the pelvic, groin, lower abdominal, back, and during bowel movements, urination, or exercise.
An interesting feature of this disease is that the severity of symptoms do not always correlate with the severity of endometriosis. The severity of the symptoms are more so related to the location of the tissue growth in the abdomen.
Endometriosis is a challenge to diagnose. To receive a definitive diagnosis, a woman must either undergo a laparoscopy, which is a minimally invasive surgery that allows your doctor to visualize and take samples from the organs in the abdomen with a small video camera. Or a laparotomy, which is a more invasive version of the former. In many cases, a woman is given a working diagnosis of endometriosis based on her symptoms.
This disease does not have a known cause. The main risk factor is heredity, although this is not always the case. Other risk factors include an estrogen imbalance and poor liver detoxification pathways (which can be genetic), lack of exercise, a high-fat diet, personal history of abuse, immune dysfunction, among many others.
No cure currently exists, although surgeons may perform a biopsy and remove excess tissue, which can provide relief in some cases. In naturopathic medicine, treatment is highly individualized based on the patient’s presentation, medical history, and health goals. Below are a few therapeutic considerations.
Minimize Obstacles to Healing
Avoid exposure to environmental pollutants (e.g. plastics, PCBs from poorly sourced fish, etc.), and avoid dietary triggers (e.g. reduce sugar, alcohol, caffeine and in some cases, red meat).
Reducing Omega 6 fatty acids in the diet (found in animal products, corn, soy, safflower oil, sunflower oil, and certain nuts and seeds) can help to lower inflammation. Balance these with Omega 3s, which can be found in fatty fish (e.g. salmon, sardines, anchovies, Arctic char, and trout), flaxseeds, and walnuts. Consider taking a high quality fish oil supplement and/or anti-inflammatory herbs like turmeric. Be mindful of the fact that the quality of turmeric supplements vary considerably and dietary turmeric alone will not be enough to shift symptoms. Speak to a naturopathic doctor prior to starting supplementation.
Acupuncture is a wonderful treatment that can reduce inflammation, balance periods, and calm the nervous system. I have had great success with endometriosis patients by incorporating regular acupuncture treatments into their treatment plans.
Optimize Liver Function
Avoid unnecessary pharmaceuticals and all recreational drugs and alcohol. Consume liver supporting foods like leafy greens, orange vegetables, and cruciferous vegetables (e.g. broccoli, cauliflower, and brussels sprouts). Consider taking a high quality B complex to provide the liver with nutrients needed to detoxify excess hormones.
Daily Bowel Movements
Eat a plant forward diet that consists of lots of vegetables and fruits along with proteins and healthy fats. Consider taking a fiber supplement or 2 tbsp of ground flaxseed daily to feed the healthy bacteria in the gut and to promote a full bowel movement at least once per day.
Balance the Immune System
Eliminate sugar from the diet with the exception of fresh fruits and freshly squeezed/pressed fruit juices on occasion. Consume onions, garlic and leeks regularly. Consider taking a high quality vitamin C supplement.
Support Circulation and Metabolism
60 minutes of daily movement (e.g. walking, stretching) is key to managing this condition. Be mindful not to over-exercise and cause undue stress on the body.
As always, speak with a trained medical professional before starting any new treatment or making any drastic lifestyle change including diet and supplement changes. Do your own research but check-in with qualified professionals. Because endometriosis not only impacts one’s quality of life but can also compromise fertility, it is very important to ensure you have a strong care team around you (when possible) including a family physician, specialists, naturopathic or functional medicine doctor, and other practitioners of your choosing who can help you manage this condition.
Pizzorno, Joseph E., et al. The Clinicians Handbook of Natural Medicine. Elsevier Inc., 2016.
Davila, G. Willy. “Endometriosis: Practice Essentials, Background, Pathophysiology.” Endometriosis: Practice Essentials, Background, Pathophysiology. 10 May 2021, https://emedicine.medscape.com/article/271899-overview?_ga=2.29113596.1597637803.1651020844-1783391863.1651020842#a4.