Endometriosis

Endometriosis is a disease that affects 1 in 10 people who menstruate (or have had the ability to menstruate previously). For people who have endometriosis, tissue similar to the lining of the uterus grows in other parts of the body, usually in the pelvic cavity. On average, it takes 7-10 years for a person to receive an accurate diagnosis of endometriosis, and even after diagnosis, treatment options are limited, leaving many people struggling with pain, infertility and more.

Your pain is real.

You deserve to be heard.

You deserve to feel better.

Natural Harmony Reproductive Health specializes in caring for people with endometriosis, recognizing that many people living with this disease have traveled a long and often challenging road. Our practice is dedicated to providing a safe space to come share your story, receive support to meet your unique needs, and heal. 

People living with endometriosis may experience:

  • Chronic, severe pain
  • Inflammation
  • Fatigue
  • Infertility
  • Extreme bloating
  • Digestive issues
  • Frozen pelvis 
  • Hormonal swings
  • Pain with penetration/intercourse and more

Modern medicine still doesn’t understand what causes endometriosis, but there are many common theories about why it occurs in some people and not others. Some of these theories include metaplasia (when one type of tissue changes to another), genetic predisposition, lymphatic or vascular dysfunction, autoimmune issues and retrograde menstruation (reverse menstrual flow through the fallopian tubes into the pelvis).

Most researchers agree that retrograde flow alone is not the cause of endometriosis, because nearly all people who menstruate experience it and not all people who menstruate have endometriosis. Retrograde flow combined with a faulty immune system, genetic predisposition, and/or lymph and vascular dysfunction, however, might point towards some potential causes. Whatever the root is, newer studies are supporting that women with endometriosis nearly always have significant immune system dysfunction, which can contribute to chronic inflammation, pain and more. (1, 2, 3)

Inflammation: When the Immune System Gets Stuck

People with endometriosis are constantly battling inflammation, which can contribute to pain, scarring, fertility complications, and more. Inflammation is a natural response of the immune system and necessary for survival. Short term, acute inflammation is essential for keeping us healthy and safe from injury, bacteria, viruses and more. With endometriosis however, the immune system becomes stuck in the “on” position, causing chronic, persistent inflammation and a potential myriad of long term health challenges.

Why does the immune system get “stuck”? People with endometriosis develop tissue called “endometrial lesions” in various parts of the body, usually in the pelvis. Similar to the endometrial lining of the uterus, endometrial lesions build up throughout the month, then bleed along with uterine tissue during the menstrual period. The body’s immune system registers the lesions outside of the uterus as foreign and sends out “troops”—immune cells like Natural Killer (yes that’s really the scientific name!) and Macrophage cells—to “tag and kill” the lesions. This is the same way the immune system responds to any foreign invader.

The problem is, for people with endometriosis, the immune system isn’t actually able to clear the lesions, but it continues trying, and trying… and trying. These immune soldiers continue to recognize that these lesions don’t belong, and so continues to try to clear them using macrophage cells and inflammatory cytokines in an attempt to obliterate the foreign tissue and remove it from the body. Eventually this leads to chronic inflammation, or, an immune system that can’t turn itself off.

The Hormone Connection

Endometriosis is an estrogen dominant disease (4). Estrogen dominance means that a person’s body has either too much estrogen, an inadequate ratio of estrogen to progesterone, or both. Estrogen dominance occurs for a number of reasons, but regardless of the cause, when estrogen levels are too high or are not adequately balanced, endometriosis gets worse.

What causes estrogen dominance?

  • Environmental agents – certain pesticides, body products, plastics, certain cleaning products, etc
  • Impaired immune function – inflammation creates a host of issues
  • Impaired liver detox function – hormones are processed primarily through the liver
  • Low fiber, nutrient-poor diet – proper nutrients are essential for healthy hormone metabolism
  • Excess body fat – estrogen is stored in and produced by fat tissue
  • Stress – high cortisol levels lead to insulin resistance, fat storage and hormone imbalance

Excess estrogen can negatively impact the immune system, endocrine system (decreased thyroid function and low progesterone are common examples) and more, and can make it difficult for people to break the cycle of chronic inflammation. 

Estrogen dominance is just one piece of the puzzle when treating endometriosis, and is best managed by supporting optimal liver detox and a balanced lifestyle. In today’s modern world, it’s nearly impossible to avoid all synthetic estrogens. You don’t have to be prefect, but if you limit your exposure at home, you’ll be able to significantly reduce your estrogen load.

So what can you do about it?

Treatment for endometriosis varies; there is no one-size-fits-all approach. Diet, lifestyle, lab testing, surgery, acupuncture, herbs and supplements, hormone support and more are all useful tools to understand and manage endometriosis. At Natural Harmony Reproductive Health, our goal of care is to soothe and bolster the immune system to reduce inflammation and balance hormones, ideally resulting in less pain, improved fertility or reproductive health, and a better quality of life.

How does treatment work?

Acupuncture & Chinese Medicine can be an extraordinarily helpful tool for managing endometriosis because it can reduce inflammation and pain, balance hormones, promote healthy circulation and detox and regulate the immune system.  

At Natural Harmony Reproductive Health we utilize nutrition therapy, acupuncture, herbal and supplemental medicine, lab testing and lifestyle modifications to support our patients in feeling their best. We also enjoy working closely with reproductive endocrinologists (REs), OB/GYNs, surgeons and other care providers to collaborate on our patients’ care plans, recognizing that a “village” approach is often helpful in managing endometriosis.

No two cases are alike. With each patient, we take into account their personal goals, family history, the stage of the endometriosis, a persons lifestyle and more. We take an integrative approach when working with patients and are here to be a supportive care provider on our patients’ team.

If you have endometriosis, or suspect you have endometriosis: we see you, we hear you, we’re here for you. Your pain is real. You deserve to be heard. You deserve to be helped, and we would love to be a part of your journey.

 Read more about Merritt’s story with endometrisis. 

References:

  1. Capobianco A, Rovere-Querini P. (2013) Endometriosis, a disease of the macrophage.
  2. Harada T, Iwabe T, Terakawa N. (2001) Role of cytokines in endometriosis.
  3. Thiruchelvam U, Wingfield M, O’Farrelly C (2015) Natural Killer Cells, Key Players in Endometriosis
  4. SE Bulun, KM Zeitoun, K Takayama and H Sasano (2000), Estrogen biosynthesis in endometriosis: molecular basis and clinical relevance