Endometriosis
Integrative Endometriosis Support
Understanding Endometriosis
Endometriosis is a chronic, inflammatory condition where tissue similar to the uterine lining grows outside the uterus—on the ovaries, fallopian tubes, bladder, bowels, and other areas where it doesn’t belong. It affects an estimated 1 in 10 people assigned female at birth and often takes 7–10 years or more to receive an accurate diagnosis.
While endometriosis is best known for causing painful periods and ovulation, it’s much more than just “bad cramps.” This is a complex, full-body disease that can impact the immune system, nervous system, digestion, pelvic floor, and even cardiovascular health. Symptoms vary widely and may include chronic pelvic pain, painful sex, bowel or bladder issues, fatigue, and infertility.
Because endometriosis affects multiple systems in the body, it requires a holistic and individualized treatment approach. At Natural Harmony, we specialize in integrative care for endometriosis—combining acupuncture, nutrition, herbal medicine, and collaboration with trusted excision surgeons, physical therapists and more to support healing at the root.
Your symptoms are real.
You deserve to be heard.
You deserve to live well and thrive.
“I have had a wonderful experience at NHRH from the start. Everyone is incredibly thoughtful and knowledgable with infertility struggles. I was diagnosed with endometriosis about a year ago. Dr. Merritt developed a nutritional/herbal plan that focused on reducing inflammation. We had a successful IUI after working with Dr. Merritt. I love the vibe at NHRH!”
Our Endometriosis Philosophy
Living with endometriosis can be complex, but it doesn’t mean you have to suffer. With the right tools and care, you can feel better, stronger, and more in control of your health. At Natural Harmony, we provide compassionate, evidence-based, and patient-centered care—because endo is too complex for a one-size-fits-all solution.
We take a team-based, “village” approach. That means working closely with San Diego’s top excision surgeons, pelvic floor physical therapists, and mental health providers to help you understand your diagnosis and build a treatment plan that supports your unique body, needs, and goals.
Our Integrative Approach to Endo
We believe that combining the best of conventional and holistic medicine offers the most sustainable path to relief and vitality for people with endometriosis.
For many, that means expertly performed excision surgery paired with:
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An anti-inflammatory, nutrient-dense diet
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Acupuncture to support circulation and reduce inflammation
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Strategic herbal and supplement plans
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Gentle, pelvic-aware movement
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Functional lab testing to uncover root imbalances
We know—this can feel like a lot to navigate. That’s why we act as your partners in care, helping you identify what’s most effective and realistic for your life. You don’t have to do everything at once. You don’t have to do anything that doesn’t feel supportive. This is your journey—we’re just here to guide, collaborate, and cheer you on.
Each treatment plan we create is personalized and backed by research. We understand no two people experience endometriosis the same way, and while it’s a challenging condition, it doesn’t have to define your life. With the right tools and support, you can absolutely thrive.
“Dr. Erin is a literal angel sent from heaven! She has helped me immensely the last few months with my endo pain. Always a pleasure to come and see her!”
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.
Understanding Endometriosis
Despite how common it is, there’s still a frustrating gap in modern medicine’s understanding of endometriosis—and no single known cause. But research is finally gaining momentum, and after years of being dismissed, endo is starting to get the attention it deserves.
Here’s what we do know:
Endometriosis is a chronic, whole-body condition that’s likely multifactorial—shaped by a combination of genetics, immune function, gut health, and environmental exposures. It’s not just a reproductive issue; endo can influence (and be influenced by) many systems in the body, including:
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Immune and inflammatory pathways
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Circulatory and lymphatic health
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Gut and microbiome balance
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Hormonal regulation
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Mental and emotional well-being
Emerging research continues to reveal just how interconnected these systems are—and why endometriosis care must be just as multidimensional.
Types and Stages of Endometriosis
There are three main types of endometriosis, categorized into four established stages (with a potential fifth stage still being debated by researchers). The stages are based on the location, depth, and severity of tissue growth—but they do not reliably predict how much pain or disruption a person may experience.
Types of endometriosis:
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Superficial peritoneal endo (often Stage I or II): Thin, surface-level lesions on the pelvic lining.
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Ovarian endometriomas (typically Stage III or IV): Also known as “chocolate cysts,” these are fluid-filled cysts that form in or on the ovaries.
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Deep infiltrating endometriosis (DIE) (usually Stage III or IV): Dense, fibrotic lesions that grow deep into tissue and can impact organs such as the bladder, bowel, and uterosacral ligaments.
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Diffuse or extra-pelvic endo (a proposed Stage V): Widespread endometriosis that affects multiple organs, sometimes found far from the reproductive system (e.g. diaphragm, lungs).
Pain Is Not a Reliable Indicator of Severity
One of the most misunderstood aspects of endometriosis is the disconnect between the amount of tissue growth and the level of pain or dysfunction someone experiences. For example, someone with Stage I endo may live with daily, life-altering pain, while another person with Stage IV endo might only discover it during fertility testing or imaging for unrelated issues.
This is why it’s so important to listen to patients—not just imaging or staging—and treat the whole person, not just the disease.
People living with endometriosis may experience:
- Chronic, severe pain
- Inflammation
- Fatigue
- Infertility
- Extreme bloating
- Digestive issues
- Frozen pelvis
- Hormonal swings
- Severe PMS
- Pain with penetration/intercourse and more
Endo + Chronic Inflammation
If there is one thing we understand about endo, it’s that it is a highly inflammatory disease, and that amongst those living with endo, we often see significant immune dysfunction. There is still scientific debate, however, about whether immune dysfunction contributes to the development of endo, or if the endo lesions themselves create immune chaos simply by existing.
Some research suggests that people with endometriosis may have significantly altered immune markers, potentially having reduced natural killer cell (the pathogen destroyer cell) activity, reduced macrophage and phagocytosis (defense cell) activity, altered T cell (immune regulator) activity, increased inflammatory cytokine (cell signaling) activity and elevated prostaglandins (inflammatory hormone like substances).
A common complication of living with chronic inflammation is that over time, it will lead to scar tissue. This is an issue that people living with endo often face after years the disease impacting their body, especially in the more advanced stages of endo. Similar to what happens when you have a pimple or a bug bite that you pick at, and pick at, and (dang it, listen to that little voice in your head telling you stop stop picking!), continue picking at, eventually, as a way of protecting you from further injury, it will scab over and scar.
In some cases, scar tissue can be so severe that it interferes with the function of other organs, like the bowel, and require radical interventions like bowel resection surgery and/or removal of some or all of the reproductive organs (aka partial or total hysterectomy).
Addressing the immune system is a critical component for integrative treatment of endometriosis. This is where looking at gut health, health history and and family history become essential.
Endo + the Gut
One of the cornerstones of supporting the endometriosis patient (and often a piece that gets overlooked) is addressing the root of gastrointestinal issues. The dreaded “endo belly,” where a person with endometriosis experiences extreme bloating and discomfort, is all too common, and often (but not always) has ties to undiagnosed GI imbalances.
Two of the most common gut issues that we see in endo patients are dysbiosis (aka bacterial imbalances, most commonly seen in the gut, but also may effect the pelvic cavity, vagina and other mucosal areas like the sinuses) and intestinal hyper-permeability (aka leaky gut syndrome).
Interestingly, some research has suggested that people with endo tend to have more “gram negative” bacteria in their system, bacteria like e-coli and klebsiella, for example. In fact, there have been several studies suggesting that people with endo may be more prone to pathogenic levels of bacteria in their pelvic cavity.
Addressing intestinal hyper-permeability (leaky gut) is also an essential piece of effectively treating the endo patient. A recent study came out showing that there is a potentially significant connection between endometriosis and “leaky gut syndrome.” People with endometriosis tend to be more likely to have leaky gut, which can create a rather vicious cycle of chronic inflammation that can be difficult to get out of without some strategic support.
The good news is, we can heal the gut! And when we heal the gut, we lay the foundation to help the rest of the body heal from endometriosis.
Endo + Hormone Sensitivities
Endometriosis is an estrogen sensitive disease. This means that even in normal amounts, estrogen can aggravate endo and promote its growth. Genetics, environment and lifestyle factors can all influence this. Some of the most common triggers that may complicate hormone metabolism for the person with endo include:
- Impaired immune function
- Poor gut function
- Impaired liver detox function
- Low fiber, nutrient-poor diet
- Blood sugar imbalances
- Stress
Estrogen sensitivity is just one piece of the puzzle looking at how hormones impact endometriosis.
Progesterone resistance, where a person’s progesterone receptors (the little ‘docking zone” that progesterone land on) can also become dysfunctional with endo, essentially becoming “desensitized.” In fact, progesterone resistance, possibly in combination with chronic inflammation and estrogen dominance, may be a key piece and a common missing link for the endo patient dealing with “unexplained infertility.”
Managing hormone imbalances is one piece in the multidimensional puzzle that is endometriosis. Supporting optimal liver detox and a balanced lifestyle, taking good care of the gut, and optimizing nutrient intake will go a long way in keeping hormones happy.
I must say that I went in skeptical. How can pins and needles help me with my pain? I suffer from Endometriosis and the usual aches and pains that come with getting older…
My first session with Dr. Merritt was a lot of talking about my medical background… she truly listened. It was wonderful!
Each session I go in with pain, and I walk out with none. It’s absolutely freakin’ mind-boggling!
Our Integrative Approach
We take a collaborative, whole-person approach to endometriosis care—partnering with your existing providers to create evidence-based treatment plans that support long-term relief, vitality, and sustainable wellness.
Nutrition Therapy
Optimal nutrition is the cornerstone of healing from endometriosis (and we’re not talking about “the endo diet” here). Nutrition therapy for endometriosis requires a layered approach, addressing one issue at a time, ultimately fortifying the body with strategic, deep nutrition to promote healing at a cellular level. Our team will create a custom treatment plan for you based on your unique history.
Acupuncture
Acupuncture has been shown to optimize blood flow to the reproductive organs, regulate the cycle and reduce inflammation. By gently inserting hair fine needles into select points on the body, we are able to promote circulation to areas that need a little extra love, and also connect with the immune and nervous system to help reduce inflammation and pain.
Herbs + Supplements
Herbs and supplements offer powerful medicine to regulate the cycle, soothe the immune system and heal the gut. Your providers will create a custom herb and supplement regimen for you based on your cycle patterns and individual health history.
Lab Testing + Functional Medicine
Endometriosis presents with some unique patterns and health challenges. Often lab testing can help to uncover more precisely where an endometriosis patient’s body may be out of balance. Tests may range from simple blood work to functional lab testing to evaluate more subtle imbalances in the body.
Lifestyle Support
Stress management, healthy sleep, work life balance and a joyful quality of life all play a role in a successful endometriosis plan. Very often, our patients come in “tired and wired” and utterly burnt out trying to get through another day dealing with debilitating pain (we get it — this process can be downright devastating!). Our team will help you rediscover tools to cultivate a balanced lifestyle.
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.