Please visit our PCOS page for more on integrative PCOS care.
Integrative Endometriosis Treatment
Endometriosis is a complex and often poorly understood disease affecting 1 in 10 people assigned female at birth — that’s TEN percent of the female (and some of the gender non-binary) population, or roughly 176 million people across the globe.Typically, it takes an average of 7 to 10 years after onset of symptoms for a person to receive an accurate diagnosis of endometriosis, leaving many patients suffering with excruciating pain, fatigue, and other “mysterious” symptoms and no answers. Even after conventional treatment interventions, endo has a high recurrence rate.
Your pain is real.
You deserve to be heard.
You deserve to live well and thrive.
Endo is a multidimensional disease that reaches far beyond just “bad period pain.” Often thought of as “a hormone issue,” research is actually pointing to the pathology of endo being more accurately described as an immune disease which is highly influenced by hormones.
Currently, there is no cure for the disease, but that does not mean there is no hope for feeling better! Each person’s journey will look different and may require both holistic and conventional treatment (hurrah for integrative medicine!).
We can help you navigate which tools may be the best option for you and your unique health needs. The endo patient’s journey to better health is bound to be a bit of a wild ride, but our experienced doctors are here to help you navigate it, and we believe in you!
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
- Extreme bloating
- Digestive issues
- Frozen pelvis
- Hormonal swings
- Severe PMS
- Pain with penetration/intercourse and more
Understanding Endo: The Perfect Storm
What causes endometriosis? Unfortunately, we just don’t know for sure (yet!), but there is some pretty interesting research emerging pointing towards possible answers.
Essentially, the “perfect storm” that we think leads to endometriosis involves 4 basic components. If someone has been diagnosed with endometriosis, then we can expecting to find the following:
- Endometrial lesions. An endometriosis patient will have the presence of endometrial lesions, usually found in the pelvic cavity. The severity of these lesions may be mild (superficial/stage 1), moderate (ovarian, stage 2) or severe (deep infiltrating, stage 3/4). severe. These lesions grown and respond to changes in the monthly cycle, and often cause pain and scarring.
- Hormonal imbalances. Endometriosis is infamous for the hormonal drama that we often see with it — PMS, mood swings, awful periods, weight struggles, acne, to name a few. Estrogen sensitivity is a cornerstone of the disease, and often endo patients have unique needs to efficiently metabolize estrogen appropriately.
- A genetic predisposition. The role of genetics and endometriosis is becoming more clear. We know that endo tends to run in families. Research is pointing to epigenetics — the study of how one’s environment may significantly influence genetic expression — playing a significant role in the development of endo.
- Immune dysfunction (and probably gastrointestinal issues). This is listed last, but is perhaps the most important piece. As we learn more about the immune system’s role in endometriosis, it will have significant implications for how to best manage the disease. There is much to say here about auto-immune tendencies, and the role of the gastro intestinal tract.
Whatever the cause(s) of someone developing endometriosis are, we know for certain that it is an inflammatory, immune related disease that is highly influenced by hormones, and that often people living with it will have special requirements in order to thrive.
Chronic Inflammation: When the Immune System Gets Stuck
Many of our patients are often surprised to learn that despite it’s bad wrap, inflammation is actually a very necessary and helpful process of the immune system. In fact, it is a huge part of why our species is able to survive and thrive in this world that is literally covered in all kinds of potential pathogens.
A normal reaction to an illness or injury is for the body to create acute, short term inflammation. When a person gets a cut, for example, the injured area will temporarily become red, inflamed and perhaps a bit painful while the immune system works on repairing it, thus preventing infection. Or when someone has a cold or flu, the body generates a fever (inflammation) to help fend off whatever pathogen has invaded. When the immune system’s job is done and the virus has successfully been eradicated, the fever subsides.
In a healthy, normally functioning body, the immune system turns on when it identifies an invader, some kind of “non-self” pathogen. It addresses whatever issue(s) the immune system has identified, and then calms down again and continues surveying until the next trigger is identified.
For people living with endo, however, it seems their immune systems have gone rogue and are essentially “stuck” in the “on” position, trying (and failing) over and over again to clear endometrial lesions that it has identified as a problem or a “pathogen” from various parts of the body — usually in the pelvis.
The person with endometriosis has an immune system that can’t clear endometrial lesions, but it IS able to recognize that it’s a problem, and so continues trying to get rid of it. In fact, research has shown that women with endometriosis tend to have significantly altered immune markers, often 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). Clearly, there is something going on with the immune system.
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.
A Gut Instinct
One of the cornerstones of treating endometriosis (and often the piece that gets overlooked) is addressing the root of gastrointestinal issues. “Endo belly,” where a person with endometriosis experiences extreme bloating and discomfort, often to the point of looking several months pregnant, is very common, and usually not well understood, both by providers and those living with the issue.
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 permeability (aka leaky gut).
We often see dysbiosis show up as Small Intestine Bacterial Overgrown (SIBO), an all too common occurrence in people with endo — this is often a big part of the “endo belly” bloat that is so common for endo patients. Bacterial imbalances in the stomach and large intestine are also common and must be treated for the endo patient to feel better.
Interestingly, research has shown that people with endo tend to have more “gram negative” bacteria in their system, bacteria like e-coli, for example. In fact, there have been several studies showing that often people with endo have pathogenic levels of bacteria in their pelvic cavity, which, researchers theorize, may have been translocated from dysbiosis in the gut. Dysbiosis engages the immune system and can contribute to chronic inflammation, essentially “adding gas to the fire” for endo patients.
Addressing intestinal permeability (leaky gut) is also an essential piece of effectively treating the endo patient. A recent study came out showing that there is a strong connection between endometriosis and “leaky gut syndrome.” People with endometriosis are more likely to have leaky gut (in fact, we’ve never met an endo patient who didn’t have some degree of leaky gut). Leaky gut is especially problematic for endometriosis patients because it significantly contributes to chronic inflammation and is well recognized as playing a big role in immune related diseases — leaky gut wreaks havoc on the immune system.
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.
The Hormone Connection
Endometriosis is an estrogen dominant disease. 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 looking at how hormones impact endometriosis. Progesterone resistance, where a person’s progesterone receptors (the little ‘docking zone” that progesterone land on) become “desensitized” may also contribute to hormone imbalances for endo patients. 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,” when a patient has functioning ovaries and tubes, but still has difficulty conceiving.
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.
Our Approach to Endometriosis
Our integrative reproductive health clinic uses time tested and evidence based tools rooted in natural medicine to create customized treatment plans for each endometriosis patient we see.
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 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.
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.