Please visit our PCOS page for more on integrative PCOS care. 

Integrative Endometriosis Support

Endometriosis is disease in which tissue that is similar to (but not the same as) the endometrial lining is found outside of the uterus where it does not belong. It effects 1 in 10 people assigned female at birth, and often takes 7 -10 years or more to get an accurate diagnosis.

Although endo is perhaps most infamous for causing debilitating pain with menstruation and ovulation, when we take a closer look we see that endo is much more than just “bad periods.”

At it’s root, endometriosis is a complex disease that impacts and is impacted by the entire body from the immune system to the circulatory system, musculoskeletal systems, nervous system and more.

This is to say, endometriosis is complex, and therefore requires a unique and thoughtful approach to treatment.

Your symptoms are real.

You deserve to be heard.

You deserve to live well and thrive.

Understanding Endo

The truth is, there is a frustrating lag in modern science’s understanding of endometriosis — we don’t know for certain what causes it. There are several leading theories circulating about what might be at the root of the disease, however, with more promising research coming out every year. Thankfully, after so many years of being brushed off and misunderstood, endo is finally starting to get the attention it deserves in the medical community.

What we DO know about endo is this: endometroisis is likely multifactorial, and, similar to some types of cancer, probably has different etiologies depending on the type of endometriosis, the person’s unique genetic history and the environment a person lives/lived in. Note: although endometriosis does share some characteristics similar to cancer in how it behaves, it is important to note that it is quite rare for endometriosis to become malignant.

There are 3 primary types of endometriosis, categorized into 4 different potential “stages” (with a 5th “stage” currently being debated amongst the scientific community). These types of endo include superficial endometriosis (typically categorized as stage 1, sometimes 2), ovarian endometriomas/cysts (stage 3 + 4) and deep infiltrating endometriosis (stage 3 +4). Endometriosis is be “staged” based on the type and severity of growth. The debated 5th “stage” refers to “diffuse” endometriosis, or, severe endo found on multiple organs.

The later stages of endometriosis may cause more severe damage to the effected organs, however it’s important to note that the severity of pain and other symptoms are not indicative of the severity of the endometriosis growth itself. Someone with stage 1 endometriosis might live with debilitating pain, while someone with stage 4 may not have even known they had endo until they had trouble getting pregnant or are facing other “mysterious” pelvic and/or bowel symptoms. 

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.