How a naturopathic doctor approaches endometriosis (Part I)

First off, what is endometriosis?

Endometriosis is a condition where endometrial tissue, the tissue that lines the inside of your uterus or womb, grows in other areas outside of the uterus. Other areas include your ovaries, fallopian tubes, tissues holding the uterus in place. Tissue can also grow in other areas of your pelvic cavity, including your cervix, vagina, bowel, rectum, and bladder.

These tissues are responsive to hormonal changes that happen throughout the month just like the endometrium inside of your uterus. That means these tissues are responsive to estrogen and progesterone like your uterus and ovaries are.

Endometriosis may impact more than 11% of American women, between the ages of 15 and 44. Endometriosis can be hard to diagnose because the symptoms are broad and there isn’t one definitive test that will diagnose endometriosis. Pelvic exams, ultrasounds, and MRIs will be done to investigate and rule out other possible causes of symptoms. Because there are many broad symptoms that are included in endometriosis, this can cause a delay in diagnosis and many women can go years without knowing what is going on.

The diagnosis usually comes after a thorough history of symptoms, chronic pelvic pain, and ruling out other possible diagnoses through imaging and labs. Surgery or laparoscopic investigation can be useful in confirming the diagnosis by taking samples of tissue in the pelvic region to look for endometrial tissue or lesions.

What are common symptoms of endometriosis?

This is a chronic condition that can cause many different symptoms including pain at times of your period, during sexual intercourse, bowel movements, urination, and just overall chronic pelvic pain. Women with endometriosis can also experience anxiety and depression, fatigue, bloating, nausea, fatigue, and even infertility.

Infertility can be a big issue for women who are struggling with endometriosis. There can be scarring and fibrosis on the tissues of the pelvic region including the fallopian tubes, uterus, and ovaries, making it hard to become pregnant. Endometriosis can cause inflammation in the pelvic region. The inflammation can make it hard for a fertilized egg to stick around and the immune system is so powerful, it may end up making the environment tough for a fertilized egg to survive.

Hormonal imbalances can be at the root of the problem as well. Progesterone is vital during the second half of the cycle, it helps to build up the endometrial lining. Without this lining, the egg won’t have anywhere to stick to. This is why working on hormones before pregnancy is important.

Why does endometriosis happen?

Scientists are still trying to uncover why endometriosis happens, but there are a few theories and factors that increase your risk for endometriosis.

Genetics can be a contributing factor. If you have a mother or sister who has been diagnosed with endometriosis, this increases your risk. There can be abnormalities in genes that code for detoxification enzymes that causes an abnormality in how your body processes toxins and hormones, putting you at greater risk for endometriosis.

Women who are exposed to high levels of estrogen, environmental estrogens, or even overall endocrine disruptors can put you at risk for endometriosis. Endocrine disruptors include like PCBs (polychlorinated biphenyls), weed killers, detergents, household cleaners, tin can liners.

Your liver has several processes that play a big part in hormone regulation

Estrogen gets processed in your liver through phase 1 and phase 2 detoxification, this requires vitamins, minerals, and protein in order to work properly. If you are eating a specific diet that cuts out certain nutrients or not absorbing your nutrients, this process won’t work as well. Estrogen breakdown will slow down, increasing your estrogen pool (the amount of estrogen in your body, also known as estrogen dominance).

There is also a third phase of estrogen detoxification, this is elimination or your bowel movements. Did you know you should be pooping every day? If you’re not, that means your constipated!

If these 3 processes aren’t working properly, you will have some problems with hormone balance.