Endometriosis - the known and unknown

Written by Courtney O’Connell & Naturopath Ellen

Endometriosis is a disease where endometrial tissue, tissue that is similar to the lining of the uterus, grows in other parts of the body, outside of the uterus. It is commonly found in the pelvic/reproductive region, affecting the ovaries, fallopian tubes, intestines, and bladder. However, it is not limited to the pelvic area, in fact, it has been found in many other major organs of the body (gut, lungs). 


Just as the normal endometrial tissue in the uterus goes through various changes throughout the monthly menstrual cycle, so does the endometrial tissue that has grown in other parts of the body. It responds to the same hormones that stimulate your monthly bleed. The bleeding irritates the region and causes inflammation and scarring.  Imagine ‘period pain’ in other parts of your body… ouch!


Now let’s get something clear... Although period pain is common it is NOT normal. 


Endo is a chronic debilitating disease, affecting 1 in 9 women (3). The main symptom is extreme period pain. For some women it is consistent pelvic pain. Others experience pain with sex, bowel movements, urination, or ovulation. Some experience bloating, diarrhoea or constipation, nausea, and fatigue. Many experience all symptoms, and some are asymptomatic. Asymptomatic sufferers often are first diagnosed when they are having infertility issues; another awful consequence of endo that some women may go through. The amount of endometriosis you have does not equal how much pain you have. You can have very little endo and severe pain, or a lot of endo and severe pain. Because the symptoms are quite ubiquitous and often overlap other conditions, they are frequently dismissed or misdiagnosed as things like irritable bowel syndrome (IBS). If you suspect you may have endo, it is important to plead your case.. Sadly, for some women it can take up to 10 years to be diagnosed. Remember, advocating for your health does not make you a difficult patient. Although infertility does not affect all endo sufferers, it is worthwhile identifying if you have endo to reduce the risk of becoming infertile. 




COMMON TREATMENT: 

The oral contraceptive pill is commonly prescribed for endo treatment. Although it may relieve some symptoms it does not treat endo. Surgical removal via laparoscopy is the gold standard, and is effective for pain and fertility. However, around 50% of the time it grows back within 5 years (2). Endo is affected by oestrogen, but it is not caused by excess oestrogen. Therefore, treatment by the pill is not treating the cause. The pill shuts down ovulation and suppresses oestrogen (Read more on how the pill works here). This helps endo sufferers as low oestrogen slows the growth of endometrial lesions when they are oestrogen driven. However, oestrogen deficiency can have many side effects including bone mineral density loss and mood changes. Additionally, there are limited scientific studies to show that the oral contraceptive pill is effective for treating endo related pain (1). The exact cause of endo is also unknown, which makes it even harder to treat. However, it is thought that an abnormal immune response is involved in the development and progression of the condition - potentially being considered as an autoimmune condition - which leads to inflammation of the whole body (4). The immune system is involved in stimulating endometrial tissue growth and inflammation. It also is what eliminates the abnormal endometrial tissue. Therefore, addressing immune dysfunction is paramount for treating endo. 




HOW CAN WE IMPROVE IMMUNITY AND REDUCE INFLAMMATION? 

While healing endometriosis can be a long journey, there are things we can do alongside your current treatment to improve your symptoms, most importantly pain and quality of life. 


Include anti-inflammatory foods in your diet to reduce inflammation and pain: 

  • Oily fish eg. salmon, sardines

  • Nuts and seeds such as walnuts, chia seeds, sunflower seeds, pumpkin seeds, almonds.

  • Green leafy vegetables 

  • Purple and other colourful vegetables eg. beetroot, sweet potato, pumpkin, brussel sprouts

  • Citrus fruits

  • Berries - opt for organic where possible

  • Cacao

  • Extra virgin olive oil 

  • Cook with herbs and spices: Ginger, cinnamon, and turmeric. 


Turmeric - most specifically: Curcumin

The active constituent in turmeric called curcumin has potent anti-inflammatory effects. Additionally, turmeric can reduce endometrial growth and size in two ways. Firstly, by inhibiting oestrogen production and its' stimulatory effect (5), and secondly by inhibiting the stimulation of the vascular endothelial growth factor; which is what triggers new blood vessels to form (6). 


Foods to avoid: 

  • For some women, certain foods can induce inflammation. Commonly, dairy and gluten. One study (7) showed a gluten free diet had reduced pain in 75% of endo sufferers. 

  • Red meat, alcohol, refined carbohydrates and trans-fats are also best to limit to reduce inflammation. 



Improve gut health: 

  • Did you know that 70% of your immune system is found in your gut?? Crazy, I know. But when you think about it, the immune system is there to protect us, right? Anything we put through our mouths can either benefit us or not. That’s why it is so important to look after our wonderful immune system and feed it all the nourishing foods that it deserves. Including plenty of dietary fibre and fermented foods will ensure your gut bugs are fed. 



Castor oil packs: see my blog on how castor oil packs can reduce period pain and inflammation. 

Studies published have shown castor oil packs: 


Support oestrogen elimination

As mentioned earlier, oestrogen is an important hormone needed in the body. However, excess oestrogen may be problematic in endo sufferers. Endometrial tissue can make its own oestrogen, and excess oestrogen can induce endometrial growth… It is a vicious cycle. Assisting the breakdown of oestrogen is a viable way to reduce endometrial growth which in turn, will minimise inflammation and pain. For those wanting more of a natural approach, supporting oestrogen elimination is a similar concept of how the pill is postulated to work. 



So how do we support elimination… 

Oestrogen is metabolised in the liver. Providing the liver with the nutrients required for detoxification can help clear excess oestrogen. Eating an abundance of vegetables, fruits and quality protein will ensure you are consuming the nutrients required: 

  • Vitamin C

  • Magnesium

  • Brassica vegetables: think broccoli, brussel sprouts, cauli etc

  • Zinc 

  • B Vitamins

  • Antioxidants

  • Quality protein 

Phytoestrogens are a group of plant compounds naturally found in some foods. They have a similar structure to oestrogen and can exert anti-estrogen effects… Basically block oestrogen from doing its job. 

              Sources: 

  • Flaxseed: freshly ground is best. 

  • Fermented soy products eg Tempeh 

While these tips can most certainly help, everyone's Endometriosis presents differently and is triggered by different things. Identifying what is triggering your endo is the first step to helping you heal. If you would like assistance on your journey please feel free to contact me. 

Ellen TattamComment