Endometriosis: The Most Common Cause of Infertility
What is Endometriosis?
Endometriosis is when the endometrium, or tissue that lines the uterus, grows in locations where it is not supposed to. The most common areas of growth are the abdominal cavity, the fallopian tubes, the ovaries, the intestines, and sometimes the bladder.
Endometriosis is not caused by hormonal imbalance, but it is affected by it! Endometrial tissue is triggered by the hormones of your menstrual cycle, particularly estrogen.
The hormones that tell your lining to shed during menstruation also cause the endometrial tissue to shed, leading to trapped tissue in the abdomen and other parts of the body. This can be extremely painful. Over time it can lead to chronic inflammation and scarring.
Endometriosis is very complex and can be difficult to understand. It is systemic inflammation rooted in immune dysfunction. It has a gut bacterial component, is triggered by hormones, and acts like cancer with its growth. We are sent to the gynecologist to diagnose and treat this condition when we don’t even know if it is a gynecological disease.
Common Symptoms
Common symptoms of endometriosis are pelvic pain and cramping during and between periods, pain with intercourse, pain with bowel movements or urination, occasional heavy menstrual periods or bleeding between periods, infertility, and fatigue. Endometriosis is the most common cause of infertility, up to as many as 50% of cases. It affects 1 in 10 women in America, and likely many more. Due to growing awareness, it may be highly under-diagnosed, especially in younger women.
How does it develop?
Nobody knows why endometriosis happens, but some contributing factors could be exposure to environmental toxins, an impaired immune system, or chronic stress. And we do know that things will worsen if left untreated.
How is it treated?
Conventional medicine has not found a way to treat endometriosis as a disease and instead relieves the symptoms through medication and surgeries. The removal of endometrial tissue through surgery can give much-needed pain relief and sometimes is needed to continue living a “normal” daily life. Surgery is not a guarantee and is only a temporary solution. The endometrial tissue typically grows back within two to three years. If you choose to have the surgery, make sure to also focus on adopting a healthy lifestyle and diet. Working holistically can help reverse the chances of regrowth and uncover the root of the disease.
What is the best holistic approach for endometriosis?
After your diagnosis and discussing the best options with your healthcare provider, you might be interested in starting a holistic protocol to alleviate symptoms. You can do this by implementing a nutrient-dense, whole foods diet and adding in lifestyle changes to eliminate stressors and environmental hormone disruptors.
It is important to remember that the body is a self-healing organism; it can heal itself without drugs and surgery. The idea of this should relieve some worries and stresses.
With Endometriosis being a disease rooted in inflammation, it acts very much like an autoimmune condition. The first step towards healing would be to treat this as an autoimmune disease and follow an AIP style diet until symptoms have disappeared for a period of time.
The Autoimmune Protocol or Anti-inflammatory Protocol, AIP, is a strong focus on nutrient density. It has slightly strict guidelines on eliminating foods for a short period to allow the body to heal and reduce inflammation. After some time, many of the excluded foods, those with nutritional merit, can be re-introduced slowly to be observed with your body’s reaction.
AIP focuses on four key areas that are known to be relevant to endometriosis and other chronic illnesses.
nutrient density
gut health
hormone regulation
immune system regulation
Nourishing nutrient-dense foods you get to eat while following the AIP protocol:
Fish and shellfish
Carrots! They help your body usher out excess estrogen.
Limited well-sourced animal proteins and avoid red meat as it is pro-inflammatory
Vegetables of all kinds: green, colorful veggies and fruit, cruciferous vegetables, sea vegetables and mushrooms
Herbs and spices (not derived from seeds)
Healthy fats (olive oil, avocado oil, coconut oil)
Fruit: but keep this minimal and focus on berries
Probiotic and prebiotic foods: fermented veggies, fruit, kombucha, water kefir, coconut milk kefir, coconut milk yogurt
Bone broth
Eat as much variety of these foods as you can!
The foods you will want to remove:
Grains
Legumes (includes peanuts)
Dairy
Refined sugars and oils
Eggs, especially the whites
Nuts: includes nut butters, flours, and oils
Seeds: including seed oil, cocoa, coffee, and seed-based spices like mustard, dill, fennel, paprika, black pepper
Nightshades: potatoes (sweets are fine), tomatoes, eggplants, sweet and hot peppers, cayenne, red pepper, tomatillos, goji berries
Gluten cross-reactive foods: such as cassava flour, coconut flour
NSAIDs: aspirin and ibuprofen
Non-nutritive sweeteners: yes, all of them! Some honey and pure maple syrup is okay
Emulsifiers, thickeners: corn starch, etc.
Food additives: nitrates and sulfates
You will need to avoid these foods 100% of the time. This is a therapy protocol that will need to be followed directly.
Ideally, you’d wait to reintroduce foods until you feel 100%, but as long as you are seeing grand improvements and a reduction in pain, you can try to re-introduce after 4-5 weeks. The best way to reintroduce foods is to do one food a week. When you introduce foods, you should be looking for symptoms every day such as headaches, swelling (even minimal swelling like fingers feel tight), GI issues, symptoms of endometriosis, reduced energy, fatigue, or afternoon dips, sugar and fat cravings, dizzy, sneezing, itchy eyes, increase in phlegm, aches, pains, skin issues, brain fog, anxiousness and anything that might just feel “off”.
To reintroduce, choose the food you wish to add in and start with small things like black pepper or mustard, do not add in gluten or sugar as those foods we know should always be eliminated with endometriosis. Sugar and gluten are on the Endo’s most wanted list. If you have endo-pain, endo-belly, systemic inflammation, or any other chronic disease issue, you are not tolerating gluten as well as you think.
Consume that reintroduced food with all three meals in one day and not again for the remaining one week. Look for these signs. If a reaction occurs, then you will know this food is a trigger food for you and it should be avoided until you are ready to try again, and for some, that is never.
In addition to diet, we can eliminate plastics, especially storing our food and drink in plastic, and clean up our beauty and household cleaning products to avoid hormone disruptors.
Castor oil packs on your lower abdominal area are also an excellent option for breaking up and reducing the scar tissue and also helps to detox and eliminate excess estrogen. I recommend setting a goal to do this every night.
I hope this information finds you well and inspires you to seek a healthful approach to your endometriosis.
Natalie Semmelmann
Functional Nutritional Therapist
Natalie is a Functional Nutritional Therapist who specializes in finding the root cause of issues pertaining to chronic illnesses and hormonal dysfunctions. She is passionate about helping women make informed decisions and take control of their own health. When she is not working you can find her at her local CrossFit Gym working out or training female athletes going through the motherhood transition. She also loves cooking and revamping classic recipes into a more healthful version and spending time with her daughter and husband.