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March is Endometriosis Awareness Month, a time to shed light on a condition that affects millions of women worldwide. Despite its prevalence, endometriosis is often misunderstood, misdiagnosed, and dismissed, leaving women suffering in silence for years before getting the help they need. If you or someone you love has struggled with painful periods, digestive issues, or unexplained infertility, this article is for you.
What Is Endometriosis?
Endometriosis is a condition in which endometrial cells, the cells lining the inside of the uterus, grow outside of the uterus.These growths, called lesions or implants, can appear on the ovaries, fallopian tubes, bladder, intestines, and even in distant areas like the lungs or gallbladder.
Every cycle, your uterine tissue will grow under the influence of estrogen and mature under the influence
of progesterone and then shed, when you get your period. When you have endometriosis and have endometrial cells outside of your uterus, you can imagine that these cells can still respond to your monthly hormonal fluctuations. However, unlike the cells lining the uterus, the tissue has no way to exit the body, so it remains trapped. Hormone stimulation causes the tissue lesions to bleed, which leads to swelling and triggers an inflammatory response. The surrounding tissue becomes irritated and eventually forms scar tissue and adhesions. This can be extremely painful and fertility is often compromised.
How Many Women Are Affected?
Endometriosis affects an estimated 10% of women of reproductive age worldwide, which equals around 190 million women (World Health Organization, 2023). Endometriosis is most commonly diagnosed in women in their 20s to 40s, though symptoms often begin in adolescence.
Symptoms of Endometriosis
Endometriosis symptoms can vary, but the most common ones include:
Severe menstrual cramps that interfere with daily life
Excruciating pelvic pain
Pain during or after intercourse
Heavy or irregular periods
Digestive issues like bloating, diarrhea, or constipation (often mistaken for IBS)
Painful urination or bowel movements, especially during menstruation
Infertility or difficulty conceiving
Fatigue
How Is Endometriosis Diagnosed?
One of the biggest challenges with endometriosis is its delayed diagnosis. On average, women wait 7-10 years for a proper diagnosis.
Common methods of diagnosis include:
Symptom Assessment: Doctors evaluate pain patterns, menstrual history, and associated symptoms.
Ultrasound & MRI: While helpful, imaging tests cannot definitively confirm endometriosis.
Laparoscopy: The gold standard for diagnosis, this minimally invasive surgery allows direct visualization of endometrial lesions. - use transvaginal ultrasound instead - your doctor must be looking for endo lesions though
Unfortunately, many women are told their pain is "normal" or misdiagnosed with conditions like IBS, leading to years of suffering before receiving the correct diagnosis.
One of the most common GI conditions that accompanies endometriosis actually is Small Intestine Bacterial Overgrowth or SIBO.
Endometriosis can infiltrate the bowel and alter the intestinal motility and the bacterial population, causing SIBO. A significant number of IBS cases are linked to SIBO.
This is why many people are diagnosed with IBS before getting an actual endometriosis diagnosis.
I guess the consensus is that the best way to get a fast diagnosis is working with a practitioner who is experienced in this and who is able to reference a combination of medical tests and symptom tracking:
Type, frequency
Cycle length
Ovulation signs
Fatigue
Non-menstrual pelvic pain
Bloating and digestive symptoms
What Causes Endometriosis?
The exact cause of endometriosis remains unclear, but several theories exist:
Retrograde Menstruation: Some menstrual blood, containing endometrial cells, flows backward into the pelvic cavity instead of leaving the body.
Hormonal Imbalances: Excess estrogen and disrupted progesterone levels may contribute to the abnormal growth of endometrial tissue.
Immune System Dysfunction: The immune system may fail to eliminate misplaced endometrial cells.
Genetics: Women with a family history of endometriosis are at higher risk.
Environmental Factors: Exposure to endocrine-disrupting chemicals, such as BPA and dioxins, may increase the likelihood of developing the condition.
The Link Between Gut Health & Endometriosis
Emerging research like this article suggests a strong connection between gut health and endometriosis. While gut issues may not directly cause endometriosis, they can worsen inflammation, estrogen dominance, and immune dysfunction - all of which contribute to the severity of the disease.
1. Dysbiosis & Inflammation
Women with endometriosis often have an imbalanced gut microbiome (dysbiosis), leading to chronic inflammation. A 2023 review in Frontiers in Immunology found that endometriosis patients have gut microbiome imbalances similar to those seen in inflammatory bowel disease (IBD).
A recent study from 2023 documented how Fusobacterium might be involved in the development of endometriosis: The study found that 64% of patients with endometriosis had Fusobacterium in their uterine lining.
2. Leaky Gut & Immune Dysfunction
Increased intestinal permeability (leaky gut) allows toxins and inflammatory molecules to enter the bloodstream, triggering immune responses that worsen pain and inflammation. A 2020 study in Reproductive Sciences found higher levels of endotoxins and inflammatory markers in women with endometriosis.
3. The Estrobolome & Estrogen Clearance
The gut microbiome plays a crucial role in metabolizing estrogen through the estrobolome. When dysbiosis occurs, estrogen is not properly broken down and eliminated, leading to higher circulating estrogen - one of the main drivers of endometriosis. A 2021 study in Cell Death & Discovery confirmed that endometriosis patients had distinct differences in their gut bacteria affecting estrogen metabolism.
4. SIBO & IBS-Like Symptoms
Many women with endometriosis experience bloating, constipation, and diarrhea, often due to Small Intestinal Bacterial Overgrowth (SIBO). A 2022 study in BMC Women’s Health found that 77% of endometriosis patients met the criteria for IBS, with many testing positive for SIBO.
Natural Solutions for Managing Endometriosis
While there is no cure for endometriosis, natural approaches can significantly improve symptoms and quality of life.
1. Anti-Inflammatory Diet
Reducing inflammation is key to managing pain and flare-ups. Focus on:
Omega-3-rich foods like sardines, mackerel, hemp seeds
Cruciferous vegetables (broccoli, kale, Brussels sprouts) to support estrogen balance
Turmeric and ginger, which have anti-inflammatory properties
Cutting out processed foods, sugar, dairy, and gluten, which can worsen inflammation
2. Balancing Hormones Naturally
Seed cycling (flax and pumpkin seeds in the first half of the cycle, sesame and sunflower seeds in the second half) may help balance estrogen and progesterone.
Liver support: The liver helps process excess estrogen. Eating bitter greens, drinking dandelion tea, and reducing alcohol intake can help.
3. Gut Health & Microbiome Support
Since endometriosis is linked to gut health, healing the gut can make a big difference:
Probiotic-rich foods like sauerkraut, kimchi, and yogurt help maintain a healthy microbiome.
Reducing gut irritants like gluten, dairy, and processed foods can ease digestive symptoms.
4. Stress Management
Chronic stress worsens inflammation and hormone imbalances. Mind-body practices like:
Yoga, meditation, and deep breathing help calm the nervous system.
Acupuncture may reduce pain and improve circulation to the pelvic area.
5. Detoxification & Environmental Toxins
Reducing exposure to endocrine-disrupting chemicals (EDCs) found in plastics, cosmetics, and household cleaners can support hormonal balance.
Endometriosis is real, it is painful, and it deserves more attention. If you suspect you have endometriosis, don’t let your symptoms be dismissed. Find a healthcare provider who takes your concerns seriously.
Natural approaches can offer relief, but every woman’s journey with endometriosis is unique. Whether you explore dietary changes, stress management, or hormone-balancing strategies, know that there is hope - and you are not alone.
Let’s keep raising awareness so more women get the support they deserve!
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