Endometriosis

Endometriosis is a painful, debilitating condition that affects up to 1 in 10 of women or reproductive age. It occurs when tissue that is similar to the endometrium (lining of the womb) grows outside of the womb, most commonly in the pelvis and bowel.

Known as endometrial lesions, this misplaced tissue causes a range of symptoms including:

Pain is the most common symptom of endometriosis and occur anywhere depending on where the endometrial lesions are.

Why does endometriosis occur?

There are a couple of prevailing theories about why endometrial lesions end up outside the womb. The historical theory was that ‘retrograde menstruation’ occurs – essentially blood from womb flowing backwards into the pelvis. More recently, it is thought that these lesions are laid down prior to birth.

What is clear is that the immune system plays a critical role in determining how our body responds to these endometrial lesions. Inflammation is the response of our immune system to a threat such as infection or injury. The aim of inflammation is to attack and destroy an infection, or to repair damaged tissue in the case of injury. 

Unfortunately, our modern diet and lifestyle predisposes us to a state of low-grade chronic inflammation which is a significant driving force in many of our common chronic conditions.

Inflammation stimulates the growth of endometrial lesions, as well as hormones such as oestrogen.

Symptoms

• Frequently pain occurs in the pelvis, bowel, bladder and legs.
• As the lesions are sensitive to oestrogens, the pain be worse around periods.
• Unfortunately, pain can also be throughout the entire cycle too. 
• Heavy or painful menstruation
• Painful sex
• Bowel problems, also known as ‘endo belly’.
• This occurs in up to 90% of people with endometriosis.
• Lesions which occur on the bowel can lead to bloating, constipation, diarrhoea, and bacterial/yeast overgrowth in the bowel.
• Painful or frequency urination occurs when lesions are on the bladder
• Infertility can occur if scar tissue develops at the site of the lesions and affects normal functioning of the reproductive tract

Treatments

Your GP or gynaecologist may suggest painkillers, hormone therapy or surgery which can be helpful in reducing symptoms of endometriosis. 

Other areas to focus on include:

• Reducing inflammation. Possible contributing factors include current diet, poor sleep, stress, chronic infections, environmental toxins.  
• Supporting healthy hormones, particularly addressing high levels of oestrogens. The liver and gut are primarily responsible for eliminating oestrogen from the body. 
• Optimising immune function  
• Diet and lifestyle recommendations:
• Eliminate pro-inflammatory foods such as refined sugar and processed foods
• Incorporate anti-inflammatory foods such as dark leafy green vegetables, orange/yellow vegetables, turmeric, berries, broccoli, cauliflower, olive oil, onions and SMASH fish (salmon, mackerel, anchovies, herring, sardines)
• Ensure regular bowel movements by increasing fibre intake
• Address poor sleep and stress
• Take vitamin D. All adults in the UK should take a minimum of 400 units a day
• Reduce exposure to hormone-disrupting chemicals. For example, eat organic food; store food in stainless steel or glass; use cans that are BPA-free and switch to natural skincare
• Working with a functional medicine practitioner can be particularly useful in targeting specific areas such as gut health, nutrition, and hormonal imbalance. 

Although endometriosis is not a curable condition, there are treatments available that can significantly improve quality of life. Heading upstream and addressing the driving factors behind endometriosis may be a more acceptable treatment strategy to some women than surgery or hormonal therapy.

To find out more about Functional Medicine : (link to www.ifm.org or to Essential Guide to Functional Medicine?)

To find your nearest practitioner:
https://www.ifm.org/find-a-practitioner/