What is Endometriosis

Endometriosis (Endo) is a disorder which effects over 200 million women worldwide. It is when endometrial tissue that usually lines the uterus grows outside of it, sometimes o the ovaries, fallopian tubes, and pelvis. Rarely, this endometrial tissue can grow beyond this region, such as your bladder or lungs. Unlike PMS and PCOS, endometriosis is not a hormonal condition. It is an inflammatory condition, involving the immune system, that is affected by hormones.

This tissue then acts like it would within the uterus – thickens, breaks down and bleeds with each menstrual cycle. Without an exit route, this tissue becomes trapped leading to cysts, scar tissue and adhesions. Endo can cause severe pain and fertility issues, and in some rare cases can lead to ovarian cancer or adenocarcinoma.

In Australia, Endo affects 1 in 9 women, with diagnosis is occurring earlier than previous generations with 6.6% of women born in 1989-95 being diagnosed by aged 25-29 compared to 4% in those born between 1973-78. Despite this, it can take an average of 6 and a half years to be diagnosed, which shows a great need for people to be aware of risk factors, signs and symptoms!

Symptoms of Endometriosis

Every case of endometriosis is different, which is why it must be stressed that individualized care by a healthcare practitioner is crucial. Some women may experience severe pain whereas others may not experience any symptoms at all. Some of the most common symptoms include:

• Painful menstruation (dysmenorrhea) including lower back and abdominal pain before and during your period.
• Pain with intercourse.
• Pain with bowel movements and urination, particularly during your menstrual period.
• Excessive bleeding or bleeding between periods – ‘excessive bleeding’ constitutes the menstruation being greater than 80ml, a period that is longer than 8 days, or if you are repeatedly soaking throat a bad, or tampon, or changing your cup every few hours.
• Infertility or difficulty in becoming pregnant.
• Fatigue
• Diarrhea, constipation, bloating or nausea, particularly around periods.

Causes of Endometriosis

Although the cause of Endo isn’t necessarily known, there are a few associations and risk factors that have been recognized. Factors such as pregnancy at an older age, heavy or long periods, first period at a young age (less than 11 years old), and shorter cycles. Low BMI, and heavy alcohol use, or tobacco smoking have all been linked to increased risk of Endo. Lifestyle factors as decrease physical activity, IUD use or environmental toxin exposure may also be implicated.

Causative factors include:

• Family history: women who have endometriosis in their family (i.e. a close family member) are 7-10 times more likely to also have endometriosis, this has been proven by twin studies.
• Retrograde menstruation: this is when during menstruation, the menstrual blood flows out of the vagina but also backwards along fallopian tubes into the pelvis.
• Surgical scar implantation where cells attach to incision such as after a surgery or c-section.
• Hormonal factors: Excess oestrogen levels, or imbalance between oestrogen and progesterone.

How to manage Endometriosis

Dietary

• Cruciferous vegetables can help to metabolise excess hormones. Examples: broccoli, kale, cauliflower, cabbage.
• Increase fibre to improve binding and detoxification of hormones. Examples: flaxseed, chia seeds
• Minimise inflammatory foods such as gluten, dairy and refined sugars and trans fats. Also reduce inflammatory beverages such as alcohol and coffee (☹). Inflammatory diet habits can disrupt the immune system and increase inflammation.
• Increase consumption of essential fatty acids to reduce inflammation. Examples: wild caught fish, nuts & seeds, avocados).

Lifestyle

• Increase exercise! Studies have found that 4 or more hours of medium-to-high intensity exercise per week can reduce risk of endo, improve hormones, and reduce inflammation.
• Manage stress levels – reducing stress is always important, especially if the body is inflamed or dysregulated. Try gentle yoga or mindfulness.

Herbal & Nutraceutical Support

• NAC: (N-acetyl cysteine) is a natural anti-inflammatory that can reduce endometriomas and pain.
• Turmeric: Turmeric reduces inflammatory proteins and blocks oestrogens stimulating effect, reducing size and activity of Endo lesions.
• Vitex: Balances hormones, particularly increasing progesterone.
• Omega-3 & Fish Oils: helps to reduce inflammation and reduce chronic pain symptoms.
• Magnesium: may be a promising treatment for period pain in general due to it’s relaxing effects on muscles.