Endometriosis is a gynecological disorder that impacts as many as 10 percent of all women. (1)
Symptoms range from pain to fertility problems, and many issues in between. Research continues to search for a cure, but in the meantime, many women who have this painful disorder look to medical and natural treatment options to find relief.
This article will explore the causes and symptoms of endometriosis, as well as treatments and lifestyle changes that can help.
What is Endometriosis?
Endometriosis is a disorder that impacts women. It occurs when the lining of the uterus, known as the endometrium, begins to grow where it should not, including the outside of the uterus, other pelvic tissue, and even the intestines.
Because this tissue is still affected by a normal menstrual cycle, endometriosis can cause significant pain wherever tissue has spread before and during a woman’s period.
Endometriosis can result in scar formation and adhesions, pain, and infertility.
Symptoms of Endometriosis
Endometriosis can present with no symptoms, or there can be many. The most common symptoms associated with endometriosis are:
- Pelvic pain
- Painful periods
- Heavy menstrual flow
- Lower abdominal pain
- Heavy cramping before and during the menstrual cycle
- Infertility or miscarriage
- Pain during or after sexual intercourse
- Painful bowel movements or intestinal cramping
- Diarrhea and/or constipation (or both)
- Excessive bloating not associated with food intake
- Lower back pain
Risk Factors and Causes of Endometriosis
Endometriosis is an autoimmune disorder that has multiple risk factors and potential causes. No single known cause exists, much like no cure has yet been found.
Endometriosis is most often diagnosed in the 30s or 40s, and often the symptoms naturally resolve after a woman enters menopause.
Symptoms of endometriosis are driven by too much estrogen or too little progesterone, or both, and when hormone levels decrease and balance out after the end of menstruation, the disorder tends to go dormant.
Women who have endometriosis and do get pregnant will typically experience a complete disappearance of symptoms during pregnancy thanks to the higher levels of progesterone.
Likewise, some doctors use progesterone to treat symptoms of endometriosis and provide more balanced hormones.
Causes of endometriosis are not definitively proven, but many theories exist. Of them, the common ones include:
- Retrograde menstruation, where particles from menstrual blood back flow and leave remnants outside of the uterus, in the pelvic cavity
- Endometrial cells transferring or appearing outside of the uterus, for various unknown reasons
- Leakage from the endometrium through cesarean or other surgical scars on the uterus
- Genetics, that a woman is born with the proclivity to develop endometriosis
- Environmental exposures, such as toxins, that can trigger the development of the disease from genetics, hormone problems, or other reasons
While the exact cause of endometriosis is not known, risk factors are more certain. A risk factor does not guarantee that someone will develop the disorder, but simply increases the risk that they could have the right conditions to develop it.
Risk factors for endometriosis can include:
- Being a woman in the 30s or 40s
- Being a woman who has not yet had a child or had their first child after age 30
- Having short menstrual cycles, less than 27 days, or having a short luteal phase
- Having autoimmune problems of any kind, such as another autoimmune disorder
- Having increased inflammation in the body that could be a precursor to autoimmunity
- Exercising infrequently or not at all
- Estrogen dominance
How Endometriosis Is Diagnosed and Treated
Endometriosis is diagnosed by either laparoscopy or ultrasound. It is almost impossible to diagnose without one or both of these methods.
Typically when symptoms present, your doctor will order these tests to confirm a suspected endometriosis diagnosis.
Once a diagnosis is confirmed, there are a few different treatment approaches. These typically depend on what stage of endometriosis you are in.
The different stages of endo include:
- Stage 1: only small lesions are found around the ovaries or pelvic cavity.
- Stage 2: implants that are shallow have started to appear on the ovary, pelvic lining, outside of the uterus, etc.
- Stage 3: implants are deeper and increase in amount.
- Stage 4: implants are deep and the location has expanded to include fallopian tubes, intestines, and elsewhere in the body.
Treatment for endometriosis can range from pain medication to hormones to help ease symptoms to, in more extreme cases, the recommendation for hysterectomy.
Treatment plans are individualized based on the stage of endometriosis a patient is in as well as her personal health goals, age, and severity of symptoms.
It is possible to be in stage one and have extreme pain or to be in stage four with minimal symptoms or pain. Whether or not a woman hopes to become pregnant can also alter the treatment approach.
How Endometriosis Can Cause Problems
Endometriosis is not life-threatening but it can have long-term complications.
It is particularly problematic for fertility. If you’re trying to conceive and have been diagnosed with endometriosis, working with a fertility expert or reproductive endocrinologist could be important to preserve fertility options since as many as 40 percent of women with endo will have trouble conceiving. (2)
The pain and discomfort associated with endometriosis could impact the quality of life and could even interfere with the normal ability to work or socially function.
Working with a physician to manage pain through medication or medical procedures could improve one’s quality of life.
Natural Care for Endometriosis
While there is not yet a cure for endometriosis, there are many natural care approaches that can ease symptoms and make the condition more bearable.
Some of these work in conjunction with traditional medical treatment and others are able to be used instead. Always check with your medical provider before using alternative or natural methods to ensure that they don’t interact with or interfere with medical treatments or prescriptions.
If you are pregnant or trying to get pregnant, don’t assume that natural therapies or safe or advised unless your OBGYN has said so.
The following are natural methods that can be used to ease potential symptoms of endometriosis.
Much has been written about the “endo diet,” but research does not definitively offer a single way of eating that could help. Still, nutrition science and research do offer some eating protocols that could help.
An important first step is to remove junk and processed foods because they don’t offer nutritional value and could be causing digestive problems. Next, it’s important to make sure you’re hydrated and drinking plenty of water.
Beyond that, some other basic principles of anti-inflammatory eating apply, such as:
- Boosting intake of vegetables, especially leafy greens
- Eating cruciferous vegetables to promote natural detox
- Increasing omega-3 fatty acid intake, especially in fatty fish like salmon
- Decreasing the intake of sugar (even “healthy” ones like honey) and artificial sweeteners
- Decreasing intake of red meat, ham, pork, and bacon
- Eating more fresh fruits, especially berries and citrus
- Eating eggs, since they’re rich in folate
- Eliminating alcohol entirely, primarily because it dramatically alters the microbiome balance
- Adding fermented foods or probiotics for gut health
- Reducing caffeine intake and limiting coffee
- Quit dairy products with the exception of fermented, like kefir or unsweetened yogurt (unless allergic)
- Stop eating soy products
- Increase bone broth and collagen in the diet
- Eat enough food each day since calorie restriction can actually worsen inflammation and health problems
Losing weight can benefit women with endometriosis and can contribute to better hormone balance, but weight alone is not a causative factor or the cure.
A healthy diet can reduce inflammation and result in natural weight loss, but eating to only lose weight tends to result in calorie restriction and not taking in enough healing nutrients.
An ancient TCM (Traditional Chinese Medicine) treatment, acupuncture has successfully been used to alleviate pain and inflammation associated with endometriosis and has also been used to improve fertility and conception. (3)
For the best results, try weekly treatments for six to 12 weeks, and then afterward, get treatments for maintenance as needed. For example, getting acupuncture for one or two weeks before a period could help to reduce pain and increase comfort as well as contribute to overall hormone balance.
Some herbal or other supplements can provide relief for certain aspects of endometriosis. More research needs to be done to evaluate whether results can consistently be replicated, but the following supplements may be beneficial: (4, 5)
- Resveratrol: antioxidant that may slow the progression of endometrial growths
- Calcium: bone and hormone balance
- Magnesium: bone and hormone balance
- Vitex: an herbal supplement that can support a healthy estrogen to progesterone balance
- Red raspberry: helpful for cramps and uterine tone
- Turmeric or curcumin: fights inflammation and serves as natural pain relief while promoting natural hormone balance
- Ashwagandha: reduces stress, promotes hormone balance, and helps lower inflammation levels
- Probiotics: to support health gut bacteria, immunity, inflammation levels, and hormones
4. Heating Pad
Whether you’re having pain from menstrual cramping or low back pain, heat can help to relieve tension and ease the pain when associated with endometriosis. Use a re-heatable rice (or similar) heating pad, not one that uses electricity.
You can also use warm baths or hot water bottles, too.
Massaging the muscles in the pelvic area can help relieve pain associated with menstruation or endometriosis. This can be effective with or without other pain-relieving methods but might work best when paired with other options.
Add some essential oils, like clary sage, which can help relieve pain and support balanced hormones. Always use a carrier oil with essential oils and do not apply them undiluted to the skin.
To successfully massage, gently work the area for 5 to 10 minutes at a time. You can repeat every few hours as needed for relief and comfort.
Massage is most effective in the days leading up to menstruation and may actually worsen symptoms if done during the first few days of the cycle. Determine what is comfortable for your symptoms and focus on that for the best results.
6. Essential Oils
While we’re talking about massage, essential oils, in general, can be beneficial for providing relief from some aspects of endometriosis. These can include cramps and other pain, hormone problems, headaches, depression and mood swings, and fertility.
The best essential oils to use for endometriosis are:
Research finds that combining one or more of these oils and pairing with a carrier oil can be an effective way of addressing some aspects of endometriosis when used in a topical massage. (6)
You can also gain several benefits from diffusing or inhaling.
Endometriosis is a chronic condition with no cure, but that does not mean that it has to ruin your quality of life. Your health goals will determine the course of treatment, and typically a mix of traditional and natural care can work to help ease or downgrade the severity of symptoms.
No two cases of endometriosis are alike, so it is important to work with your medical provider for a personalized treatment plan.
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- Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am.
- Simoens S, Hummelshoj L, D’Hooghe T. Endometriosis: cost estimates and methodological perspective. Hum Reprod Update.
- The American Fertility Society. Revised American Fertility Society classification of endometriosis. Fertil Steril. 1985;43: 351–352
Aimee McNew, MNT, CNTP, is a certified nutritionist who specializes in women’s health, thyroid problems, infertility, and digestive wellness. She ate her way back to health using a Paleo diet, lost 80 pounds, and had a healthy baby after numerous miscarriages. She focuses on simple nutrition practices that promote long-lasting results.