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A Natural Approach to Endometriosis

This week marks Endometriosis Awareness Week which campaigns every year to raise awareness about this hidden, often unrecognised and under diagnosed condition.


So what is endometriosis, what are the signs to look out for and what can we do about it?


What is endometriosis?

Endometriosis is a painful and sometimes debilitating condition that affects 2 million women in the UK alone. Most women are diagnosed between 25 and 40, and shockingly it can take on average 7.5 years for a woman to be diagnosed.


It is a long term chronic condition that occurs when cells that are normally only found inside the uterus embed and grow outside the uterus, often on the ovaries, fallopian tubes, covering the top of the vagina or else on intestines. Doctors have even discovered endometrial cells in the eyes and brain, and whilst I was training I can recount a client sharing her story of having endometriosis in her shoulder!

Here’s where the problem is: those cells are hormonally active, just like those that line your uterus, and when womb cells shed every month (your period), the other cells do, too. The blood can’t flow out of the body, and this leads to the build-up of scar tissue and cysts. Because these endometrial cells can grow almost anywhere, women experience different symptoms, ranging (in addition to heavy painful periods) to painful bowel movements, pain during sex, back pain, fatigue and depression.



What are the other signs to look out for?

  • Painful periods or cramps (that often stop you from completing your day to day activities)

  • Heavy or long periods

  • IBS like symptoms e.g. bloating, constipation, diarrhoea, gut cramping

  • Painful sex

  • Infertility

  • Fatigue

  • UTIs or bladder problems

  • Pain in your lower stomach or back pain

  • Pain when peeing or passing a stool during your period

The only way to officially diagnose endometriosis is by laparoscopy, an operation during which a tiny camera is inserted into the pelvis. If you have any concerns that endometriosis might be part of your picture, you should visit your GP right away.


There is currently no cure for endometriosis, treatment involves surgery to remove lesions and the birth control pill or other medications to control your hormones. This might sound bleak but it doesn’t have to be, as diet and lifestyle can also be an effective way to help you manage symptoms.



What are the underlying causes of endometriosis?


1. Inflammation

Endometriosis is an inflammatory condition and is often also driven by inflammation. Inflammation comes from our environment, through the food we eat, lifestyle we live or the state of our gut health to name just a few things.


2. Faulty immune system

The immune system's job is to not react to things. For example, it should consider the clothes you are wearing as safe, the water you drink as not a threat and your breakfast shouldn’t spark world war three. However, some of the time it is appropriate for the immune system to spring into action, for example when you ingest a pathogen or bacteria. The immune system should also spring into action to help clear down the uterine tissue that has grown outside of the uterus, but this doesn’t always occur in endometriosis.


3. Oestrogen overload

Oestrogen, or rather too much oestrogen fuels endometriosis making it worse. This can stem from an imbalance in how much oestrogen is made, imbalance between other hormones, difficulty detoxifying and eliminating oestrogen, as well as from our environment through xenoestrogens. Xenoestrogens are ‘foreign’ oestrogens found in our environment that have a very similar structure to the oestrogen found in our body. They are however, far more potent that our naturally produced oestrogen.



What to address to help with endometriosis?


1. Look at your environment

Eliminate your exposure to toxic xenoestrogens found in cleaning products, beauty products, cosmetics, pesticides and plastics. These work by mimicking oestrogen in the body and increase your overall oestrogen load.


To start with, look at reducing the number of products you use. For example, do you really need three different cleansers, two serums and a moisturiser as part of your daily morning routine? Do you really need five different cleaning products to scrub your bathroom? Reducing the number of products you use automatically reduces the number and load of chemical exposure.


Next, look to change to cleaner greener alternatives. The Think Dirty app and the EWG are good sources to start exploring more natural options.


It is also wise to opt for organic produce where possible to reduce pesticide exposure (another xenoestrogen) and avoid plastic use, especially plastic that comes into contact with anything that is ingested.


2. Optimise your diet

What to add more of:

  • Up your intake of dark green leafy vegetables, cruciferous vegetables, berries and other high fibre vegetables to support your liver and gut. The liver is responsible for breaking down and eliminating excess oestrogen, and once detoxified it is excreted via the stool. Other foods such as artichokes, beetroot, lemon, lime and burdock are also powerhouses for the liver.

  • Including fermented foods can also help to keep the gut happy so get the 3 K’s in - like kimchi, kraut and kefir.

  • Add in more healthy fats to support hormone production and balance including coconut oil, olive oil, oily fish and avocados. Make sure to include sufficient protein levels to help balance blood sugar levels to reduce excess insulin which helps to reduce oestrogen levels and keep inflammation at bay.

What to include less of:

  • Limit red meat which has been associated with endometriosis (1) and opt for lean sources of animal protein such as white fish and chicken instead which are less inflammatory.

  • Get rid of sugar which is just an inflammation bomb in the body. It can also suppress your immune system and mess with hormone balance so there really are no benefits when it comes to endometriosis (or health for that matter!).

  • Try to limit processed foods which contain additives and preservatives. Not only is the nutrient content often less in processed foods but the added chemicals give your liver an extra job to detoxify.

  • Consider your intake of alcohol and caffeine. Alcohol in particular is inflammatory, suppresses the immune system and is hard on the liver. Caffeine is a little less cut and dry, but there is research linking caffeine with endometriosis (2) so it is best to play on the safe side and cut it out or reduce your consumption.

3. Support your immune system

Trial eliminating foods which commonly spark inflammation such as dairy and gluten can help support the immune system and reduce your inflammatory load.


Also load up on lots of brightly coloured vegetables which are rich in antioxidants and can help support your immune health. Garlic, ginger, mushrooms, green tea and berries are all especially good for the immune system too.


Check your vitamin D status. Vitamin D deficiency is very common in the UK as we generally don’t get enough sunlight to produce sufficient vitamin D. It can be tested via a simple blood test and supplemented accordingly.


4. Support detox pathways

Support all detoxification routes and not just the liver. Make sure to sweat daily either through exercise, hot baths or saunas and add in some body brushing or rebounding to get the lymph flowing. Breathwork can also be another useful detox resource along with keeping hydrated and having a good old cry if you feel like it (yes we can detox via our tears!)


5. Manage stress

Where there is stress, there is cortisol. Producing high amounts of cortisol can knock other hormones out of balance and suppress the liver and the gut…which isn’t good for our hormones! Prioritise daily relaxation and include activities that you find calming such as meditation, mindfulness, stretching, walking, listening to a podcast, reading a book or enjoying a long hot bath.


6. Targeted supplements

There are many supplements or targeted nutrients that can be used in addition to diet and lifestyle measures. Remember, supplements should always be just that, a supplement to what you are already doing (not a cure all!) and it is best to work together with a qualified practitioner to understand what might support you as an individual and check for any interactions.


7. Testing

Using a comprehensive test like the DUTCH test to understand what your oestrogen (and other hormones) levels are and how well you are detoxifying is invaluable information to understand where you might need targeted support.


Remember, if you think endometriosis might be part of your picture then please visit your GP as your first port of call to rule it in or out.


However, if you would like to understand more about how the DUTCH test could benefit you and your symptoms please book in a call here to discuss more.


References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330594/

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548216/

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