Endometriosis is an increasingly common women’s health condition where endometrial tissue grows outside of the uterus. Under normal circumstances, endometrial tissue grows every month in the uterus to prepare for embryo implantation. If pregnancy doesn’t occur that month, the endometrial lining is shed via your monthly period. However, women with endometriosis experience endometrial tissue growth in places other than the uterus, such as the fallopian tubes, ovaries, cervix, and more. Endometriosis is a common cause of infertility and affects roughly 10% of women between 25-40. According to the The American Society for Reproductive Medicine, 24-50% of women diagnosed with infertility have endometriosis and many don’t know it! Fortunately, it is possible for many women to get pregnant with endometriosis by targeting the root cause and correcting the underlying hormone imbalance.
What Causes Endometriosis?
For a long time doctors and obstetricians weren’t sure what caused endometriosis. In fact, many will still tell you they don’t know. However, research shows that women with endometriosis have unusually high levels of estrogen that cause a hormone imbalance called estrogen dominance. Estrogen dominance is a factor in many other hormone imbalances including fibroids, dysmenorrhea, and PCOS. In estrogen dominance, women overproduce estrogen which then goes unchecked by other female sex hormones like progesterone. When estrogen levels are too high, your body isn’t able to process and excrete all of the excess hormone. Estrogen ends up circulating through the body, leading to more buildup over time. Reversing estrogen dominance is a speciality of mine. You can read more about the root causes of estrogen dominance here! Many women mistakenly believe removing the misplaced endometrial tissue will solve their problem. Unfortunately, unless you solve your estrogen imbalance, the endometrial tissue will likely regrow.
Endometriosis and Fertility
It’s challenging and sometimes impossible to get pregnant with endometriosis due to the endometrial tissue growing outside of the uterus. That’s because endometrial tissue responds to the same hormonal cues from your monthly cycle even when it’s outside of the uterus. It goes through monthly periods of growth and sloughing off, which can cause scarring of the affected organs, create inflammation, and even cause blockages. Since endometriosis most commonly grows in reproductive organs, like the ovaries, fallopian tubes, and cervix, it’s often difficult or impossible for egg and sperm to meet or for normal embryo implantation to occur.
Symptoms of Endometriosis
Endometriosis often goes undiagnosed for years or even decades. That’s because the only way to diagnose it is through an exploratory surgery, called a laparoscopy, which is invasive and often seen as a last resort. Many women end up suffering in silence or believing their symptoms are “normal.” Common symptoms of endometriosis include:
- Painful periods with severe cramping
- Pain during or after sex
- Heavy bleeding during periods
- Irregular periods
- Diarrhea, constipation, or GI pain during periods
- Breakthrough bleeding/spotting
- Infertility
These symptoms are also signs of estrogen dominance, and many women might write them off as normal because they’re so common. Doctors might even overlook symptoms for years or prescribe medication like birth control to mask your symptoms. It’s often only when infertility presents that doctors look further into the problem.
Prepare for Pregnancy with Endometriosis
Women with endometriosis will often need to remove endometrial tissue growing outside of the uterus as a first step towards pregnancy. Otherwise, this tissue may block conception or implantation and continue to create inflammation that impedes fertility. If you suspect you have endometriosis, ask your OB/gyn for an ultrasound or MRI which is a non-invasive way to look for signs. Keep in mind you may not be able to see the endometriosis, and the only way to diagnose endometriosis for sure is through a laparoscopic surgery. Laparoscopy is also the only way to remove the endometrial tissue. Many women are diagnosed and have the excess tissue removed at the same time during an exploratory surgery. After removing misplaced endometrial tissue, it’s crucial to reduce inflammation and balance estrogen to lay the groundwork for a viable pregnancy.
Managing Inflammation with Endometriosis
Endometriosis is an inflammatory condition and inflammation can impede healthy pregnancy. The three top causes of inflammation in our modern lives are poor gut health, chronic stress, and lack of quality sleep, and women should start by improving each of these three areas. I focus especially on gut health and stress in women with endometriosis. The gut is a main estrogen detox pathway, and when it’s inflamed estrogen often builds up. That makes poor gut health a potential root cause of endometriosis. To reduce gut inflammation, remove inflammatory foods such as gluten, conventional dairy, added sugars, and vegetable oils, and focus on healing with a whole foods based diet. Often people with endometriosis and estrogen dominance have a microbiome imbalance, or an overgrowth of unhealthy gut bacteria. Additionally, many people with endometriosis have known GI problems like IBS and SIBO that should be addressed with a nutritionist.
In addition to following an anti-inflammatory diet, many foods and supplements can help you reduce systemic inflammation. Consider adding more omega-3 fats, bone broths, collagen, herbs, and spices on a daily basis.
Stress plays into endometriosis because cortisol negatively impacts progesterone. Keeping in mind progesterone’s balancing affect on estrogen, it’s critical for women with endometriosis to reduce stress and anxiety and nourish their adrenals. Find healthy and productive outlets for the stress you can’t eliminate such as meditation, yoga, a hobby, or a creative outlet.
Preventing Endometriosis Regrowth
The last thing you want after going through a surgery is to have to repeat it. And yet 20-30% of women who have laparoscopies experience regrowth after five years. That means that laparoscopy can offer a temporary fix, but not a solution to your hormone imbalance. Women with endometriosis will need to find the root cause of their estrogen dominance and work to correct it. Our modern diet & lifestyle plays a big role in estrogen dominance by impairing estrogen detox pathways. In addition to healing and rebalancing the gut, women with endometriosis often need to improve liver health and detoxification. That’s because the liver is the main place where we excrete excess estrogen.
Additionally, we’re all exposed to fake and manmade estrogens on a daily basis from many common household products. Xenoestrogens are a class of endocrine disrupting chemicals that mimic estrogen in the body. They can lead to estrogen build-up because they’re molecularly similar enough to be used like estrogen, however, your body is still producing its own estrogen. Take note of the biggest sources of endocrine disruptors in your life and work to reduce them. For many women the largest sources are conventional skincare and beauty products, cleaning products, food storage containers, plastics, and nonstick cookware. Start swapping in natural, nontoxic alternatives as much as possible to reduce your overall xenoestrogens exposure. Pesticides and fungicides, especially dioxins and PCB’s, have been linked to endometriosis. This makes choosing organic foods very important for women with endometriosis.
Putting It All Together
Reversing endometriosis often takes a concerted effort to improve your lifestyle over time. However, many women note improved symptoms around their periods in as little as 2-3 cycles when they begin reducing their estrogen production. While challening, it’s possible to get pregnant with endometriosis if you take the necessary steps to remove the misplaced tissue and heal the underlying hormone imbalance. Most women aren’t able to do this on their own. Book a complimentary 30-minute Discover Call to get expert guidance and a plan tailored to your unique needs.
