Endometriosis.

The word "endometriosis" originates from the combination of two Latin roots: "endo," meaning "inside," and "metra," meaning "womb" or "uterus." "Osis" is a suffix used in medical terminology to denote a condition or disease.

Endometriosis is a condition when the tissue that normally lines the inside of the womb (the endometrium) is found in other places in the body, for example in the Fallopian tubes or ovaries. Sometimes endometrial tissue can be found in more distant locations such as the intestines, lungs or joints.

During a normal menstrual cycle, hormonal changes cause the endometrial tissue to shed, and it exits the body through the vagina. In endometriosis, the misplaced endometrial tissue is also affected by these hormonal changes. It too starts to break down and bleed, but there is no exit route for the old tissue to leave the body. This leads to irritation, inflammation and pain as the immune system tries to clear the misplaced tissue.

Symptoms

The main symptoms of endometriosis include:

·       Very painful or heavy menstruation

·       Pain during sex

·       Bloating

·       Lower back pain

·       Bowel changes, especially around menstruation

·       Infertility

·       Fatigue

Endometriosis can lead to the formation of scar tissue, known as adhesions, which can cause structures to become stuck together. These adhesions may block the passage of an egg through the Fallopian tube or misalign the womb, affecting fertility. Beyond the reproductive organs, adhesions from endometriosis can also affect nearby structures like the bladder, intestines, rectum, and pelvic sidewalls. This can result in symptoms such as pain, bowel or bladder dysfunction, and infertility.

Causes

We still don’t know exactly what causes endometriosis but we do know there is an element of immune system dysfunction, stopping it from recognising the misplaced tissue or from effectively removing it. Some scientists have suggested that the endometrial tissue migrates backwards through the Fallopian tubes and settles in more distant body sites. Others have suggested that stem cells lining other body cavities or organs turn into endometrial cells. Likely under the influence of certain hormones or toxins. As with many complex health conditions, it's never one thing; there are multiple factors that can contribute to or exacerbate endometriosis. By identifying which factors are involved for each individual, a personalised plan can be developed to support the individual to better manage endometriosis.

Contributing Factors

Circadian Disruption -Studies indicate that women with lower levels of melatonin are at a higher risk of developing endometriosis. Several factors can contribute to low melatonin levels, including exposure to artificial light at night, irregular sleep patterns, shift work, and certain medications. Additionally, conditions such as insomnia or sleep disorders can disrupt melatonin production.

Toxic Body Burden - Exposure to xenoestrogens from pesticides, foods packaged in plastic and poor-quality water supplies could contribute to cells developing into endometrial tissue in places they shouldn’t. Research studies have shown that animals exposed to high levels of these contaminants have developed endometriosis.

Poor Diet - A diet high in processed foods, caffeine and alcohol or low in fibre and essential fats has been linked to a greater risk of endometriosis. Whilst proper nutrition helps to improve our general health, for women with endometriosis it can be very effective in managing some of the adjunctive symptoms such as low energy, poor bowel function and compromised sleep, as well as minimising the effects of their condition.

Hormonal Imbalance - Endometriosis is thought to be exacerbated by higher-than-normal oestrogen levels. This can be due to a number of factors, such as poor hormone metabolism and excretion. It can also occur due to poor hormone signalling, which can happen when endometrial tissue grows beyond the uterine cavity, disrupting the balance between progesterone and oestrogen, leading to progesterone resistance and unopposed oestrogen.

Stress - High stress levels have also been identified as a possible risk factor for endometriosis. This is often a vicious cycle as endometriosis in itself causes individuals significant stress due to pain, uncertainty and infertility issues. Stress leads to high levels of the adrenal hormone cortisol. Since cortisol and progesterone compete, high cortisol levels lead to progesterone being unable to properly communicate with cells. This leads to a progesterone/oestrogen imbalance, which is implicated in endometriosis.

Oxidative Stress- is associated with endometriosis due to its role in causing inflammation, a contributing factor to the condition's pathophysiology. Oxidative stress occurs when there's an imbalance between free radicals and antioxidants in the body, leading to cellular damage.  Oxidate stress occurs due to exposure to pesticides and toxins, chronic stress, certain medications, lack of exercise, smoking, heavy metal exposure, low antioxidant production, poor sleep quality, dietary imbalance, iron overload, alcohol consumption, and obesity, and insufficient antioxidants, found in fruits, vegetables, which help neutralise free radicals therefor reducing oxidative stress. Bottom of Form

Poor Liver Function - The liver regulates and removes oestrogen from the body and helps to eliminate harmful external chemicals such as xenoestrogens, synthetic chemicals that mimic oestrogen in the body, disrupting hormonal balance. If the liver’s function is compromised then serious health problems can emerge, including endometriosis. A build-up of waste products and toxins from a sluggish liver can also lead to fatigue.

Immune Dysfunction - Endometriosis may arise when the immune system doesn’t properly mop up the escaped womb cells. Many women with endometriosis appear to have reduced immunity to other conditions.

Autoimmunity- Endometriosis often coexists with autoimmune conditions like Hashimoto's thyroiditis, suggesting a complex interplay between immune dysregulation and reproductive health. Autoimmune factors may indirectly impact hormone synthesis and action, contributing to the progression of endometriosis.

Dysbiosis - Several studies have revealed that individuals with endometriosis often exhibit gut microbiome dysbiosis, characterised by reduced species diversity. This imbalance between certain bacterial groups, such as Firmicutes and Bacteroidetes, can influence oestrogen levels, immune function, and the inflammatory response in the body. Furthermore, there is a lower prevalence of short-chain fatty acid (SCFA)-producing bacteria in individuals with endometriosis. SCFAs are vital for gut health, providing energy to colon cells, reducing inflammation, and supporting immune function. They also promote the growth of beneficial gut bacteria and contribute to overall metabolic health.

Allergy or Intolerance - Research shows that in some people, food allergies or intolerances may affect endometriosis. Most endometriosis sufferers benefit from strictly avoiding cow’s dairy and gluten, which can be profoundly immune-disrupting, which is a problem for a disease that is primarily about immune dysfunction.

Leaky Gut, or Intestinal Permeability- Arises when the intestinal lining sustains damage, permitting harmful substances such as toxins, bacteria, and undigested food particles to escape into the bloodstream. Factors such as a diet high in sugar, processed foods, and alcohol, along with chronic stress, imbalanced gut flora, food intolerances, chronic inflammation, and certain medications like NSAIDs, can all contribute to this condition. Consequently, leaky gut can trigger inflammation and potentially lead to various health issues, including endometriosis.

Genetics - Endometriosis seems to run in families, indicating a possible genetic link.

Solutions to Endometriosis

Support Healthy Circadian Rhythm: Maintain a regular sleep schedule, reduce exposure to artificial light at night, and practise good sleep hygiene.

Minimise Exposure to Toxins: Reduce exposure to pesticides, plastics, and contaminated water sources to lower the toxic body burden.

Optimise Diet: Focus on a diet rich in whole foods, high in fiber, and essential fats, while avoiding processed foods, caffeine, and alcohol.

Balance Hormones: Work with healthcare professionals to balance hormone levels and manage progesterone and oestrogen effectively. We love using the DUTCH test and Nutrigenomics testing is frequently used to help asses and balance hormones.

Manage Stress: Implement stress-reducing techniques such as mindfulness, meditation, and relaxation exercises to alleviate stress.

Incorporate Antioxidants: Incorporate antioxidant-rich foods such as a broad range of colouful plant foods into your diet to combat oxidative stress.

Support Liver Health: Maintain liver health through a balanced diet, adequate hydration, and liver-supportive supplements under professional guidance.

Boost Immunity: Support immune function with a balanced diet, regular exercise, and stress management techniques.

Promote Gut Health: Promote gut health through a balanced diet, probiotics, and prebiotics to restore microbial balance and combat dysbiosis.

Identify Food Sensitivities: Identify and eliminate potential food allergens or intolerances under professional guidance to address allergy or intolerance issues. We like the KMBO test for this

Gut Integrity: Support gut health with a diet rich in fibre, healthy fats, and probiotics, and minimise exposure to gut-damaging factors such as processed foods and medications to address leaky gut.

Focus on Lifestyle Modifications: While genetic factors may play a role in endometriosis, lifestyle and dietary modifications can still help manage symptoms and improve overall health.

Work with a practitioner to help you identify the root causes, and develop a personalised plan tto help you better manage your endometriosis. Find out how we can help.