Holistic Approaches for Endometriosis

Girl, “endo belly” and SIBO are so not fun. Note: I am not pregnant in this photo. This was taken around the time I was given a presumptive diagnosis of endometriosis, and many women will call this their “endo belly.”

Since this photo years ago, I have personally and professionally learned integrative ways to help women (and myself) better care for their “endo” formally, known as endometriosis.

What is endometriosis

“Endometriosis is a systemic, inflammatory disease characterized by the presence of endometrial-like tissue found in extrauterine sites.”( Kennedy S. et al., 2005; Klemmt et al., 2018; Saunders et al., 2021). This complex condition affects up to 10% of women of reproductive age worldwide and despite its high prevalence, women on average wait 9 years for a diagnosis!

With endometriosis, the “endometrial like tissue” doesn’t exit the body the way normal menstrual shedding does, and these growths become trapped within the pelvic region, often forming lesions or “growths” on organs such as the ovaries, fallopian tubes, and even the bowel and bladder in some cases. In my situation we did a colonoscopy to see if there were growths into my colon as I had some rectal bleeding too, but there was not thankfully.

What causes endometriosis?

While the exact cause of endometriosis is unknown, researchers believe it may be due to a genetic predisposition, hormonal factors, underling inflammation, immune system dysregulation and environmental exposures as possible causative or exacerbating factors.

Endometriosis signs and symptoms:

Endometriosis affects each women differently in terms of her symptoms and the severity. While endo can be asymptomatic, common patient reported experiences related to the reproductive system include:

Painful periods
Heavy menstrual periods
Menstrual bleeding in between cycles
Pelvic and/or low back pain
Pain during sex

Endometriosis is not considered “just a reproductive condition” and these symptoms can occur in other places throughout the body as growths can spread throughout the body:

Pain with bowel movements
Painful urination
Chronic fatigue
“Endo belly” – Gastrointestinal issues such as bloating, nausea, and diarrhea
Infertility or difficulty getting pregnant which is often what leads to a diagnosis of endometriosis
Anxiety

This is a non-exhaustive list but most common symptoms.

How is endometriosis diagnosed?

Imaging, review of medical history, and pelvic exams can all be used to help diagnose endometriosis. But, a confirmed diagnosis can only be made with a laparoscopy (surgical procedure) and biopsy of visualized tissue. There are stages of endometriosis: one through 4; sometimes women have stage 1 and excruciating pain and some women with stage 4 have minimal symptoms.

Both of my maternal and paternal grandmothers had hysterectomies in their 30s due to deep infiltrating endometriosis with heavy bleeding. I have a presumptive diagnosis from OB/GYN from imaging, family history and former symptoms which have improved with drastically with the holistic approach I took. I was offered surgery, birth control and lupron which I did decline all 3 options years ago, but

I understand that sometimes these are the best option for some women depending upon their health scenario.

Conventional care approaches to endometriosis

The recommendations often include hormonal birth control to mask symptoms and rhetoric is “to control growth” but data is mixed with this approach in regards to the efficacy of managing the disease and controlling the symptoms; birth control is not curative but an option in an attempt to control symptoms.
Excision and ablation surgery help remove growths and this can be supportive for conception if endometriosis had been a barrier to conception. Surgery is also necessary in some cases as endo can have tertiary problems,meaning further health complications that arise as a result of the condition itself.
Hysterectomy is a recommendation in a lesser amount of cases.

Limitations to conventional care approaches

Some listed studies (see below) actually have data showing birth control increases risk of endometriosis later in life.
Hormonal birth control has risks including: it is a group 1 carcinogen, increases risk of depression, blood clots, hypertension, and insulin resistance. Some women are also not candidates for hormonal birth control.
Excision and ablation surgery have risks and downsides too: undergoing anesthesia and possible complications from surgery; not getting relief from pain and pain worsening; dealing with recovery, time off work and out of pocket costs if not covered
Hysterectomies are done in some cases but also not considered curative. Some view as drastic measure especially in a younger woman, but endometriosis can be life threatening in some situations. The risk/reward of this method must be weighed with the surgeon.

The hard question I want to ask: if you are pursuing surgical interventions or prescriptive interventions…what is triggering the underlying inflammation, immune system dysfunction in the first place and is there toxin or biotoxin exposure or bioaccumulation?

If these (sometimes modifiable) root issues are still present, how helpful will conventional approaches be and what is “the end game” of possible ongoing surgeries if there are root culprits not being addressed? This is the side of coin many in the integrative/holistic space will bring up.

I personally know women who have gone under the knife many times with no relief and regret surgery; in the same breath I know surgery has helped many of my friends conceive and control pain. It is definitely a conversation with a skilled surgeon but the point I am bringing up for this blog is: have you overturned all the possible stones that might be driving factors? Could you look at deeper root causes instead of symptom management (while important) alone?

Holistic and Integrative approaches to endometriosis:

I love this world because it is generally low to no risk and high reward. No complementary or alternative approaches for endometriosis are yet seen as curative but can be beneficial in regards to reducing (and sometimes resolving) symptoms, decreasing or slowing growths, and increasing quality of life. This is a non-exhaustive list, but below are top areas I explore with patients:

1. Find and address heavy metal bioaccumulation. It is well documented in medical databases that exposure to heavy metals increases risk of developing endometriosis. We also know that heavy metals, such as lead, cadmium, and mercury, can worsen endometriosis by acting as endocrine disruptors and potentially promoting the growth and spread of the endometrial like tissue. These metals can interfere with hormone signaling, particularly estrogen, and may contribute to inflammation and oxidative stress, all of which can exacerbate endometriosis symptoms. Given this it is crucial to pursue supporting the body in innate metabolic detoxification when applicable. I also am a huge advocate for tap water avoidance when it comes to drinking. RO and distilled water only for drinking is a must and getting minerals from other sources. Using targeted binders is also a tool in my toolkit.

2. STOP buying endocrine disrupting skincare & haircare. Avoid products with ingredients like phthalates, BPAS, parabens which worsen inflammation and disrupt normal hormone signaling. Buy organic only if possible which is not perfect but better.

3. Stop using conventional feminine products with endocrine disruptors like BPAs, dyes, fragrances, bleaches. Get organic only products. You don’t want these toxicants having direct access to your vascular system for about 20% of your reproductive years. It ADDS UP!

3. Find and address gut dysbiosis; SIBO and endometriosis are bidirectional meaning they can influence each other’s development and progression. Endometriosis can create conditions that favor SIBO, and SIBO, in turn, can exacerbate symptoms and potentially contribute to the progression of endometriosis. Get a GIMAP test an/or SIBO breath test, find and eradicate, and deal with the reasons the SIBO grew in thee first place, like low stomach acid or mold exposure. Also, screen for and correct nutrient deficiencies that are common with SIBO; this is to optimize digestion and absorption and decrease reoccurrence of intestinal microbial growth.

4. Eat an anti-inflammatory diet and screen for and correct nutrient deficiencies and provide targeted nutrition to optimize levels. This supports phase 1 and phase 2 liver detoxification – which are the body’s pathways of packaging up and shipping out toxicants. Optimize the following in the diet or take via supplement as appropriate: zinc, magnesium, omega 3, propolis, quercetin, curcumin, N-acetylcysteine, probiotics, resveratrol, alpha lipoic acid, vitamin C, vitamin E, selenium.

5. Pursue mold inspection and remediation. Certain molds are estrogenic and mold is inflammatory for the body and can lead to a diagnosis of CIRS. Start with checking the home for clinically significant levels via an ERMI at home dust test. If elevated, pursue hiring a certified mold inspector for remediation and whole home small particle cleaning. Pursue an evidenced based detox program to help eliminate the mycotoxins from your body. I am the only Dr. Shoemaker Proficiency Partner in the country who accepts insurance.

6. Reduce EMF exposure in your home and on your cell phone. Some studies have shown that EMF exposure can induce oxidative stress, apoptosis, and alterations in gene expression in endometrial cells in vitro and in animal models. However, these findings do not establish a causal relationship with endometriosis in humans. Regardless, EMFs are arguably not good in general for the human body. Take this cook out of the kitchen. “I’ve seen what I needed to see” so far with all the data coming out on EMFs and the ways they harm human health. If we ever the study the totality of exposures, I bet we won’t like what we find. Get a EMF mitigator(code HEAL25 for 25% off and free shipping) for your home and err on the side of caution.

7. Use Red light therapy, also known as low-level laser therapy (LLLT). This at home therapy shows promise as a complementary treatment for endometriosis, potentially alleviating pain and reducing adhesions. Studies suggest that red light therapy can improve pain, inflammation, and potentially even enhance the endometrial lining for embryo implantation if TTC. Treatment protocols vary, but some studies have shown success with 1-3 sessions per week for 4-8 weeks. Red light therapy is considered a safe and effective method for reducing pain and improving the quality of life for women with endometriosis, according to medical research databases.

There are thankfully a multitude of options to improve life with endometriosis. For me, eradicating SIBO, heavy metal detoxing, switching to organic pads and tampons drastically reduced my bloating, my pain, and took my menstrual blood from dark, thick blotted, to red, normal flow. I maybe use one ibuprofen on the first day of my cycle and hold my red light device over my pelvic region, but it became pretty much smooth sailing.

When I think back to the days of high school in college where I would vomit and lay in the fetal position and cry, I have come along way. My wish for you is that you get the relief like I did from overturning other stones. Many women with endometriosis get better with “giving the body what it needs and taking out what it doesn’t.”

Schedule a consultation package if you would like one on one assistance.

Studies on Endometriosis:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8820085

https://pubmed.ncbi.nlm.nih.gov/16580400

https://pubmed.ncbi.nlm.nih.gov/23157050

https://pubmed.ncbi.nlm.nih.gov/18265901

https://pmc.ncbi.nlm.nih.gov/articles/PMC4560478

https://drseckin.com/can-parasites-cause-endometriosis

https://www.pathologyjournal.rcpa.edu.au/article/S0031-3025(24)00288-5/fulltext

https://pubmed.ncbi.nlm.nih.gov/29668354

https://pubmed.ncbi.nlm.nih.gov/36199735

https://pubmed.ncbi.nlm.nih.gov/39683382