Everything I Wish Women With Endometriosis Knew Sooner

Getting an endometriosis diagnosis can feel relieving at first (it’s not all in your head!), but then what the hell are you actually supposed to do about it?

As someone who had to advocate for many years for my own diagnosis and now works with women in every stage of their endometriosis journey, I know the frustration well. This post is everything I wish someone had told me about endometriosis and my full approach to supporting my clients. 

Conventional care tends to focus on two things for managing endometriosis symptoms: 1) surgery to remove endometriosis lesions; and 2) medications to control pain. These can both be extremely helpful, but they fall short of addressing what’s actually driving the endometriosis.

Endometriosis is a consequence of immune system dysfunction. 

A normal immune system will clean up harmful cells (including endo-like cells) before they become problematic. It often does this by temporarily creating inflammation (think about the 1-2 days of redness and pain you feel around a new cut in your skin). This becomes dysfunctional when your immune system is in overdrive and begins to confuse normal and abnormal cells.

This can show up as autoimmune conditions like Celiac Disease (intestines) or Hashimoto’s (thyroid), where the immune system attacks a normal part of your body. It can also show up as cancer, where the immune system isn’t able to recognize an abnormal cell, and even connects the cancer cells to a blood supply that allows them to grow. 

Endometriosis lesions show up when the immune system thinks endo-like cells need help instead of destroying, and mistakenly allows them to attach and become lesions with their own blood and oxygen supply. Then the lesions themselves start producing their own inflammatory factors and estrogen, which can fuel the growth of even more lesions and lead to hormonal imbalances.

So the big question is: what’s triggering chronic inflammation in your body and how do we stop it?

Whether you’re looking to reduce pain naturally, prevent recurrence after surgery, or optimize fertility, this is everything I use to support my endometriosis clients far beyond what their doctor is giving them.

1. GUT HEALTH

Your gut is the home of roughly 70-80% of your immune system, so it deserves a lot of attention! If you have low stomach acid, low digestive enzymes, constipation, intestinal permeability (“leaky gut”), or dysbiosis (an imbalanced gut microbiome), your immune system will ramp up inflammation. 

On top of that, dysbiosis in the gut can influence dysbiosis in other parts of the body, including the vaginal tract. A healthy vaginal microbiome supports implantation and reduces risk of miscarriage, and dysbiosis can further contribute to inflammation and even infertility. 

I highly recommend anyone with endometriosis get a GI-MAP stool test to assess digestive function and microbial balance, and follow a targeted plan from a practitioner to bring things back into balance. What you may know as “endo belly” could actually be a result of gut dysbiosis rather than endometriosis lesions themselves. 

2. ESTROGEN/PROGESTERONE BALANCE

Estrogen is often painted as the villain of endometriosis, and I can understand why. Estrogen encourages tissue growth, which is super important in building bones, muscle growth, and preparing your uterine lining for pregnancy. But it also contributes to endometriosis lesion growth, and the lesions themselves then produce more estrogen, and the inflammation cycle continues.

Progesterone opposes estrogen and is considered a calming hormone. If there isn’t enough progesterone compared to estrogen, it can lead to estrogen dominance. This makes heavy bleeding, PMS, headaches, and other common endometriosis symptoms worse. So we want to make sure you have plenty of progesterone by reducing stress, nourishing your body well, and supporting ovulation (because you only make progesterone after you ovulate!). 

We also want to support normal estrogen levels by removing endocrine-disrupting chemicals from personal care products, supporting gut health (because the gut clears out excess estrogen), and eating plenty of cruciferous veggies to support estrogen detoxification. 

3. BLOOD SUGAR STABILITY

Every time you eat carbs, your blood glucose levels rise. Insulin rises along with it to help your cells use that glucose to create energy. It’s normal for blood sugar to fluctuate up and down during the day, but creates problems when it spikes too high or too low. 

High glucose and insulin levels contribute to endometriosis pain, inflammation, and tissue damage. Low glucose levels create an increased demand for stress hormones like cortisol, which raise blood sugar to keep you going in the absence of enough food. The fatigue, energy crashes, and mood changes you might associate with endometriosis could actually be a blood sugar rollercoaster. 

It’s important for anyone with endometriosis to be mindful of blood sugar stability by eating balanced meals (always pair carbs with protein, fat, and fiber), avoid skipping meals, getting adequate sleep, supporting healthy mineral levels (needed for cells to use glucose well!), and move their body regularly. 

4. THYROID FUNCTION

Women with endometriosis are more likely to have thyroid issues, including autoimmune thyroid issues like Hashimoto’s. The connection makes sense because they share a lot of the same drivers – nutrient deficiencies, inflammation, immune dysregulation, and toxin exposure. 

Your thyroid’s job is to create hormones that go on to tell the cells in your body how much energy to produce. Low thyroid function often leads to constipation, fatigue, blood sugar instability, and other hormone imbalances (all of the things we’ve already talked about as super important to address for endo!). It can also lead to hair thinning, feeling cold all the time, brain fog, and heavy or irregular periods. 

It’s important to advocate that your provider properly assess thyroid function with a full bloodwork panel (not just TSH!) and to assess for nutrient deficiencies that could be contributing to thyroid issues. 

5. LIVER SUPPORT

Your liver is filtering waste from your bloodstream and packaging it for elimination through bile (via your gut) and urine (via your kidneys). This includes endocrine-disrupting chemicals like BPA, dioxins, glyphosate, parabens, and phthalates.

Some of these chemicals act as xeno-estrogens, worsening estrogen dominance. They can also trigger inflammatory responses in the immune system, disrupt your gut microbiome, and affect thyroid function. Problems arise when you’re deficient in key nutrients your liver needs to detox chemicals, or the toxic burden is simply too high for your body to keep up with (or both!). This leads to symptoms like headaches, PMS, painful periods, skin issues, and even sensitivities to fragrances. 

It’s important to slowly swap out toxic household products, drink filtered water, and breathe clean air to prevent your detox pathways from becoming burdened. Your liver also needs plenty of protein, B vitamins, antioxidants, cruciferous vegetables, and bitter foods to do its job well. 

6. NERVOUS SYSTEM

Your nervous system constantly takes in information from your body and carries messages back and forth from your brain to appropriately respond to stress. We often think of stress as things that happen to us, but all of the things we’ve talked about so far can also be a form of stress – undereating, poor gut health, poor detoxification, blood sugar instability, hormone imbalances, etc. Your nervous system will respond to all of it the same way. 

Inflammation is also its own stressor, so endometriosis itself contributes to a chronically activated fight-or-flight response. It’s extremely important that stress be reduced in whatever ways possible, and that you practice nervous system regulation regularly (breathwork, meditation, movement, somatic practices, etc.) to encourage a parasympathetic (rest-and-digest) state to support full body balance and help reduce pain signals. 

7. PELVIC FLOOR PHYSICAL THERAPY

Pelvic floor physical therapy for endometriosis doesn’t get nearly as much attention as it deserves! As a society, we’re sitting down for huge portions of our day, often with bad posture. Over time, these positions can limit blood flow to the pelvic region and affect our breathing mechanics. That contributes to nervous system activation in and of itself, and it also contributes to even more inflammation as the body constantly tries to rebuild tissue to increase normal blood flow, ultimately contributing to the formation of lesions. 

You can mitigate this with pelvic floor therapy (send me a message if you need a good at-home program recommendation!), practicing diaphragmatic breathing (lots of free online tutorials for this), finding time to stretch and move throughout the day, and being more active in general.

There’s nothing wrong with using conventional tools like excision surgery and medications to help manage endometriosis, but your body deserves a holistic, root-cause approach to reduce symptoms as much as possible and prevent progression of this disease.

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Ready for a holistic, root-cause approach to managing endometriosis?

If you’re ready to go beyond symptom management and address what’s actually driving endometriosis, this is exactly what I help women do in my practice. You can learn more about my approach and apply to work with me here.

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