Endometriosis Treatment
How the treatment of Endometriosis may start with building a healthy gut microbiome
Most women will have heard of endometriosis, and an estimated 10% will have experienced it themselves. That means thousands of women around the world know how painful and frustrating it can be.
But what many women don’t know is why they have Endometriosis. In fact, it is described as a ‘mysterious disease’ as the exact cause is not yet certain. This is a big part of why treatment is so much more difficult.
Research suggests that one of the main causes of Endometriosis is retrograde menstruation, in which menstrual blood passes through the fallopian tubes and transfers endometrial cells to the peritoneal cavity. (The peritoneum is the membrane which lines our abdomen and the peritoneal cavity is the space between the layers of membrane.)
Endometriosis tends to run in families, which suggests a genetic link. Hormonal imbalances are also suspected, as estrogen appears to promote endometriosis.
Environmental, epigenetic, autoimmune and allergic risk factors have also been linked to the development of endometriosis.
Recent research has helped to shed new light on another possible cause: the gut microbiome.
The role of the microbiome in managing oestrogen
There is increasing interest in how gut microbiota or gut flora is involved with the development of endometriosis.
Endometriosis is influenced by both the breakdown of oestrogen metabolism and inflammatory processes in the body, which in turn are modulated by many other factors, including the gut microbiome and estrobolome.
Estrobolome is the collection of gut bacteria that metabolises oestrogen and thus has a major influence on oestrogen levels.
Estrobolome activity modulates how much excess oestrogen is removed from or reabsorbed into the body. But when gut imbalances impair this activity, the excess oestrogen may not only stay in the body but can travel from the gut to the endometrial and peritoneal cavity, triggering endometriosis.
The estrobolome and endometriosis
Oestrogen dysregulation is one of the main factors in endometriosis, as well as in infertility and pelvic pain. As explained above, both the estrobolome and the gut microbiome can influence circulating levels of oestrogen.
The metabolism of oestrogen in the gut involves enzymes from specific gut bacteria, and studies show that dysbiosis (imbalance in the gut flora) in the gut or genital microbiota is associated with a range of gynecologic conditions, including Endometriosis and Infertility. Changes in the gut microbial composition can then result in higher or lower levels of oestrogen, which can have widespread impact on the body.
The menstrual cycle is regulated by the production of oestrogen and progesterone which then influences the receptivity of the endometrium. Dysregulation of estrogen production or its metabolism could lead to dysregulation of the menstrual cycle, which then impacts the function of the endometrium.
Women with endometriosis also typically have higher levels of inflammation, which is a major factor in pain symptoms. Inflammation, immune dysregulation, and hormonal imbalance have all been linked to changes in the microbiome. Dysbiosis in the gut and female reproductive tract disrupts normal immune function, leading to inflammatory responses by increasing proinflammatory cytokines (molecules that promote inflammation) and compromising immune cell function. This immune dysregulation can lead to chronic inflammation, which promotes increased adhesion and angiogenesis (the formation of new blood vessels), potentially driving endometriosis onset and progression.
Harmful bacterial species in the endometrium may also contribute to endometriosis. Bacterial vaginosis has been shown to increase levels of proinflammatory cytokines that damage epithelial barrier function, which may then increase the risk of developing further health issues.
Gastrointestinal disorders such as IBS may also play a key role in contributing to endometriosis and related disorders. Many women with endometriosis are also affected by IBS or other inflammatory gut issues, and it has been suggested that dysbiosis of the gut microbiome may trigger or worsen oestrogen-related conditions. Endometrial lesions often grow on the peritoneal cavity on top of the ovary, which is close to the gut.
While research into ‘the microbiome link to endometriosis’ is continuing, current evidence highlights the importance of gut health for all women. Optimising gut microbiome may support immune function, reduce dysbiosis, and prevent the inflammatory processes associated with the development of endometriosis.
How to build a healthier gut microbiome naturally
Take probiotics
Probiotics play significant roles in gut microbiota composition, which can inhibit the colonization of harmful bacteria, help build a healthy gut lining, and boost the immune system. Some studies have already shown that certain species of probiotics such as Lactobacillus are effective in treating endometriosis. This adds weight to the theory that the gut microbiome is involved in the progression of endometrial dysfunction.
Eat a balanced, healthy diet
A diet rich in both whole foods and fermented foods is essential for a healthy gut.
Limiting caffeine, alcohol, and foods that contain high amounts of sugar, trans fats, and/or artificial additives is also recommended.
Foods to improve gut health include:
Fresh fruits and vegetables (organic where possible)
Grains or gluten-free grains
Fibre-rich foods such as nuts, seeds, wholegrains
Healthy fats such as fatty fish, avocado, olive oil, eggs
Fermented foods such as yoghurt, kefir, sauerkraut, miso, natto
Manage stress levels
Stress is known to deplete healthy gut bacteria and contribute to dysbiosis. Techniques such as meditation, yoga, or other mindfulness exercises can help to reduce the stress response and even help restore gut bacteria. Studies have shown that mindfulness-based therapies can significantly improve gut bacteria and increase bacterial diversity. Researchers believe this is due to gut-brain axis communication.
Exercise regularly
Exercise is a powerful environmental factor that can determine changes in the qualitative and quantitative gut microbial composition. Exercise enriches microflora diversity and improves the species of bacteria shown to assist in weight loss and gastrointestinal disorders, and also stimulates bacteria capable of producing substances such as short-chain fatty acids that protect against gastrointestinal disorders. Regular exercise is recommended as a treatment to maintain the balance of the microflora or to rebalance dysbiosis.
Getting help with your endometriosis
Like many gynaecological conditions, there is no ‘one treatment that fits all’ approach with Endometriosis. Of course, every case is unique, and your own symptoms and drivers will be completely different from one woman to the next.
It can be very confusing when searching the internet for natural solutions to health conditions such as Endometriosis. That’s why it’s so important to seek treatment from a qualified naturopath who has a special interest in reproductive medicine such as myself.
You can feel rest assured that I’ve been working with women with various reproductive health complaints including endometriosis for over 20 years.
As an Acupuncturist, Chinese Medicine Practitioner and Naturopath, I use an integrative and holistic approach to the management and treatment of Endometriosis.
If you are interested in having a 15 minute complementary chat with me about how I can help you with your condition please contact me here. To book either an in person on online Naturopathy appointment please click here.
