Endometriosis and Functional Medicine

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 ovaries or fallopian tubes. 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 starts to break down and bleed, but there is no exit route for the old tissue to leave the body. This leads to inflammation and pain as the immune system tries to clear the misplaced tissue.

Symptoms include:

  • Painful periods (dysmenorrhea).
  • Pelvic pain and cramping which may begin before and extend several days into a menstrual period.
  • Pain with intercourse.
  • Pain with bowel movements or urination.
  • Excessive bleeding.
  • Infertility.

Doctors still don’t know exactly what causes endometriosis but there are a number of theories:

  • Some scientists have suggested that the endometrial tissue migrates backwards through the fallopian tubes. The theory is that this can then settle elsewhere in the pelvic cavity or travel via the blood and lymph to 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.

In both situations there seems to be altered functioning of the immune system, stopping it from recognising the misplaced tissue or from effectively removing it.

Apart from being very painful, endometriosis can also lead to fertility problems. The constant inflammation around the areas of misplaced tissue can lead to the formation of scar tissue. Sometimes the scar tissue develops in a way that causes two structures to become stuck together, an adhesion. These adhesions can block the passage of an egg through the fallopian tube or cause the womb to become misaligned. Endometriosis on the ovaries can also cause the development of chocolate cysts. These are blood filled sacs on the ovaries that can interfere with normal ovulation.

The only definitive way to diagnose endometriosis is by laparoscopic surgery – an operation in which a camera is inserted into the pelvis via a small cut near the navel. The surgeon uses the camera to see the pelvic organs and look for any signs of endometriosis.

There is no cure for endometriosis so medical treatment focuses on managing the symptoms.

Functional medicine takes a more holistic view of endometriosis. A typical support protocol will include steps to:

  • Support the immune system.
  • Address gut health as this directly impacts the immune system.
  • Balance female hormone levels and support the hormone detoxification pathways.
  • Remove any foods that might be contributing to inflammation and immune distress.
  • Assess any environmental exposures that might be contributing to the endometriosis.
  • Put in place an anti-inflammatory diet and supplement protocol.