Understanding Endometriosis: More than Just "Bad Cramps"

Healthy View

Written by: Dr. Atousa Faraz, ND, Naturopathic Doctor, Adelaide Health Clinic

Endometriosis is a chronic condition that affects around 10-15% of women during their reproductive years (Obrycka et al., 2024). It occurs when tissue similar to the uterine lining grows outside the uterus, most commonly on the ovaries and pelvic lining. In some cases, this tissue can grow deeper into nearby organs and structures such as the lungs, spine, intestines, bladder, and kidneys. Since this tissue responds to monthly menstrual cycles, it bleeds just like the uterine lining would, but with no exit path. It, therefore, can lead to chronic inflammation, scar tissue formations, and adhesions. The result will be pain and other symptoms that vary depending on where the endometrial tissue is located. 

Though commonly diagnosed in women of reproductive age, endometriosis can also appear in teenagers and even postmenopausal women, particularly those with structural uterine issues (Agostinis et al., 2021). The development of this condition is influenced by a combination of genetic, hormonal, immune, and environmental factors (Agostinis et al., 2021). A growing body of research suggests that immune dysfunction may play a key role. Women with endometriosis often show abnormal immune cell behaviour and higher levels of inflammation in the pelvic region (Agostinis et al., 2021). 

As a functional and naturopathic medicine practitioner, I see women with endometriosis and unfortunately, their path to a diagnosis is usually long and frustrating. Many women see multiple healthcare providers, sometimes five or six, before being diagnosed. Pain is usually the most recognizable symptom, but it’s often dismissed as “just part of being a woman.” For those not actively trying to conceive via Assisted Reproductive Technologies such as IVF, their fertility struggles may go unnoticed or unaddressed. 

A Functional and Naturopathic Medicine Perspective: Root-Cause Healing for Endometriosis

From a functional and naturopathic medicine standpoint, endometriosis is not just a reproductive issue, it’s a whole-body condition. The goal isn’t just to suppress symptoms or remove lesions but to identify and address the root causes contributing to inflammation, hormonal imbalances, and immune dysfunction. 

Here are some core principles of a functional, naturopathic approach: 

Gut Health & the Microbiome: Recent research has begun to explore the role of the microbiome, specifically the bacterial communities in the gut, pelvic fluid, and reproductive tract, in connection to endometriosis (Uzuner et al., 2023). Emerging evidence suggests that certain microbial patterns may be linked to the development and progression of the condition (Colonetti et al., 2023). These insights open the door to potential non-invasive, targeted treatments aimed at restoring immune balance. Supporting the gut lining and promoting a healthy microbiome may help reduce systemic inflammation and enhance hormonal byproduct elimination. Approaches may include an anti-inflammatory diet, the use of targeted probiotics, and digestive support strategies. 

Progesterone Therapy: The role of progesterone as an anti-inflammatory hormone may be more complex than previously understood. While progesterone can help control the growth of lesions, some women with endometriosis exhibit progesterone resistance (Obrycka et al., 2024). Reducing systemic inflammation may help decrease this resistance. Diets rich in polyunsaturated fats, such as those containing fish oils, have shown promise in supporting this approach (Hopeman et al., 2015). 

Liver Detoxification: The liver plays a central role in processing estrogen, largely through the activity of the cytochrome P450 enzyme family. Research has identified several genetic variants within the cytochrome P450 family that are present in women with endometriosis (Bento et al., 2019; Wang et al., 2012). Supporting both phase I and phase II liver detoxification pathways can enhance the body’s ability to metabolize and eliminate excess estrogen, helping to reduce estrogen dominance, a common factor in endometriosis. 

Immune System Modulation: Since endometriosis involves immune dysfunction, supporting immune system regulation through stress reduction, sleep hygiene, and anti-inflammatory nutrients (like omega-3s and vitamin D) is essential (Xie et al., 2024). 

Personalized Nutrition Plan: A whole-food, anti-inflammatory diet serves as a cornerstone of treatment. I collaborate closely with my patients to develop personalized plans tailored to their individual needs, preferences, and health goals. This approach not only supports hormonal balance but also helps reduce systemic inflammation, which may improve overall treatment outcomes. 

Final Thoughts

Endometriosis is a complex, multifaceted condition that deserves more than symptom management, it requires a thoughtful, root-cause approach. By integrating functional and naturopathic medicine, we can begin to unravel the interconnected factors driving endometriosis and work toward true healing. 

If you are tired of feeling dismissed or are looking for a more comprehensive and personalized strategy, I invite you to take the next step. Book a consultation today and let's explore how I can support your health journey together. 

About the Author

Dr. Atousa Faraz, BSc (Hon), ND has been educating, treating, and supporting patients with a wide range of health concerns for nearly two decades. She practices with a functional medicine lens, taking an individualized approach to uncover the root causes of illness. Dr. Faraz integrates evidence-informed therapies with a holistic perspective to support lasting health and well-being.

Disclaimer:  

The medical information and general information in this article are provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-doctor relationship and should not be used as a substitute for professional advice, diagnosis, and treatment. 

Please consult your health care provider before making any health care decisions or for guidance about a specific medical condition. Dr. Atousa Faraz BSc (Hon), ND, expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered because of your reliance on the information contained in this article. 

References: 

Agostinis, C., Balduit, A., Mangogna, A., Zito, G., Romano, F., Ricci, G., Kishore, U., & Bulla, R. (2021). Immunological Basis of the Endometriosis: The Complement System as a Potential Therapeutic Target. Frontiers in Immunology, 11, 599117-. https://doi.org/10.3389/fimmu.2020.599117 

Bento, I., e Silva, K., Moura, K., Ribeiro, C., & da Costa, I. (2019). CYP2C193 polymorphism in patients with endometriosis. Genetics and Molecular Research, 2. https://doi.org/10.4238/gmr18199 

Colonetti, T., Saggioratto, M. C., Grande, A. J., Colonetti, L., Junior, J. C. D., Ceretta, L. B., Roever, L., Silva, F. R., da Rosa, M. I., & Patini, R. (2023). Gut and Vaginal Microbiota in the Endometriosis: Systematic Review and Meta-Analysis. BioMed Research International, 2023(1), 2675966–2675966. https://doi.org/10.1155/2023/2675966 

Hopeman, M. M., Riley, J. K., Frolova, A. I., Jiang, H., & Jungheim, E. S. (2015). Serum Polyunsaturated Fatty Acids and Endometriosis. Reproductive Sciences (Thousand Oaks, Calif.), 22(9), 1083–1087. https://doi.org/10.1177/1933719114565030 

Obrycka, P., Soczynska, J., Gawelczyk, W., Tomecka, P., & Mozdziak, P. E. (2024). Endometriosis – hormones and treatment. Medical Journal of Cell Biology, 12(2), 54–60. https://doi.org/10.2478/acb-2024-0008 

Uzuner, C., Mak, J., El-Assaad, F., & Condous, G. (2023). The bidirectional relationship between endometriosis and microbiome. Frontiers in Endocrinology (Lausanne), 14, 1110824– 1110824. https://doi.org/10.3389/fendo.2023.1110824 

Wang, H.-S., Wu, H.-M., Cheng, B.-H., Yen, C.-F., Chang, P.-Y., Chao, A., Lee, Y.-S., Huang, H.-D., & Wang, T.-H. (2012). Functional analyses of endometriosis-related polymorphisms in the estrogen synthesis and metabolism-related genes. PloS One, 7(11), e47374–e47374. https://doi.org/10.1371/journal.pone.0047374 

Xie, B., Liao, M., Huang, Y., Hang, F., Ma, N., Hu, Q., Wang, J., Jin, Y., & Qin, A. (2024). Association between vitamin D and endometriosis among American women: National Health and Nutrition Examination Survey. PloS One, 19(1), e0296190–e0296190. https://doi.org/10.1371/journal.pone.0296190