The Truth About Endometriosis
Thanks to celebs like Amy Schumer, Chrissy Teigen, Halsey, Padma Lakshmi, Bindi Irwin and Julianne Hough, who’ve all revealed they have endometriosis, people are much more familiar with the condition, yet it’s still somewhat mysterious. Doctors and researchers are flummoxed by what causes it. Approximately 10 percent of women have it and it’s a significant factor contributing to infertility.
Endometriosis occurs when cells that are normally found only inside the uterus migrate out and onto nearby structures in the pelvis. The cells can adhere to the bladder, intestines, ovaries and fallopian tubes—they’ve even been found on the diaphragm. Symptoms can include severe abdominal pain, back pain, spotting, urinary and bowel problems and painful intercourse.
Since they’re growing where they aren’t supposed to, these cells are highly inflammatory, which is one cause of the pain. Endometriosis can result in the loss of a fallopian tube, the buildup of scar tissue, and even poor egg quality. In fact, about 30 to 50 percent of women who are struggling with infertility have endometriosis, according to the American Society for Reproductive Medicine.
The sneaky thing about endometriosis is it’s hard to diagnose definitively without a laparoscopy (looking inside the abdomen with a long tube fitted with a camera). You can have horribly painful and heavy periods but have very little extra-uterine endometrial tissue (aka “implants”) or you can have a lot of extra-uterine tissue with very little pain and other symptoms. If you do have symptoms, including fertility challenges, and your doctor isn’t willing to do some more digging, it’s time to get a new doctor!
What To Do
The first thing I recommend for my endometriosis patients is to start an anti-inflammatory (AI) diet. It’s not going to cure the problem, but it can potentially help tame some inflammation. AI diets don’t have to be restrictive, although certain versions can be. They put the focus on eating vegetables, fruits, nuts, legumes, whole grains and fish rich in omega-3 fatty acids. (I like Dr. Andrew Weil’s Anti-Inflammatory Diet and Food Pyramid.) These foods are high in fiber and other plant compounds that have beneficial effects on the gut microbiome, the community of bacteria residing in your colon that plays a role in all aspects of your health, including reproductive health.
Obviously, you should try to reduce your intake of ultra-processed foods, alcohol, sugar, trans and saturated fats and any foods that you know you’re sensitive or allergic to. These foods can be highly inflammatory.
The most common treatments for endometriosis include hormones or other medications that suppress estrogen (fuel for endometriosis) and laparoscopic surgery. There’s a flurry of endometriosis research going on right now, perhaps since people are much more willing to talk about it than they were 10 years ago. We’re learning more about how this condition affects the body, links to the gut microbiome, and whether some new medications may help suppress it.
In addition to dietary shifts, integrative approaches, such as acupuncture and Chinese herbs, can help you manage some of the symptoms of endometriosis and may even help decrease some of the inflammation and tissue growth.
Wherever you seek treatment, it’s important to find someone who can explain the ways endometriosis can affect fertility and some of the treatment options. In my practice, I work with patients and help them find doctors who specialize in treating endometriosis with an eye toward boosting fertility. Don’t be afraid to advocate for more investigation and education.
