Natural Approaches to Managing Endometriosis

Endometriosis (“endo”) is a condition that affects roughly 10 to 15% of women between the ages of 24 and 40. It’s commonly recognized as a triad of symptoms: dysmenorrhea (painful periods), dyspareunia (painful sex) and infertility (the inability to conceive a child).[1]  While these are three common symptoms associated with endo, other symptoms may include pelvic pain, painful bowel movements, gastrointestinal or urinary tract problems, and fatigue.

What is Endo?

The cause of endometriosis is still not known, however one perspective is that endo occurs when cells that mimic the endometrial lining inside the uterus implant themselves outside of the uterus.  Very specifically, the cells grow where they’re not supposed to grow. These implants can also travel to other areas of the body like the bowels, bladder and ovaries. Because these implants are part of the female reproductive organs, they respond to hormonal signals from the body. During a woman’s period, the endometrial lining would normally be shed through her uterus. Because the endo implants are outside of the uterus, this cannot happen. These implants respond to hormonal cues but are trapped between layers of tissue and cannot shed their lining. This leads to inflammation, adhesions, scarring and many of the symptoms associated with endo.

Causes of Endo

The medical community hasn’t pinpointed an exact cause for endo, although many theories exist. One such theory is that endo results from retrograde flow, the backwards flow of menstrual blood during a woman’s period. However, more than 90% of women are likely to experience retrograde flow at some point during their periods and may or may not have endo. Another theory is that endometrial cells are more likely to implant in women who have weaker cell immunity or immune systems. [2]

The theory that’s gained the most prominence suggests that excess estrogen plays a role in either causing or worsening endo symptoms. This excess estrogen can come in many forms: in foods such as meats and cheeses, phthalates in skincare products, PCBs from plastics like water bottles, and dioxin, a toxin commonly found in drinking water. These external estrogens that negatively affect the body are called xenoestrogens. When absorbed into the body, xenoestrogens alter the balance of our bodies’ natural hormones, which can result in many of the endometriosis symptoms reported by women.

Endo tissue responds to hormones, so if a woman were exposed to high sources of xenoestrogens on a daily basis, this exposure would perpetually trigger a response from the endo tissue.

Natural Approaches to Endo

Endodoesn’t just affect one area of the body; it affects the whole person. The philosophy of a natural healthcare practitioner such as a naturopathic doctor or a holistic nutritionist is to treat the whole person, not simply a symptom. Natural healthcare practitioners believe in finding the root cause in order to alleviate the symptoms permanently.  This works in many ways. As we’ve previously mentioned, endo symptoms can vary widely, from pelvic pain to gastrointestinal problems to fatigue, and women with endo may have a weaker immune system than women who don’t. As a result, every woman’s experience with endo will be unique and different — no two women will experience it in the same way.  By looking at the individual as a whole person, the natural healthcare practitioner can assess what treatment plan is best. In natural healthcare, there is no shortage of options to manage endo symptoms.

Let’s consider diet. Lots of research suggests women with endo are sensitive to gluten[3], a protein composite in grains that is essentially the “glue” to keep things together and help food keep its shape.  As well, there appears to be a link between endo and candidiasis, an overgrowth of yeast in the body that can cause a variety of symptoms. By addressing gluten and candidiasis issues with a changed diet, a woman may experience a reduction in her endo symptoms. A further body of research suggests a vegetarian diet low in saturated fats can also help reduce endo symptoms. While there are many benefits to adopting this type of diet, one important benefit is the two-fold reduction in sources of xenoestrogens. By cutting down on animal products like meats and dairy from your diet, you reduce a source of xenoestrogens.  Second, vegetarian diets tend to be higher in fibre, especially if you’re eating lots of veggies, which is necessary for healthy, regular bowel movements. The fibre will also bind to excess estrogen in our bodies and will get rid of it when we have a bowel movement. Fewer xenoestrogens can mean fewer endo symptoms.

While modifying your diet is an important strategy for reducing endo symptoms, sometimes it’s not enough. A naturopathic doctor (ND) can help you at this stage. NDs are trained as primary healthcare doctors, as well as trained in many different modalities such as acupuncture, homeopathic medicine, traditional Chinese medicine, herbs and lymphatic drainage. An ND can offer many different treatment options for women looking to manage their endo symptoms naturally. Botanical medicines such as Vitex agnus castus, used to help balance women’s hormones, and motherwort, used to soothe cramping muscles, are anti-spasmotics that reduce cramping and increase progesterone (the counterbalancing hormone to estrogen). An ND can tap into any of these modalities to devise an individual treatment plan that treats the endo symptoms while considering the needs of the individual woman. There are many well-researched natural options to manage endo symptoms, and a natural healthcare practitioner can help you find the right treatment for you.

Dr. Joseph Steyr, ND, is a Naturopathic Doctor with a focus on endocrinology (hormones). He brings a blend of conventional medical sciences and traditional health philosophies into his practice, which allows him to see a person’s health from multiple points of view. Michelle Heighington, B.A., RNCP ROHP, is a registered holistic nutritionist with over eight years of specialized experience helping clients take a holistic approach to maintaining a healthy diet and lifestyle.


[1] Hudson, Tori. (2008) Women’s Encyclopedia of Natural Medicine. (McGraw Hill: New York)

[2]  Petta, Carlos A., et al. (2010)  “Natural Killer Cells and Telomerase in the Endometrium of Patients with Endometriosis” Journal of Endometriosis. 2(4): 182-188.

[3]  Marziali M., et al. (2012) “Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?” Minerva Chir. 67(6): 499-504.