Causes of Endometriosis
Endometriosis & Fertility
Endometriosis is when the tissues of the endometrium lining of the uterus grow outside of the uterus. The endometrium is the inner mucosal lining of the uterus. It has two layers. The stratum functionale contains the excretory glands and is shed as menses during menstruation. It is then built-up again by stimulation of the ovaries releasing hormones. The deeper layer that resides next to the myometrium is vascular (vessels that carry fluids) and serves to regenerate the stratum functionale after each menstruation ends.
In women with endometriosis the displaced tissues function and are influenced by hormones just as a normal endometrium would. This means that these displaced tissues go through the same cycle that any endometrium would; the tissues build up as the body approaches ovulation, then begin to break down when ovulation does not occur and then the displaced tissues bleed during menses. When the endometrial lesions bleed, the blood accumulates locally and triggers inflammation and pain. Over time this may cause development of adhesion (internal scar tissue).
Endometriosis may attach to the ovaries, fallopian tubes, bowel, bladder, ligaments or other areas in the abdominal cavity. Rarely the endometrial cells will attach to other areas in the body including the lungs and nasal cavity. If adhesions develop, this may cause internal organs to become stuck to other internal parts of the body and may even cause displacement of organs and other tissues.Some of the symptoms are:
- Heavy menstruation with pain, large clots, long or abnormal length of cycles
- Lower abdominal pain, back pain, burning pain over the site
- Frequent or constant pain all month long
- Painful sexual intercourse
- Painful during bowel movement or urination
- Rarely bleeding after intercourse, bowel movement, or urination
- Ovarian swelling
- Swollen abdomen
There are are a variety of risk factors for the development of endometriosis. Here are the main risk factors:
- Too much estrogen/too little progesterone
- Genetic predisposition
- Too much conventional meat
- Radiation and EMF’s
- An abnormality in the immune system
- Exposure to environmental toxins
- Benign uterine fibroids
What Causes Endometriosis?
Doctors and Scientists don’t really know for sure what causes endometriosis. Combined theories agree that there are many different factors in the development of this condition, which makes endometriosis a complex condition with a many different origins. Because researchers cannot find one direct link to the cause, it also makes it very difficult to treat.
Genetic predisposition in women with a family history of mothers or sisters that have endometriosis are at a higher risk for developing endometriosis. Women who also have low progesterone often have a family history of low progesterone.
Genotyping studies have associated a link between endometriosis and individual genomic changes in certain chromosomes. This may have been passed down genetically from a parent. Changes in the chromosomes and gene expressions may also be caused by exposure to environmental factors or altered metabolism.
Lymphatic Flow Theory
This theory suggests that the endometrial tissue is spread throughout the body via the lymphatic system.
Retrograde Menstrual Flow Theory
Researchers and doctors suggest that endometrial tissue flows backward through the fallopian tubes and into the abdominal cavity causing the displacement of endometrial cells. These cells then attach to other areas of the abdominal cavity. This is the most widely accepted theory. It is recognized though that other environmental, immunological and hereditary factors may contribute to the development of endometriosis.
Low Progesterone and Estrogen Dominance
Low progesterone disrupts hormonal imbalance overall. When progesterone becomes low, estrogen usually becomes too high. Estrogen dominance and progesterone deficiency have been linked to the development of endometriosis. Estrogen dominance may happen from chemical toxin exposure from xenoestrogens (toxins that mimic estrogen), including hormones in foods we eat, pesticides, fertilizers, and dioxin, all of which disrupt endocrine system function.
Numerous studies have shown a correlation between dioxin exposure and the development of endometriosis. In a study using monkeys it was shown that Dioxin increased the severity and growth of endometrial tissues as well as promoted survival of endometrial tissue outside of the uterus.
Dioxin is a group of highly toxic chemicals that are a by-product of industrial processing using chlorine to manufacture herbicides and pesticides, process pulp and bleached paper products (including the raw materials for feminine care products) as well as incinerate waste.
Dioxin is considered a Persistent Organic Pollutant, POP for short, that slowly over time accumulates in our bodies. This pollutant is carried in the air and in our water systems as well, which affects the entire food chain and planet. Dioxin is not only present in feminine care products, but most paper products we use including napkins, paper towels, tissues, make-up removal pads, toilet paper, diapers, ect.
Immunological factors have been linked to the development of endometriosis and endometriosis related infertility. In early endometriosis (stage 1 & 2) there are elevated levels of inflammatory mediators. Studies have shown elevated levels of cytokines, lymphocytes, and macrophages in the peritoneal fluid of women with early stage endometriosis.
Over time the immune system function appears to alter and may increase the number of peritoneal macrophages, decreased T-cell activity and natural killer cells (NK), increased antibodies and altered cytokine network function. Overall this creates depressed immune function and poor inflammatory response. This may allow endometriotic tissues to implant elsewhere in the body more easily. This may also be why women with endometriosis have more pain, inflammation and are more susceptible to recurrent infections, especially yeast infections.
Cell damage from free radicals has been suggested as the leading contributing factor for development of endometriosis. This may be due to dietary factors, exposure to chemical toxins, aging, immunological and inflammatory response.
Free radicals are unstable molecules that can damage cell structures, this is known as oxidative stress. In normal everyday life free radicals are produced from the activity in our bodies (for example free radicals are made during energy production) but chemicals in our surrounding environment can also create free radicals. It is said that each cell in our body is attacked about 10,000 times a day by free radicals, accelerating the aging process and allowing for tissue damage and the spread of disease.
How Does Endometriosis Affect Fertility?
Endometriosis is an estrogen dominant condition. When there are too much estrogen in the system, it causes hormonal imbalance. Proper hormonal balance is essential for healthy fertility.
Endometriosis also creates a situation of “congestion” where there are excess tissues growing in the uterus (as well as other areas of the body) which makes it harder for an embryo to attach and grow healthy.
Every month the excess tissues bleed which cause inflammation to occur and scar tissue to begin adhering to uterus, fallopian tubes, the ovaries, and other organs. This causes some serious “congestion”. If endometrial cells attach to the ovaries or fallopian tubes this may alter normal ovulatory function or cause the fallopian tubes to become blocked.
As if that was not enough some researchers suggest that the woman’s body may form antibodies against the misplaced endometrial tissue. The same antibodies may attack the uterine lining and cause miscarriages (up to three times the normal rate).
There are four stages of progression of endometriosis. As the disease progresses, fertility is negatively impacted in different ways. Stage I is considered the most mild, while Stage IV is considered the most severe and the most devastating to not only reproductive health, but the entire surrounding organs and tissues of the uterus.
Medical Options for Endometriosis
If endometriosis is left untreated this condition has serious negative impact on reproductive health. There are both medical options and natural therapies to help heal the body from endometriosis. Endometriosis is usually diagnosed by laparoscopic surgery.
Doctors will often suggest laparoscopic or abdominal surgery to remove the endometrial lesions, scar tissue damaged areas and clip away adhesions if possible. The best surgical option today, for endometriosis, is the advanced surgical technique known as excision surgery. Excision surgery aims at removing the roots of the disease. In the case of severe endometriosis, a doctor may suggest a full hysterectomy (removal of uterus, cervix, ovaries and fallopian tubes).
Hormonal and Pain Medications
Doctors may prescribe hormonal medications. The purpose is to stop the menstrual cycle to prevent further growth of the endometrial tissues. This may also help to reduce pain. If pain is still present they may prescribe pain medications. Hormonal medications alter the natural menstrual cycle and may prevent pregnancy. They all come with a variety of side effects. Medications are not always effective and once medications are stopped the endometriosis may come back or spread further. Your doctor can help you to determine which options may be best for your particular situation. Most times surgical options may be combined with natural therapies.
Natural Therapies for Endometriosis Infertility
Lifestyle changes are some of the most effective ways to help with endometriosis. These would be changing your diet, clearing out old tissues and congestion, balancing your hormones, and avoiding certain pollutants. The overall goal is to support proper function and health of the endometrium, endocrine and immune systems.
Step 1: Eat a nutrient dense fertility diet
To begin you will want to build a healthy foundation for your fertility by creating a baby-friendly-body. Diet changes specific to endometriosis are important. There are several types of food you may want to avoid because they have been linked to making endometriosis worse. Certain foods may trigger flare-ups, promote inflammation, or are “congesting” to the body, feeding the congestive nature of endometriosis, while other foods may increase hormonal imbalance.
Foods to Limit or Avoid
The following foods have been linked to making endometriosis worse:
- Gluten, specifically wheat
Wheat has a direct link to making pain worse in women with endometriosis. Researchers are not sure why, but nutritionist Dian Mills says, “Wheat has been genetically modified…There is also problems with gluten sensitivity, and more people are becoming gluten sensitive and I find that when I’ve taken wheat out of the diet, in 80% of the women with endometriosis, their pain subsides.”
At study performed in 2009 of 120 women with endometriosis tested positive for markers that signal the possibility of celiac disease. Of those 9 women, 4 agreed to intestinal biopsy to confirm celiac disease, all 4 tested positive. Researchers concluded that celiac disease appears to be common in women with endometriosis which may warrant further studies on the topic.
When you have Celiac disease, every time you eat something with gluten in it, your immune system goes into overdrive which results in the production toxins throughout the body. These toxins ultimately damage the villi found in the stomach. This destruction restricts the bodies ability to absorb the right nutrients which can actually starve the body of the vitamins and minerals it needs to work properly, eventually affecting every system in the body – including the reproductive system.
It is suggested to remove gluten or at least wheat from the diet for a minimum of 2 months to see if pain is reduced or eliminated.
Dairy products are “congesting” to the body. Consumption of dairy products should be limited to about 2 times a week at most. Choose organic raw dairy products when possible. Homogenized and pasteurized cow milk is the most congesting and hard to digest of all dairy products. Choose dairy milk alternatives, such as hemp, almond or brown rice milk instead. Organic raw unsweetened yogurt or kefir are the best choices for dairy products. Be sure that all dairy you do consume is organic or says it does not contain any added hormones.
Red meat, especially commercially raised beef
A study performed in 2004 compared 504 women under the age of 65 who had endometriosis to 504 women under the age of 65 who had no known fertility problems. They found that women who ate beef or other red meat seven times a week or more were 100 percent more likely to have endometriosis than women who ate red meat three times a week or less. The study did not mention what the connection between red meat consumption and endometriosis is, but that it does exist. It may very well be that most red meat contains a variety of xenohormones and antibiotics which are known to be toxic the the human body. See Non-organic foods below for more information on how non-organic meats affect fertility.
The same study from above showed that women who ate ham three or more times per week were 80 percent more likely to have endometriosis than those who ate it less than once a week. Pork is one of the fattiest meats a person could consume, which means pigs store more toxins than other animals.
Soy foods are highly processed and contain concentrated amounts of isoflavones. The isoflavones are known to be phytoestrogenic. In fact soy contains more concentrations of isoflavones than any other phytoestrogen, which may contribute to estrogen dominance. Most soy is genetically modified and not organic, both of which have been linked to numerous infertility cases.
We have learned that exposure and consumption of pesticides, herbicides, synthetic fertilizers and GMO foods can create hormonal imbalance through endocrine disruption and suppressed immune function. Conventional fruits and vegetables are regularly sprayed with these chemicals and then not only do we eat them daily, but so do animals that are raised for meat.
If you eat non-organic meats, you are being doubly exposed to these toxins. This is because xenohormones become more concentrated as they move up the food chain. Xenohormones are often stored in the fat cells of animals. The more fatty the meats you are consuming the more xenohormones you are consuming. For example if you are eating 80% lean/20% fat beef, you may be consuming 20% toxins that cow has stored in its fat. What was that non-organic cow eating? Well, conventional beef is raised in feedlots. They are fed corn and soy feed. This is GMO corn and soy, sprayed with pesticides, fertilizers and possibly herbicides. The cows eat this everyday. Then on top of that the animals live in horrible living conditions and are given antibiotics to stave off the spread of disease.
Foods to Focus On
Fresh Vegetables and Fruits
These foods should make up most of your diet. The study from 2004 that linked red meat consumption to endometriosis also Studies showed that women who eat green vegetables 13 times or more per week (roughly twice a day) were 70 percent less likely to have endometriosis than those who green vegetables less than six times per week.
Women who ate fresh fruit 14 times or more per week (at least twice a day) were 40 percent less likely to have endometriosis than those who ate fruit and vegetables less than six times per week.
This study suggests that there may be link between eating a healthy diet, low in red meat and high in fruit and vegetables and a reduced risk of developing endometriosis.
The current advice is to eat at least five 80g portions of fruit and vegetables every day.
The Importance of Fiber
Your main focus and one of the first things you should do right now is eating more fiber. Fiber helps the body to get rid of excess estrogens.
Some good sources of fiber are:
- Dark leafy greens
- Swiss chard
- Chia seeds
Essential Fatty Acids
In addition make sure to eat a diet high in essential fatty acids. EFA’s, specifically omega 3’s, reduce inflammation in the body which will help to lessen the pain that endometriosis can cause. Omegas also support hormonal balance. A diet high in Omega EFA’s and lower in trans fatty acids protects cellular integrity, which protects the cells in the body from oxidative stress.
Good sources of omegas are:
- Omega 3: Flax seeds (ground or oil), cage free organic eggs, wild Alaskan salmon
- Omega 6: Borage Oil, Evening Primrose Oil
- Omega 9: fresh seeds and nuts, avocado and sunflower oil
- The pineapple and papaya in this smoothie are anti-inflammatory and the naturally occuring protein digesting enzymes may help the body to dissolve abnormal tissues. You can usually find the pineapple, papaya, and mango frozen if you can’t get it fresh.
- The chia seeds and coconut flakes serve as extra fiber to help remove excess estrogens from the body as well as providing essential fatty acids.
- Bee Propolis – In a recent study, women with endometriosis have a 60% greater chance of getting pregnant than the women who take nothing. Suggested usage is 500 mg twice a day of bee propolis.
1/4 C. Pineapple
1/4 C. Papaya
1/4 C. Mango
2 scoops FertiliWhey protein powder
1 T. chia seeds
1/4 tsp. Bee Propolis (equivalent to 500mg)
1 T. Coconut flakes (dried)
1.4 C. -3/4 C. water or juice of choice (I love the pineapple coconut juice from Knudsen’s) fresh squeezed orange juice goes great!
Blend and enjoy!
Step 2: Avoid Exposure to Environmental Toxins
We have learned that exposure to certain environmental toxins may contribute to the development of endometriosis or make it worse. Some toxins are known to be endocrine disruptors. Endocrine disruptors, also known as xenohormones, are human-made chemicals. These chemicals have the ability to interfere with the natural functions and development of our bodies. The main function of the endocrine system is to serve as our body’s message center. Hormones deliver messages, the endocrine system coordinates hormones.
Ways to support healthy endocrine function and avoid xenohormones:
- Eat organic foods
- Avoid exposure to pesticides, herbicides and synthetic fertilizers
- Use natural feminine care products
- Use organic, natural body care products, including makeup
- Avoid food preservatives and dyes
- Use low VOC paints
- Use recycled unbleached paper products
- Use non-chlorinated oxygen based bleach in the laundry
- Avoid plastics
Step 3: Prepare your body with a cleanse
Cleansing specifically for fertility is an important first step if you are experiencing endometriosis. Cleansing using specific herbs helps the body to clear out old tissue, increase circulation to the reproductive system, support hormonal balance, reduce inflammation and pain caused from endometriosis. There is a correlation between the body’s inability to remove excess toxins and waste products in women with endometriosis.
A fertility cleanse also aids the liver in removing excess estrogens from your system. Again, supporting proper hormonal balance is vital to reducing the spread of endometriosis. We find doing a Fertility Cleanse 2 times a year is important for supporting a healthy endometrium and hormonal balance.
Step 4: Systemic Enzyme Therapy
Systemic Enzyme Therapy is one of the best and most effective natural therapies for helping the body to deal with endometriosis. Specific systemic enzymes can help support the body to reduce the “stagnation”, scar tissue and breakdown the excess tissues left from endometriosis.
Certain systemic enzymes also have the ability to reducing the inflammation caused from the scar tissue irritating the surrounding organs and may help with the pain that sometimes comes from having endometriosis.
The blood cleansing actions of this therapy help to bring proper circulation to the reproductive system and get the “stagnant blood” cleared out, bringing fresh oxygenated blood to your uterus and ovaries.
It is best to start the Systemic Enzyme Therapy in conjunction with fertility cleansing. For endometriosis you will want to stay on a systemic enzyme for many months so all of the stagnant tissues and scar tissues can be cleared. This should only be done in the months prior to trying to conceive.
Step 5: Supportive Herbs and Supplements for Hormonal Balance and Creating a Healthy Endometrium
Herbs and supplements can be very helpful for women with endometriosis. Many of these natural therapies support the body in eliminating excess hormones, endometrial tissues, inflammation, while promoting the reduction in endometrial growth.
If you have endometriosis, Dr. John Lee recommends using progesterone cream from days 8 to 26 of your cycle, to reduce the effects of estrogen on the body (estrogen stimulates endometrial growth). Take a short week off to refresh your receptor sites. He has had success with this controlling symptoms within six months. Once the outbreaks of endometriosis are tolerable reduce the usage to days 12 till menstrual cycle.
DIM helps to balance the hormones by breaking down excess estrogen and removing it from the body. Endometriosis is an estrogen dominant condition. Cleansing the body of excess estrogen should help the body to reduce the growth of excess endometrial tissues.
Women’s Best Friend
Women’s Best Friend takes down pain and swelling caused from endometriosis so you start feeling better right away. Women’s Best Friend goes to the source of the problem, helping to reduce excess estrogen that fuels abnormal growths, and stimulating liver activity for improved estrogen metabolism. It works with your body’s natural detoxification processes to clear congested endometrial tissues while reducing symptoms like abnormal bleeding.
Key herbs in Women’s Best Friend that make this product so effective:
- Goldenseal Root (Hydrastis canadensis)- This herb is extremely antibiotic, antimicrobial and anti-inflammatory. It works to heal any infection in the reproductive system, while also reducing pain and inflammation from foreign tissue growth. Reduction in inflammation may help to prevent scar tissue and adhesion.
Jamaican Dogwood (Piscidia erythrina)- This herb is extremely antispasmodic and analgesic. It reduces muscular cramps and spasm. This is an herb that is often relied on by herbalists for women who have unrelenting pain disturbing daily life activities; debilitating pain.
Wild Yam (Dioscorea villosa)- Helps to promote normal hormone levels and overall balance within the reproductive system. Wild Yam may also help the uterus to work more efficiently during menses.
Cramp Bark (Viburnum opulus)- This is one of the most effective herbs for reducing uterine spasm and cramping. Cramp Bark brings relief of pain and muscle spasm for smooth muscle, especially the uterus.
Peony Root (Paeonia officinalis)- Peony has been found to aid in increasing progesterone levels, lower testosterone and balance estrogen. Overall this herb has excellent hormone balancing support.
Additional Supplements that are helpful for endometriosis…
Whole Food Prenatal Multivitamin
A major part of increasing egg health and preparing the uterine lining is to take a prenatal multivitamin. Making sure your body has all of the nutrients necessary is a lot easier when you are taking a multivitamin. My favorite is the 100% whole food Baby and Me from Mega Food. Synthetic multivitamins don’t have the same effect. If you decide to change your diet to reduce endometriosis, you will need to make sure your body is supported nutritionally as your body adjusts to the diet changes. For women that have gluten or wheat intolerance, the digestive system may be damaged, which make absorption of nutrients from the diet difficult, it is vital you supplement with a multivitamin to ensure make up for lost nutrients in foods.
Pycnogenol: Pycnogenol is a powerful antioxidant that comes from the bark of the pine tree Pinus maritima. It has been shown to help women with endometriosis, improve egg health, and increase sperm health. Antioxidants are important in restoring and protecting cellular health and DNA. Pycnogenol is a therapeutic alternative to Gn-RHa in the treatment of endometriosis.
Bee Propolis is a resinous mixture of tree sap, tree buds, tree leaves and other botanical sources that the bees make to seal small openings in their hives. A study published in Fertility and Sterility (2003;80:S32) showed that 60% of women with endometriosis related infertility who took 500mg of bee propolis twice a day for 9 months became pregnant as opposed to 20% in the placebo group. Endometriosis pain, scar tissue and adhesion formation is thought to be triggered by inflammation response. Bee propolis has been shown to be extremely anti-inflammatory which may reduce endometriosis. Bee propolis may also contain immunomodulating properties. This may be beneficial for autoimmune related fertility issues. Some doctors theorize that endometriosis may be an autoimmune disorder.
Maca is an incredible fertility super food. It helps to balance the hormones, but does not contain any hormones itself. Maca is able to do this through nourishing and balancing the endocrine system. This is essential in preparing for women with endometriosis because healthy hormonal balance contributes to healthy fertility.
Endometriosis is a complex fertility issue that has been shown to have multiple causes. Because of this there are a variety of steps that need to be taken to heal and reduce the effects it can have on fertility. The following 5 steps can help you to support a healthy endometrium!
1. Diet is your foundation. There are many foods that contribute to the spread and pain of endometriosis, limit those. Choose foods that support estrogen metabolism and reduce inflammation.
2. Avoid exposure to environmental toxins. Exposure to certain toxins may make endometriosis worse.
3. Fertility Cleansing is vital to supporting hormonal balance and uterine health.
4. Systemic Enzyme Therapy supports both proper inflammatory response and immune function. It also aids in the breakdown of scar tissue and adhesion.
5. Use supportive herbs and supplements for hormonal balance and to create a healthy endometrium.