Last updated on November 7th, 2017

Endometriosis is a truly puzzling fertility health issue. It’s experienced differently by each woman diagnosed with it. Doctors understand it differently and treat it differently as well. Many women experience menstrual cycle issues and hormonal imbalances, along with pain, digestive upset and impaired immune function (and more), all as a result of endometriosis. Many women have questions about how to deal with endometriosis and they come to us. Here are two questions that you may also have if you too have endometriosis.

Q1: I have reoccurring stage 2 endometriosis (had surgery once to remove it but it came back very quickly) and have been under the care of a Reproductive Endocrinologist for infertility. I have read on your site that women with endometriosis have an estrogen dominance and should take DIM and/or Maca to reduce the excess estrogen. However, my RE told me my estrogen and progesterone levels came back “normal” after a blood test.

I’m trying to understand the conflicting information and trying to decide whether I would benefit from DIM and Maca.

A: This is a really great question. Medical doctors have different opinions about the role of estrogen and different times when they test hormones, which impact the results. Further, some people have issues metabolizing hormones, and this may not show up in traditional blood tests.

It may be surprising to learn that too much natural estrogen doesn’t always cause estrogen dominance symptoms. It’s possible your blood hormone test show normal results, and yet you still have an estrogen dominance issue.

Hormones are tricky substances to work with; small amounts can cause big reactions. Estrogen dominance symptoms can be caused by:

• too little progesterone in relation to estrogen
• exposure to xenoestrogens
• short term estrogen fluctuations when beginning natural progesterone cream

Additionally, some women may be on the low or high side of a “normal hormone range” which can lead to hormonal symptoms or challenges (as is pretty common with thyroid issues and “borderline PCOS”).

For your question on Maca (Lepedium meyenni), it works mainly as a superfood and body balancer. Maca is an excellent herb for the endocrine system, which can help boost fertility, energy and libido. While Maca can influence hormonal balance, it does not contain hormones itself.
DIM works differently than Maca. It helps to metabolize excess harmful 16-hydroxy estrogen metabolites. DIM is a really good choice if you need estrogen metabolism support. Many women with endometriosis do! DIM can often really help relieve estrogen-dominance symptoms.

I want to mention that hormone issues aren’t the only factors in endometriosis development. Immune imbalance plays a huge role, along with increased inflammation and free radical activity. Dietary changes are critical for long-term endometriosis recovery. Eliminating gluten (which often imbalances immune response) really helps some women. Eating a largely organic foods’ diet with plenty of fresh fruits and vegetables helps, too.

Our guide 5 Steps to Addressing Endometriosis Infertility elaborates more on this.

Please let us know if you want more support, have additional questions and how we can best help.

Q2: I have endometriosis and my doctor has told me I also have poor egg quality. Can endometriosis affect egg quality? Are there natural options to enhance egg quality with endometriosis?

A: In some cases, endometriosis does affect egg quality. One of the big reasons why is that endometriosis causes increased free radical production in the reproductive system. New research finds women with endometriosis may benefit from antioxidants to help fight excess free radical activity.

Another problem is as abnormal endometrial tissue develops, it can lead to scar tissue or adhesions that affect circulation to the ovaries. Over time, a lack of proper circulation can affect follicle development.

Endometriosis may also spread to the ovaries, causing more problems. While small chocolate cysts on the ovaries may not be an issue, large chocolate cysts in danger of rupturing can create a real challenge for egg health. In addition, endometriosis can cause the ovaries to become twisted or adhere to each other (kissing ovaries). If endometriosis damage is profound, distorting the reproductive organs, medical fertility interventions may be necessary.

Some clients create a timeline to work with natural therapies (usually 6-9 months) and follow up with testing to see what their next best steps are. In each case, I always recommend focusing on diet improvements with a targeted natural Egg Health support program when appropriate. It may be the key to successful conception or IVF if you have severe endometriosis.

Endometriosis is really a systemic problem. It has a tendency to recur if the underlying imbalances are not addressed. Working with an endometriosis specialist may be your best choice if your fertility problems are long-standing or your symptoms are severe. For a complete natural program for fertility concerns caused by endometriosis, a Fertility Consultation with a fertility herbalist can help guide your way, and create a lifestyle program that best fits your needs and situation.

Sarah Abernathy - Certified Herbalist

Sarah has worked in the field of natural foods and herbalism for over 20 years. She’s a published author, Certified Herbalist, and health and wellness consultant. Sarah Graduated from the Professional Herbal Studies from the East West School of Herbology, and holds a Bachelor’s Degree in English. Working with women on their journey to wellness is her passion and she loves to share what she has been blessed to learn from naturopaths and other herbalists over the years.