Article co-written by Bree Nabholz & Heather Fairfield 

What Is Endometriosis?

Did you know Endometriosis is the leading cause of gynecological surgeries and hysterectomies in women? 

Endometriosis, or “Endo”, is one of the most common gynecologic problems, affecting as many as 10% of women worldwide. It occurs in women of reproductive age, but is most common in women in their 30s and 40s and often resolves after menopause (unless post-menopausal hormone therapy is used).

Endometriosis occurs when tissue similar to the material that normally lines your uterus (the endometrium) grows OUTSIDE of the uterus in other places where it doesn’t belong. This happens most commonly on the abdominal wall or peritoneum, but endometriosis lesions can be found on the ovaries, fallopian tubes, vagina, cervix, bowel, or bladder. Rarely, endometriosis lesions can even occur in areas like the brain or lungs. Similar to how the lining of your uterus responds to cyclical hormonal changes every month, so do endometrial lesions, which grow and shed (bleed) outside of the uterus. 

As you can imagine, this cycle of repeated bleeding creates a cascade of health issues: the bleeding irritates the local tissue and creates tons of inflammation. This leads to scarring and adhesions that can cause dysfunction to the body parts where the endometriosis lesions are embedded, and most of all, PAIN. 

What Are the Most Common Symptoms of Endometriosis?

The most common symptom of endo is pain, including: 

• Very painful menstrual cramps that may get worse over time
• Chronic pain in the lower back or pelvis
• Pain during or after sex
• Intestinal pain, or pain with bowel movements or urination during menstrual periods
• Endo sufferers often struggle with long, heavy periods
• Some women get bleeding or spotting between their periods
• Constipation and/or diarrhea may be an issue, particularly during menstruation
• Chronic fatigue is common. 
• Fertility challenges (Symptomatic and asymptomatic women alike may experience significant problems with fertility because of endometriosis.)

What Causes Endometriosis? 

No one knows for sure what causes this disease. There are several theories that researchers are investigating, including retrograde menstrual flow (where some of the endometrial tissue shed during menstruation flows through the fallopian tube into other areas of the body), genetic factors, immune system disorders, estrogen imbalances, or surgery such as caesarean section or hysterectomy where endometrial tissue could be picked up and moved by mistake.

What is the Natural Approach to Treating Endometriosis?

Endometriosis is a tough condition to treat and both Western medicine doctors and herbalists consider it hard to completely “cure”. Overall, symptom control and general health improvement are the focus of therapy. From a herbalist’s perspective, we usually consider endometriosis to be a sign of “estrogen dominance” and therefore look at supporting the clearance of unopposed estrogen in the system, through diet, lifestyle and herbal approaches. 

Healers in all cultures have herbs that have been traditionally used for treatment of pelvic and abdominal pain, and there are herbs and supplements that have been scientifically shown to not only help relieve pain associated with endometriosis, but also to reduce lesions and cysts.

What Herbs Can Help Endometriosis?

Herbalists often turn to the following herbal allies in our approach to endometriosis:

• For pain management: Jamaican Dogwood Bark (Piscidia erythrina), Corydalis (Corydalis yanhuso), Black Cohosh (Actaea racemosa), Cramp Bark (Viburnum opulus)
• For immune system modulation: Echinacea (Echinacea spp.), Dong Quai (Angelica sinensis), adaptogens like Siberian Ginseng (Eleuterococcus senticosus), Ashwagandha (Withania somnifera), Astragalus (Astragalus membranaceous). 
• For hormonal modulation: White Peony (Paeonia lactoriflora) in combination with Licorice root (Glycyrrhiza glabra), Chaste Tree berry (Vitex agnus-castus)
• To reduce inflammation: Feverfew (Tanacetum parthenium), Ginger (Zingiber officinalis), Gotu Kola (Centella asiatica), Licorice root (Glycyrrhiza glabra), Calendula (Calendula officinalis), White Peony (Paeonia lactoriflora), Rehmannia (Rehmannia glutinosa), Turmeric (Curcuma longa). 
• Antioxidant support to protect cells against damage from chronic inflammation: Dong Quai (Angelica sinensis), Rosemary (Rosemarinus officinalis), Turmeric (Curcuma longa), Gotu Kola (Centella asiatica). Gotu Kola has been shown to have antiproliferative effects as well and may be especially beneficial when healing from surgery by reducing adhesion and scar formation when used with other herbs as part of a comprehensive formula.
• Liver support for the clearance of estrogen: Dandelion root (Taraxacum officinalis), Barberry (Berberis vulgaris), Oregon Grape Root (Mahonia spp.), Rosemary (Rosmarinus officinalis), Schisandra (Schisandra chinensis)

Any comprehensive approach to treating endometriosis should address the root causes and incorporate an anti-inflammatory diet, including up to a pound of combined fresh vegetables, especially from the brassica/cruciferous vegetable family (kale, collards, broccoli, cauliflower, Brussels’s sprouts, cabbage) and fresh fruits (especially berries) each day. The brassica family contains sulfur compounds, as well as DIM (diindolylmethane), which help the liver to clear excess estrogen out of the system. 

Dairy products, gluten-containing products, corn, and sugar are common food triggers of inflammation, and should be avoided if you’re suffering from endometriosis. Red meat is also pro-inflammatory, so a mostly plant-based diet with no red meat, and small amounts of poultry and fish is preferable. All meat should be organic to avoid chemicals used in meat production that might be adding to your toxin burden (also known as xenoestrogens). Xenoestrogens are estrogen-like compounds that are present in the environment (chemicals added to personal care products & cleaning products, pesticides, plastics, synthetic hormones given to the animals we eat etc.). When xenoestrogens enter our bodies, they wreak havoc on our delicate hormone system and act like stronger versions of estrogen than our own. This can lead to more burden on the liver, plus a net effect of estrogen dominance in the body. 

Efforts should be made to reduce stress, as stress has been proven to create a hormonal cascade that affects the delicate balance of our hormonal system.