Endometriosis and fertility.....what's the deal?

ENDO….aka endometriosis

I’m seeing more and more women in practice who have been diagnosed with endometriosis…way more than ever before. This has kind of gotten me scratching my head recently…why is this?

Is endo a product of modern society and exposure to stress and artificial estrogens? OR, are we simply diagnosing it more frequently because we go looking for it?! I don’t really have the answer to this question BUT I’m going to keep being curious and if I learn anything new I’ll update this post FO SHO.

If you’ve had a recent  OR old diagnosis here are the facts:

Hey, endometrial tissue, you don’t belong there!

Hey, endometrial tissue, you don’t belong there!

Endometriosis is a condition where cells from the uterine lining began to grow in other areas within the pelvic cavity. The symptoms of having endometriosis are generally adhesions, menstrual irregularities (short or long cycles), painful super annoying and sometimes traumatic periods, horrific “don’t touch me, don’t talk to me” PMS, and fertility challenges.

 

The diagnosis can be difficult, since laproscopic surgery is the only way to accurately identify endometriosis. Studies suggest that 7 to 10% of all women in the United States have endometriosis. It is the third leading cause of gynaecological hospitalization and the leading cause of hysterectomy. It’s kind of a big deal.

 What the heck causes Endo?

We don't really know what causes endometriosis, and possible causes or factors may be different from person to person but here are a few:

  • Genetics: women who have a close relative with the condition are up to 7-10 times more likely to get endometriosis. Also, it is common with twins that both may get endometriosis, particularly if they are identical twins.

  • Retrograde (backwards) menstruation: Normally a period flows out of the vagina, but it can also flow backwards along the fallopian tubes into the pelvis. In 90% of women, the blood, which will contain endometrial cells is absorbed or broken down and causes no symptoms; however, in women with endometriosis this endometrial tissue starts to grow.

  • Metaplasia: the conversion of the normal pelvic tissue into endometriosis.

Other possible factors that may have a role in causing endometriosis are mostly related to a state of ESTROGEN DOMINANCE (AKA having a higher estrogen/progesterone ratio).

These can include:

  • having first pregnancy at an older age

  • heavy bleeding during periods and periods lasting longer than five days

  • first period before 11 years of age

  • regularly having less than 27 days between periods, or having shorter regular cycles

  • alcohol use (this is an estrogen promoter)

  • Having been exposed to a high amount of BPA in plastics, especially when YOU were a fetus

Can I get pregnant with endometriosis?

So many women are told that they won’t be able to naturally conceive when they are diagnosed with endometriosis. I can tell you with certainty, this is horse shit. Thousands of women conceive naturally with endometriosis, and it’s estimated that only about 30% of women with endo have some reproductive challenge. That means that for the other 70%, it’s a non-issue when it comes to getting pregnant.

All of this depends on a few factors:

  • Degree if any, scarring of the tubes and ovaries from endometriosis

  • Are adhesions causing any blockage of the fallopian tubes

What you can do

In the past surgery was the only option for helping improve fertility with endometriosis. It’s important to talk to your provider about your specific types of endo but surgical treatment, does actually have some evidence to support it’s use …. that being said, keep in mind, most of the time surgical treatment should be used in conjunction with other natural methods….and natural methods are more effective when combined with surgical management….so really, these two approaches do kind of work well together for women with moderate to severe endometriosis.

 If you’ve been diagnosed with mild endo and have been told your tubes are clear (usually by an HSG test) then POSSIBLY these natural methods could be helpful on their own but again, chat with your doc and ensure you’re ovulating each month but tracking your cycles. Follow me here ;)

Natural ways to support conception with endometriosis

Naturally controlling endometriosis while trying to conceive requires a three tiered approach:

  1. Balance any out of whack hormones: MOST women with endometriosis are dominant in ESTROGEN. This man mean that they either have too much estrogen or not enough progesterone to balance out their estrogen levels. It’s important to get tested with either a DUTCH test or a day 21 blood serum panel from your provider or companies like Everly Well.

    Estrogen makes things grow (think endometrial tissue), so balancing estrogen is pretty important. This is usually why most women are offered hormonal birth control as an option to manage symptoms……but remember, this won’t REBALANCE your hormones, if anything, it could make things worse. I’d encourage you to try some of my simple lifestyle based estrogen balancing options first after consulting with your care provider. Just as an example, I’m totally practicing what I preach and am writing this post on a flight to Costa Rica to take a break and chill the heck out for a few weeks. Never under estimate the power of relaxation and rest.

    There are a number of supplments that can also he helpful for endometriosis suffers.

    In particular:

    • DIM or diindolylmethane is a natural plant-based chemical is found in the cruciferous vegetables. DIM has been shown to be helpful in reducing excessive bleeding that many endometriosis sufferers have and can help naturally reduce estrogen levels.

    • Vitex may also be helpful here as it’s been shown to causing estrogen to be less available to stimulate endometrial tissue growth.

    • Pycnogenol derived from Pine Bark has been studied and shows the capacity to reduce many of the painful symptoms of endometriosis.

  2. Reduce inflammation: The body generally has an inflammatory reaction to endometriosis bleeding and tissue growth. Inflammation causes stress in the body which can again cause a reduction of progesterone and greater state of estrogen dominance. Natural ways to reduce inflammation include:

    • Curcumin: this can be a potent anti-inflammatory and has shown to be useful in the case of endometriosis.

    • Beta-carotene encourages enhanced immunity and decreases inflammation.

    • Essential Fatty Acids decrease inflammatory responses through pathways that produce prostaglandins in the body.

    • N-acetyl cysteine (NAC) has been examined for its role in helping those with endometriosis, in particular, it helps to reduce cyst size.

    • Bee Propolis Propolis is a bee product collected by the worker bees from the leaves and bark of trees, they particularly like poplar and conifer trees. Propolis along with beeswax is one of the main ingredients used to construct their hives. Test tube studies, although preliminary, suggest that propolis may have strong anti-inflammatory effects. In the new study, 40 women with mild endometriosis and primary infertility (i.e., they had never been pregnant) who had unsuccessfully tried to get pregnant for at least two years were assigned to receive 500 mg twice a day of bee propolis or placebo for nine months. Women taking bee propolis had a significantly higher pregnancy rate (60%) than those taking the placebo (20%). The women taking bee propolis reported no adverse effects.

    • CBD: There is more great potential with this product. It works much like the propolis by having a powerful anti-inflammatory effect within the body. Some of my clients have tried it and really found it worked. There have been no studies to support this yet but I’m guessing we will see some in the upcoming years.

  3. Clean up your diet : studies have shown that diets RICH in colourful fruits and veggies and high in omega 3 fatty acids may help reduce endometriosis flares and growth.

    • In particular, it’s important to reduce your intake of inflammatory SATURATED and OMEGA 6 rich fats from animal sources. This means choosing leaner cuts of meat, eating meat without the skin and sourcing your meats well (grassfed beef for example has a higher omega 3:6 ratio than conventional beef).

    • Increase consumption of all dark leafy greens and colourful veggies as well as grassfed meats and fatty fish. Following our CORE 4 Diet in Baby Making and Beyond would be IDEAL for anyone who suffers with endo.

  4. Clean up your skin care and household products. Really be vigilant about this one. Eliminating any forms of xenoestrogens from cleaning products and cosmetics is as critical as what you eat and what supplements you choose. Choose natural cleaning alternatives and safe skin care. As an example, I’m a big fan of Beauty Counter for cosmetics, serums and face creams and the Seaweed Bath Co lotions, body products and shampoos.

Endometriosis is totally manageable. Birth control pills are not your only option….give these things a shot and see if they helps. Comment below if there is something you’ve tried that worked for you that I didn’t mention!