March is National Endometriosis Awareness month! So, what is endometriosis? The endometrium is the lining of the uterus that expands and decreases with blood depending on the timing of a woman’s cycle. Endometriosis occurs when cells migrate out of the uterus and adhere to the abdomen, pelvis, fallopian tubes or ovaries. When the uterine lining thickens with blood these cells outside of the uterus also swell, and when the lining is shed during a menstrual cycle the migrated cells bleed. This causes pain in the pelvic area, abdomen, back and other areas, and can even cause adherence (tissues sticking together or sticking to organs).

         There is no one cause that is known for endometriosis but there may be immune factors involved, diet, environmental toxins and even a genetic mutation (SNP) that may be implicated.

     Symptoms may include excessive bleeding, bleeding between periods, infertility, painful intercourse, painful menstrual cycles, pelvic and back pain, diarrhea, fatigue, pain with urination, painful bowel movements.

         Sometimes a medication is prescribed to reduce estrogen, but the endometrial cells can make their own estrogen and symptoms continue.

 A functional medicine approach to diagnosing endometriosis would be evaluating a possible cause, assessing hormone levels including estrogen and progesterone. A physical exam may be done, and an ultrasound can be ordered to provide images of the pelvic organs. The definitive (sure way) to diagnose endometriosis is by laparoscopy and biopsy.

      Functional medicine treatment of endometriosis focuses on decreasing inflammation with lifestyle: healthy diet low in sugars and processed carbs and low in animal protein, exercise, good sleep and stress modifications can improve symptoms. Starting bio identical progesterone if needed reduces time that estrogen is stimulating these migrated cells and is effective in reducing symptoms. Reducing caffeine decreases pain. High fiber diet helps to bind up inflammatory “wastes” from metabolizing hormones. Cruciferous veggies improve the liver’s ability to work to decrease excess estrogen. There are many herbs and supplements that may also be helpful as well.

      If you know you have endometriosis or suspect you do, you should discuss your symptoms with your health care provider or with a functional medicine provider to help improve your symptoms and have good quality of life regardless of where you are in your menstrual cycle!