Treating Endometriosis with Functional Medicine

Endometriosis is a condition when the tissue that normally lines the inside of the womb (the endometrium) is found in other places in the body, for example in the Fallopian tubes or ovaries. Sometimes endometrial tissue can be found in more distant locations such as the intestines, lungs or joints.

During a normal menstrual cycle, hormonal changes cause the endometrial tissue to shed, and it exits the body through the vagina. In endometriosis, the misplaced endometrial tissue is also affected by these hormonal changes. It too starts to break down and bleed, but there is no exit route for the old tissue to leave the body. This leads to irritation, inflammation and pain as the immune system tries to clear the misplaced tissue.

The main symptoms of endometriosis include:

• Very painful or heavy menstruation
• Pain during sex
• Bloating
• Lower back pain
• Bowel changes, especially around menstruation
• Infertility

Doctors still don’t know exactly what causes endometriosis but there are a number of theories:

Some scientists have suggested that the endometrial tissue migrates backwards through the Fallopian tubes. The theory is that this can then settle elsewhere in the pelvic cavity or travel via the blood and lymph to more distant body sites.

Others have suggested that stem cells lining other body cavities or organs turn into endometrial cells. Likely under the influence of certain hormones or toxins.
In both situations there must also be altered functioning of the immune system, stopping it from recognising the misplaced tissue or from effectively removing it.

In addition to being very painful and uncomfortable, endometriosis can also lead to fertility problems. The constant inflammation around the areas of misplaced tissue can lead to the formation of scar tissue. Sometimes the scar tissue develops in a way that causes two structures to become stuck together. This is called an adhesion. These adhesions can block the passage of an egg through the Fallopian tube or cause the womb to become misaligned. Endometriosis on the ovaries can also cause the development of chocolate cysts. These are blood-filled sacs on the ovaries that can interfere with normal ovulation.

The only definitive way to diagnose endometriosis is by a laparoscopy – an operation in which a camera is inserted into the pelvis via a small cut near the navel. The surgeon uses the camera to see the pelvic organs and look for any signs of endometriosis.

There is no cure for endometriosis so medical treatment focuses on managing the symptoms

In most cases, the standard treatment for endometriosis is painkillers and hormones. Typically the oral contraceptive pill is recommended as this can make the menstrual cycle lighter and less painful. Another option is the contraceptive rod which stops the menstrual cycle completely.

In severe cases, laser surgery can be used to remove the endometrial deposits. However, it is common for endometriosis to reappear in 45% of cases.

Functional medicine takes a more holistic view of endometriosis. A typical support protocol will include steps to:

• Balance female hormone levels and support the hormone detoxification pathways.
• Support the immune system.
• Work on gut health to ensure a balanced microflora as this directly influences the immune system.
• Remove any foods that might be contributing to inflammation and reduced immune surveillance.
• Assess any environmental exposures that might be contributing to the endometriosis.
• Put in place an anti-inflammatory diet and supplement protocol.