Endometriosis

Painful periods, abdominal pain, heavy period flow, and bowel irregularities are just a few of the known symptoms of endometriosis. But what if we told you that it is way more complex than that? Dr. Ken Brown and Eric Reiger recently hosted Dr. Taylor Reyes on the Gut Check Project Podcast and she blew our minds with the information she provided about endometriosis.

If you’re sick of not having solutions for endometriosis, this is where you’re going to get the answers you’ve been looking for. 

What is endometriosis?

Endometriosis was originally thought to be an issue of the uterus. However, recent findings have changed how we view endometriosis. Endometriosis is a condition in which rogue endometrial cells are found in other areas of the body. 

Typically, endometrial cells should only be found within the uterus in the endometrium. During menstruation, these cells shed and are removed from the body to allow the uterus to be a healthy place for implantation should you become pregnant. With endometriosis, these cells can be found anywhere from the bladder to the colon to the brain. 

Although it is endometrial cells that are found in endometriosis, the condition actually seems to be more of an estrogen issue. Endometrial cells can actually create and give off estrogen — they don’t just react to estrogen the way we previously thought. The endometrial cells still follow cycles of estrogen the way they would during a menstrual cycle. This is where the problems come into play.

The cells don’t have a normal route of escape. Where the endometrial cells within the uterus are expelled during the menstrual phase of the menstrual cycle, the endometrial cells in endometriosis don’t have a way to be removed from the body. So they just cause inflammation which leads to the problems that are experienced.

Who does endometriosis affect?

Being that it’s an issue to deal with estrogen and not necessarily the endometrium itself, endometriosis can actually affect anyone. It used to be thought that endometriosis only affected women. But there have actually been nearly 20 cases of endometriosis found in men. Since men do not have an endometrium, this is why it is being viewed as an issue of estrogen. 

The men who have been diagnosed with endometriosis have been exposed to estrogen at higher than normal levels due to things like:

• Obesity
• Estrogen therapy (oftentimes for prostate cancer)
• Cirrhosis
• Liver failure
• Inflammation after surgery
• Dioxin exposure

Typically, though, endometriosis is diagnosed in women of childbearing age. Endometriosis affects 1 in 10 women. It is often diagnosed because of painful periods, pain during penetrative intercourse, and infertility. 

Although these symptoms can lead to the search for endometriosis, it is a hereditary condition that can be found from birth. In other words, anyone at any age can have endometriosis, but until there are symptoms that suggest doctors look for it, it often will go undiagnosed. 

There is no known cause of endometriosis only that 

1. There is a hereditary component to it
2. There is an issue of estrogen
3. Chemical exposures like Dioxin can increase the risk
4. There are overlaps with conditions like Hashimoto thyroiditis, obesity, cirrhosis, and a few others

Symptoms of Endometriosis

While we’ve already listed the common symptoms of endometriosis, there are other symptoms to look out for and talk to your doctor about if you suspect you have endometriosis. Symptoms of endometriosis can include:

• Painful periods
• Heavy bleeding during menstruation
• Periods that last longer than 7 days
• Bloating
• Constipation
• Diarrhea
• Discomfort during bowel movements
• Pain in the abdomen or pelvis
• Pain during penetrative intercourse
• Fertility problems
• Low back pain

You can have other symptoms of endometriosis too. If any of your symptoms are cyclical (they occur at the same time every month) then they should be mentioned to your doctor. There was a case of a woman who would get nose bleeds during her period and they found endometrial tissue in her nose. 

There have been other cases where people have cyclical sciatica pain. Typically treatments don’t help relieve the pain and later endometrial tissue is found on the sciatic nerve or nearby structures causing the pain. This is why it’s important to note when your symptoms flare up because if it is cyclical then it should be reported to your doctor for further examination.

So nothing is out of the question until doctors can confirm what the true cause is. 

How do you know if you are having symptoms of endometriosis?

Since the endometrial cells have their own cycles, if your symptoms flare up at the same time every month, this is a good indicator that you may have endometriosis.

There is no test to specifically find out if you have endometriosis. Oftentimes it is a long process to get an endometriosis diagnosis. Many women go 7-12 years dealing with symptoms before they get an official diagnosis. 

The more we learn about this condition the easier diagnosis can become. Unfortunately, endometriosis is much like autoimmune disorders (though it is not classified as one) in that it:

• Has a genetic factor to it (If someone in your family has it you are 7-10 times more likely to have it as well)
• Reactive based on immune system
• Long-term condition with no cure 
• Recurrent symptoms that the body reacts to it with inflammation

Doctors can do MRIs to see if they find a mass of cells (adhesions or scar tissue from the endometrial tissue) and test these cells. Doctors can also feel the area and see if there are any abnormalities that should be tested. Laparoscopies are the most common test used to get endometrial tissue, though they are controversial since they can promote scarring and inflammation.

Oftentimes a boggy uterus leads to an adenomyosis diagnosis. This very often later leads to a diagnosis of endometriosis as well. Adenomyosis is a condition where the endometrial cells are growing into the muscle wall of the uterus.

Treatment Options for Endometriosis

We mentioned earlier that there is no cure for endometriosis. Since the cells can implant anywhere and there is no set testing procedure to find all the endometrial cells within a body, it makes the road seem daunting. 

Fortunately, there are options for you if you’ve been diagnosed with endometriosis to make the journey less difficult. 

Since endometriosis symptoms are largely affected by inflammation, controlling inflammation is the first step to reducing symptoms. There are two main ways doctors will typically approach this:

1. Anti-inflammatory medications — these are a good option for acute treatment 
2. Anti-inflammatory nutrition/diet — this option is great for those who are willing to make long-term lifestyle adjustments 

Another way doctors typically try to manage endometriosis symptoms is by downregulating the nervous system which will help to control the inflammatory and immune responses. 

Excision surgeries can be performed to remove the endometrial tissues. Excision is the best surgical option because it removes all of the tissue without allowing any to flake off and implant near that point like they would if you were to have the spots cauterized as you would during an ablation. 

One of the most supportive ways to improve your symptoms is by seeing a pelvic floor specialist. Since the majority of endometriomas are found in the abdominopelvic region and on the organs and structures in this area of the body, pelvic floor specialists are one of the best doctors to have in your support circle. 

How do pelvic floor specialists help endometriosis?

As we mentioned, the majority of endometriosis cases are dealt with in the abdominopelvic area. Since many of the symptoms of endometriosis also affect these structures, pelvic floor specialists are the doctors that deal with this area the most. 

A typical treatment plan for endometriosis with a pelvic floor specialist will look like this.

• Patients are typically referred for symptoms like bloating, pain in the abdomen, pelvis, or rectum, and/or constipation
• A history of your symptoms, lifestyle choices (diet, water intake, exercise, etc.), and a family history 
• Physical testing will then be performed to see what movements cause your pain. A pelvic floor specialist that specializes in endometriosis will be able to perform tests on how your visceral mobility (how the organs move inside your body) in addition to your musculoskeletal mobility

This part is extremely important because this is often the part where the adhesions and restrictions are found so a treatment plan can be formed. From here, your pelvic floor specialist will be able to refer you out for surgery or help you with manipulative therapies like myofascial treatment to increase the mobility of the structures being affected by the endometrial masses. 

Finding the right endometriosis doctor for you

When it comes to endometriosis, it is a long road to recovery so finding doctors that you like is extremely important. Finding doctors that know their stuff is even more important. You can find a list of doctors that specialize in different areas with an emphasis on their endometriosis training at https://nancysnookendo.com/ 

When you’re looking for a doctor to perform an excision surgery keep in mind that there are less than 50 qualified doctors in the United States to perform this surgery. It is a highly specialized procedure and you want to make sure you’re getting someone that will do it right. 

**A side note with this to remember is that if your doctor is offering to cauterize or ablate your endometrial tissue FIND ANOTHER DOCTOR. While this can help in theory the recurrence rate is so much higher in cases with ablations than excision surgeries.**

Don’t be afraid to ask questions and interview your doctor. If you disagree with something they’re saying (even if they are the professional), take your health and treatment into your own hands. Become educated on the subject enough to know what you’re willing to do and don’t be afraid to voice that. 

Endometriosis is a condition that is long-term and one that takes so long to be diagnosed has a higher rate of depression, anxiety, and fatigue. This is something to keep in mind when you want to hold back your thoughts or fears. You’ve struggled for long enough and deserve to have a say in how you are treated. 

Keep in mind that there are some doctors who are just unaware of endometriosis and how complex it really is. In medical school, it is taught one way and recent research is challenging everything that has been a staple in classes. So if a doctor is not up on current research they can be in the dark about newer information regarding your condition. This is another reason it is SO important to find a doctor that truly understands your condition and can help you find the best treatment plan for you. 

A few facts about endometriosis and gut health

Now, we are a gut health company, so we couldn’t let you go without a few facts on how gut health affects endometriosis and vice versa. So here are a few facts to take away when it comes to endometriosis and gut health.

1. If your gut microbiome is healthy and balanced it can help you manage your endometriosis symptoms easier. This is because it helps to reduce inflammation and allows the anti-inflammatory diet to have the most effective impact on your symptoms. 
2. If your gut microbiome is healthy, eating cruciferous vegetables helps to control the estrogens in your body which may help with symptom management.
3. Eating a diet high in polyphenols can help to reduce estrogens and inflammation so long as your body can tolerate the high levels of fiber
4. If you experience gut dysbiosis, as many people with endometriosis do, it can exacerbate your symptoms by
   1. Contributing to the excess estrogen
   2. Creating more inflammation throughout the body
   3. Not regulating the immune response the way a healthy gut would
   4. Your body has a harder time processing the high-fiber content in the anti-inflammatory diet making it less likely to help

If you have a hard time tolerating fiber, ask your doctor about using Atrantil to help reduce inflammation, restore a healthy microbiome, and feed your healthy bacteria so you can begin tolerating more fibers in your diet. 

LowFODMAP diets are often prescribed for many of the symptoms you see in endometriosis (i.e. bloating, constipation, diarrhea, abdominal pain). But being able to tolerate these foods is a huge help when it comes to symptom management. Since there is such an overlap between symptoms in IBS and endometriosis, Atrantil could very well assist you in your symptom management while getting your gut microbiome back on track. 

Some other things you can do to restore your microbiome include light exercise, having a good sleep regimen, staying hydrated, and managing stress. 

Though it’s a long process and there isn’t a cure for endometriosis, you don’t have to spend your life struggling and being in pain. Partner with a specialist like Dr. Taylor Reyes who is willing to listen to you and create a treatment plan you feel good about following. 

Check out the podcast here: https://rumble.com/v2gxnj8-102-endometriosis-dr.-taylor-reyes.html 

Find Dr. Taylor Reyes here: 

• https://www.firephysicaltherapy.com/ — Keep an eye out for her eBook on endometriosis at this site!
• Follow her on Instagram for awesome health tips and tricks http://www.instagram.com/drtaylorreyes 

Some resources to check out include:

• Beating Endo by Dr. Iris Kerin Orbuch and Amy Stein

• Nancy’s Nook — there is a Facebook Support group and their website connects you to endometriosis specialists