Your Painful Periods Aren't Normal: What to Know About Endometriosis

“Doctors assumed I was being dramatic about my pain until I got diagnosed [with endometriosis], and it left me feeling out of control of my own health.”

For Parsley patient Tara M., getting diagnosed for endometriosis was an uphill battle with her healthcare providers. She’s not the only one. This complex condition affects 6-10% of premenopausal women and 71-87% of women with chronic pelvic pain. While about 10% of women are diagnosed with endometriosis yearly, the average time to diagnosis is 7-9 years . Unfortunately, Tara M.’s experience before coming to Parsley was the norm.

Whether or not you have an endometriosis diagnosis, you deserve to be evaluated by a knowledgeable, caring provider who will help you get to the bottom of your symptoms, explore your treatment options, and start feeling better. But first, what is endometriosis?

What is endometriosis?

Endometriosis occurs when endometrial tissue (the normal uterine lining) is present outside of the uterus. It’s most commonly found on the exterior of the uterus and nearby organs, like the fallopian tubes, ovaries, bladder, and intestines. In rare cases, it has even been found in places like the brain and the lung!

What are the symptoms of endometriosis?

The most obvious symptoms of endometriosis are chronic pelvic pain and painful periods, but it can also cause other symptoms, including:

• pain during sex
• bowel cramps
• loose stools
• painful urination
• infertility
• fatigue
• constipation
• bloating
• nausea

What causes endometriosis?

The cause of endometriosis is not well understood. However, women who have a sister or mother with endometriosis have a 7 to 10-fold higher chance of developing the condition.

Environmental factors play a role as well. Hormonal imbalance and inflammation are two key drivers of endometriosis. Research shows that endometriotic lesions—the abnormal tissue present in endometriosis—show abnormally high estrogen levels , which trigger tissue growth and activity. These lesions also fail to respond to progesterone , a hormone that would normally act as the “brakes” to the estrogen “gas pedal.”

There are also higher levels of pro-inflammatory signals, known as cytokines, in the abnormal endometriotic tissue and circulating in the bloodstream of women with endometriosis.

Why are hormones and inflammation “environmental?” Because certain lifestyle factors can promote hormone imbalance and inflammation, like eating a high-glycemic or pro-inflammatory diet, excessive mental or physical stress, or being exposed to hormone-disrupting chemicals, especially if you're already genetically susceptible to endometriosis.

I think I have endometriosis. Now what?

If you are experiencing painful periods, chronic pelvic pain, infertility, or any other symptoms of endometriosis, your next step is to seek out care from your gynecologist or a qualified healthcare provider for further evaluation.

Diagnosing endometriosis can be difficult. Pelvic ultrasound and MRI can sometimes rule in the diagnosis, but laparoscopic surgery is the only way to definitively know whether or not endometriosis is present in many cases.

Even so, a confirmed diagnosis isn’t a prerequisite to starting treatment for endometriosis if you suspect that you might have it.

What is the treatment for endometriosis?

Conventional medical treatments that are typically recommended for endometriosis include ibuprofen for menstrual pain, birth control pills to suppress your production of hormones, progestin-containing IUDs to prevent menstruation, and sometimes surgery.

Whiel these therapies can help reduce symptoms associated with endometriosis, they also have side effects and risks. What's more, they also don't address the root cause of endometriosis symptoms.

At Parsley Health, our clinicians find and treat the root cause of endometriosis symptoms. First, they recommend a comprehensive evaluation, which may include testing for hormonal imbalance, blood sugar dysregulation , nutrient deficiencies , toxic exposures, and markers of inflammation.

5 steps to reduce symptoms of endometriosis

• Avoid hormone-disrupting chemicals. Xenoestrogens are environmental chemicals that can contribute to hormone imbalance—and they're in a lot of common products. Avoid using plastic, eat organic foods when possible, and use the Environmental Working Group’s Skin Deep Database to find non-toxic makeup and personal care products.
• Eat less sugar. Minimizing intake of sugar while eating more foods that support healthy estrogen metabolism are critical for healthy hormones. Hyperglycemia from too much sugar and carbs promotes insulin secretion, which stimulates an enzyme called aromatase. Elevated levels of aromatase increase estrogen levels, which can worsen endometriosis.
• Eat SMASH fish or take omega-3. The omega-3 fatty acids, EPA and DHA, reduce inflammation by turning off inflammatory signals in the body. Inflammation drives hormonal imbalance, which can worsen endometriosis (see above). Eating a diet rich in omega-3 fatty acids can help reduce inflammation, thereby balancing your hormones. Focus on sustainable sources of SMASH fish: salmon, mackerel, anchovies, sardines, and herring.
• Go gluten-free. In a 2012 study of 207 women with endometriosis-related pelvic pain, 75% of the subjects had fewer symptoms after following a gluten-free diet for 12 months. Gluten is known to promote intestinal permeability or “leaky gut syndrome ,” which is associated with inflammation.
• Take a garlic supplement. A 2021 study of 60 women with endometriosis found that taking a garlic supplement of 400 mg daily for 12 weeks caused a 72% reduction in symptoms associated with endometriosis. Garlic is known to have anti-inflammatory properties and helps balance estrogen levels by supporting liver detoxification. (Talk to your doctor before starting a garlic supplement if you're pregnant or breastfeeding.)
  

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