Endometriosis and Pelvic Pain – Putting together the puzzle pieces

One truth I’ve learned from my journey with endometriosis is that for most women there is no one “magic bullet” fix to this disease. The exact underlying causes of endometriosis are unknown. Each woman’s personal history and genetic makeup will come into play and the severity and symptoms of the condition can vary widely.   It makes sense that treatment is more successful when it’s carried out using multiple integrative approaches.

I often think about any health condition and its treatment being represented by a big puzzle. Each piece of the treatment interlocks with another and supports and builds on it, and without all of the pieces in place, the picture of healing is never fully realized.

With endometriosis and other pelvic pain conditions, I believe it’s important to look at a number of possible contributing factors in order to put together a whole body approach program that will support a woman’s ability to heal:

  • Endometriosis is fed by estrogen. Are there genetic issues, digestive or detoxification system impairments that are decreasing the body’s ability to clear excess and harmful estrogens?
  • Are food sensitivities, nutritional deficiencies or other factors causing gut dysfunction, which then increases inflammation in the body and weakens the immune system?
  • Has there been an earlier exposure or continued lifestyle exposure to hormone disrupting toxins in foods, household goods, personal products, or the living environment?
  • Have there been chronic stressors that have strained the hormonal system and caused an imbalance, as well as contributing to anxiety, fatigue, and heightened pain response?
  • Is an autoimmune response being triggered?
  • Are there co-existing conditions that are linked and/or worsening the symptoms? A 2002 study reported in the Sept. 27 issue of Human Reproduction(1) concluded that hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma are all significantly more common in women with endometriosis than in women in the general USA population.

Once the outer edge of the puzzle is starting to build by identifying some of these issues, we can start to fill it in by correcting them. The heart of any healing protocol for chronic conditions but also for lifelong health begins with nutrition.

“The natural healing force in each one of us is the greatest force in getting well. Our food should be our medicine, our medicine should be our food”. Hippocrates

I’m not suggesting bypassing surgical treatment of endometriosis – I had two laparoscopies myself, and they were instrumental in removing the active disease and relieving symptoms.   Pelvic floor physical therapy is also a highly effective tool to treat symptoms and the dysfunction that can occur internally. These can be major parts of that treatment puzzle.

But if you never address the underlying problems that may have contributed to developing the disease in the first place, then you may find yourself struggling with symptoms again in the future, or you may develop new but related health problems as you haven’t dealt with the fundamental imbalances or dysfunctions that exist. Having your nutrition optimized also supports any other treatments you are undergoing, including improving fertility and pre-conception health.


With nutritional “therapy” we can find out if you have food sensitivities that are creating digestive tract dysfunction and feeding inflammation and pain in your body. The “endo diet” or “anti-inflammatory diets” are great foundations to this process, but going further than that, there is no one diet that will work for everyone and it’s important to look at individual food intolerances that might not even be suspected, most often through an elimination diet process.   Once you remove these potential irritants, the gut can heal and the inflammatory process isn’t being “fed”.

We also identify where you may be lacking in essential nutrients and concentrate on those foods, or by supplementing if necessary. The right nutrition can support your immune system, help keep your blood sugar and hormones balanced, improve and increase detoxification of environmental toxins and your own harmful estrogen metabolites, decrease pain, improve energy, help you maintain your healthiest weight, and even help with feelings of anxiety and overwhelm.


I know – that’s a very broad category!  Some of the areas we look at include appropriate exercise, daily routines that allow for the self-care you need, improving sleep, minimizing exposure to hormone disruptors, recognizing where stressors are happening and working on plans to minimize them or support your responses to them.   This may include becoming more aware of the mind/body connection.

I love this explanation from Dr. Kim D’Eramo’s book The Mind Body Toolkit: “When you bring negative attention to a body part… Pain sensitivity is enhanced and you propagate a pain cycle at the level of your spinal cord. Vessels constrict, which causes decreased nutrient and oxygen delivery to the cells and increased buildup of waste products. The PH of the tissues is decreased and muscles go into spasm.” Stress inducing thoughts and emotions begin a chemical cascade that affects every cell and function in your body, so this is a part of the puzzle that can’t be overlooked. As you balance the elements of your lifestyle, you take the stress off of your body, and allow it to heal.


Endometriosis and pelvic pain can be very isolating. The words “invisible pain” are often used to describe them. The pain is physical, but it’s also intensely emotional. Women love to connect, share and be heard, and there is great power in mutual encouragement.   Educating your loved ones about your condition can help them give you the support you need. I strive as a coach to be an empathetic listener, and to provide a safe zone where you can share anything that is on your mind.   We also can work together to connect you with practitioners that may help you with your medical needs such as physical therapists, MD’s and pelvic pain specialists, and continue to build your multi-disciplinary support network.

In an integrative approach to healing from endometriosis or other reproductive health conditions there truly are a variety of options available to give your body the tools it needs to support its innate and powerful healing ability.

When the pieces of the puzzle come together, the final picture can be much stronger and more beautiful than you may have thought possible.


1 Human Reprod. 2002;17(10):2715-2724

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