By Anne-Marijke Gerretsen
In today’s world of modern medicine, it is expected that if you have Endometriosis you rely on medical specialists, medication, and surgery to manage your symptoms. In fact, many of my clients have come to me after having been on that journey and not seeing the real improvement they are hoping for.
But is Endometriosis really a disease of the reproductive system and reproductive hormones? The wide range of symptoms that women with Endometriosis experience indicate Endometriosis is not a hormonal disease but an inflammatory disease. These are common symptoms I see in my clinic:
- Back pain
- Breathing difficulties
- Chest pain
- Chronic fatigue
- Chronic pelvic pain
- Dizzy spells
- Headaches and migraines
- Heavy bleeding
- Irregular bleeding
- Long bleeding
- Ovulation pain
- Painful legs and thighs
- Pain in rectum
- Pain when urinating
- Painful intercourse
- Period pain
- Urinary tract infections
The truth is that the underlying ‘engine’ of the progression and symptoms of Endometriosis is chronic inflammation, caused by problems with your digestive system and immune system.
So, let me explain the relationship between endometriosis, inflammation and these two body systems.
Your immune system and inflammation
We know that the immune system of women with Endometriosis has some problems:
- Natural killer cells, which are part of the immune response, don’t work as well as they should.
- You produce more pro-inflammatory cytokines.
- You produce an excess of T regulatory cells (which suppress the immune response of other cells of the immune system), but these cells are activated less.
- Autoantibodies and anti-endometrial antibodies are present, causing a kind of allergy response.
What this means for you is that your immune system is not able to deal properly with bacteria that produce endotoxins (the bad bacteria in your microbiome) and it reacts to foods like gluten and dairy protein as if they are dangerous pathogens. It is important to realise that one of your immune system’s key responses is to create inflammation. And it’s not a localised, acute inflammation you would get with a small wound on your hand, for example, but a systemic (widespread), chronic inflammation, affecting a wide range of organs and tissues. This inflammation provides a perfect environment for endometrial tissue outside your uterus to find places to adhere and grow.
When I look at some of the common symptoms of Endometriosis, I struggle to connect them to problems with the reproductive system. Bloating, constipation, diarrhoea, nausea, vomiting, flatulence – these scream digestive system to me. But how exactly does your digestive system relate to Endometriosis?
Most women with Endometriosis have leaky gut, often without realising it. In a normal healthy gut the lining provides a barrier between the gut and the bloodstream. Only fully digested food, once it is broken down into the smallest molecules, will be able to pass from the gut, through the gut wall, into the bloodstream to be transported to where it’s needed.
A leaky gut has a damaged gut lining – with cracks or holes that allow undigested food particles, toxins, and bacteria to get through and into the bloodstream. Now because undigested food particles, toxins and bacteria are not meant to be in the blood stream, the body reacts to this quite strongly and mounts an immune response.
In your gut, chronic inflammation creates and worsens a leaky gut, which triggers the immune system and creates more inflammation … you can see the vicious cycle.
The lack of good bacteria also contributes by creating an environment where bad bacteria can flourish. Certain good bacteria like those of the lactobacillus family, help to increase the pH in your gut as well as in your endometrial tissue, making it very difficult for the bad bacteria to survive.
So, a healthy microbiome plays a key role in keeping the pH high to make it difficult for bad bacteria to thrive, and with less bad bacteria, your immune system will be calmer. A calmer immune system means less inflammation, and that means it’s harder for endometrial tissue to ‘settle’.
And that’s where nutrition comes in. By removing foods from your diet that you are sensitive to and are known inflammatory foods, and adding anti-inflammatory foods, as well as pre- and probiotic foods, you can start to heal your gut, improve your microbiome, improve your immune function, and see your Endometriosis symptoms reduce.
About the Author: Anne-Marijke Gerretsen
I am Anne-Marijke Gerretsen (call me AMG) and I am on a mission to make ALL Australian women with Endometriosis aware of the role of diet in their symptoms, so they can make an informed decision about how to best manage their Endometriosis and live more of life.
I am a qualified Nutritionist, and have specialised in treating Endometriosis. I run and online clinic: Eat Well Live Well – The Endometriosis Nutritionist.
I could talk about food as medicine, especially for Endometriosis, all day! Not about how to cook or what my favourite recipes are, but how different foods underpin your symptoms and how what you eat and drink can improve your health in ways that medication will never be able to do.
I’ve even written a book about it: ‘Eat Your Way to Less Pain. Reduce Endometriosis symptoms one meal at a time.’
I’m also a behavioural psychologist and an expert in making diet changes stick.