Endometriosis
Endometriosis affects an estimated 1 in 10 women — and yet it takes an average of seven to ten years to receive a diagnosis. Within that time, women are often dismissed, misdiagnosed, or told that painful periods are normal.
What is Endometriosis?
Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows outside of it — on the ovaries, fallopian tubes, bladder, bowel, and other structures. Each month, this tissue responds to hormonal fluctuations the same way the uterine lining does — thickening, breaking down, and bleeding — but with nowhere to go. The result is inflammation, scar tissue, adhesions, and often significant pain.
Endometriosis is classified into four stages based on the extent and location of the tissue, though stage does not always correlate with symptom severity. Some women with stage one endometriosis experience debilitating pain; others with stage four have minimal symptoms.
Symptoms of Endometriosis
Endometriosis can present with an array of seemingly unrelated symptoms — which is part of why it is so frequently missed. Symptoms can include:
Pain symptoms
Painful periods (dysmenorrhea) — often severe and worsening over time
Chronic pelvic pain throughout the cycle
Pain during or after sex (dyspareunia)
Pain with bowel movements or urination, particularly during menstruation
Lower back and abdominal pain
Menstrual symptoms
Heavy or prolonged periods
Irregular bleeding or spotting between periods
Passing clots
Digestive symptoms
Bloating — often referred to as "endo belly"
Nausea, particularly around menstruation
Constipation or diarrhea around the time of your period
Digestive sensitivity that fluctuates with your cycle
Fertility
Difficulty conceiving
Recurrent miscarriage
Systemic symptoms
Fatigue, particularly around menstruation
Anxiety and depression
Brain fog
Disrupted sleep
One of the most important things to understand about your cyclical health is that severe pain is not normal — it is a signal to investigate.
Understanding the Root Causes of Endometriosis
The exact cause of endometriosis is not fully understood, and it is likely that multiple factors contribute. Current research points to several key drivers:
Immune System Dysfunction In a healthy immune environment, endometrial-like tissue that migrates outside the uterus would be identified and cleared. In women with endometriosis, this clearance appears to be impaired — allowing the tissue to implant, grow, and thrive. Supporting immune health is a key part of integrative endometriosis care.
Gut Health The gut is central to many body processes - from immune function to hormone processing and clearance to moods. An imbalanced gut microbiome can form an environment that drives endometriosis. Gut health is an often overlooked but its importance to overall health and healing cannot be overstated.
Chronic Inflammation Endometriosis is an inflammatory condition. The misplaced tissue triggers an ongoing inflammatory response in the pelvic cavity, which drives pain, adhesion formation, and further tissue growth. Reducing systemic inflammation is an important part of the treatment plan.
Estrogen Dominance Endometrial tissue is estrogen-dependent — it grows in response to estrogen and regresses when estrogen levels fall. Many women with endometriosis have elevated estrogen relative to progesterone, which fuels tissue growth. Supporting healthy estrogen metabolism and progesterone balance is a key part of treatment.
Environmental Factors Exposure to endocrine-disrupting chemicals — found in plastics, pesticides, personal care products, and household products — have been shown contribute to the hormonal imbalances that drive endometriosis. Strategies to reduce toxic load is an important part of a comprehensive approach.
An Integrative Approach to Endometriosis
The conventional medical approach to endometriosis typically involves hormonal suppression — most commonly the oral contraceptive pill. Surgery to remove the endometrial tissue by an experienced surgeon is also an important piece of conventional medicine, and one that often works alongside an integrative approach.
An integrative approach to endometriosis begins with a thorough assessment of your symptoms, hormonal health, immune function, gut health, and overall wellbeing. From there, we work together to create a personalized plan — one that works with your body rather than suppresses it. Due to the complexity of endometriosis, referrals are often considered, whether to pelvic floor physiotherapy or a gynecologist specializing in endometriosis. We take the time to talk through your challenges and goals, and ensure your mental and emotional wellbeing also take centre stage as your experiences with endometriosis can feel like a heavy burden to carry on your own.
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