Endometriosis can be both a debilitating issue and a sneaky one. Frequently, endo is first suspected when a woman has stabbing, horribly painful periods with lots of clots; often the period blood is dark red or purple. There are frequently digestive issues such as diarrhea, or nausea and vomiting. Pain may flare in other places, too, in your general abdominal area, the anus, hips, back.
Sometimes endo is sneaky. I’ve had patients with endo where the only sign was a very short (21) day cycle as the only symptom. No pain, no period issues: but it deeply affected their fertility.
Understanding A Normal Endometrial Lining
Every cycle, women shed their uterine lining (the endometrium) in preparation for building a fresh, vital, new lining. If you visualize your uterine lining, most of it is discharged down. But in all women, some of it goes up and out of the uterus into the body. How? If you look at the diagram above, notice that the fallopian tubes are not attached to the ovaries: it’s not a closed system. When you have your period and your uterus contracts to shed the lining, it’s like squeezing a tube of toothpaste open at both ends: most goes down, some goes up.
Normally, when the endometrial cells escape into the body, they float around, die quickly and the immune system cleans them up. But in a woman with endo, that’s not what happens.
What Happens In Endometriosis
First, the endometrial cells are super sticky, so they stick to each other, and stick to other tissues abnormally. That’s why clotty periods are common. But it also means that when the cells go into the body cavity, they stick to things they shouldn’t and act like glue, which means that other body tissues start adhering, too.
Second, endo cells secret chemical signals that tell the immune system that they are supposed to be there, so the immune cells don’t clean them up the way they normally would. That means the endo cells stay there.
Third, endometriosis cells don’t die the way they should. Most normal cells undergo a process called apoptosis, a process of normal cell death. Endometriosis cells have the kill switch off, which means they stay alive and divide, creating more of themselves.
In short, endometriosis cells go where they don’t belong, stick to things they shouldn’t, don’t get cleaned up when they should, and don’t die like they ought to.
Endo and Fertility
In terms of fertility, endometriosis creates further complications. Endometriosis has an affect on normal blood flow to the ovaries. Part of the problem is that women with endometriosis are estrogen dominant. Whether excess estrogen is the cause, the result, or both, of endometriosis, the excess estrogen inhibits normal follicular development and interferes with healthy uterine lining development. The effect is a huge problem. Endo decreases blood flow to the ovaries and creates an estrogen heavy environment, compromising the nutrients that are delivered to developing follicles and inhibiting their growth. It also affects implantation. The sticky endometrial tissue prevents healthy implantation, much like a seed you plant that sticks halfway out of the mud rather than being fully buried in the ground. So fertility in women with endo gets a double whammy: poor egg quality and poor implantation. In fact, in IVF, success rates for women with endometriosis are decreased 40-50%.
Diagnosing and Treating EndoWestern medicine doesn’t have a way to treat endo, other than birth control and surgery. While they can help, these treatment methods don’t get to the root of the problem. In Chinese Medicine, endometriosis is classified as stagnant blood: that’s the diagnosis. The key to treating endometriosis is understanding the root cause. In CM, there are four types of endometriosis: hot, cold, qi stagnant or combination types. How endo is treated depends on what type you have. Treating the root cause is important, and the foundation is lifestyle changes, supplements and CM diagnosis specific changes.
Success Treating Endo For Fertility
Endo makes it harder for women to conceive. Whether you are doing IVF or TTC, it takes time. Hormones need to be normalized, healthy egg and lining development needs to be promoted.
The good news is, my 90 Day Reset Program can help you change your hormone balance, help healthy eggs develop, and increase your chances of conceiving. It requires a strong commitment on your part to change what you eat, manage your stress, and take supplements.
Treating Endo fertility issues is very much a long term commitment to your health, but the benefits are remarkable. Women with Endo who make the changes outlined in the 90 Day reset course find that they have increased energy, cycles get more regular, pain decreases. I’ve had women tell me that the course was worth it just for the reduction in their symptoms! And there is a definite improvement in their fertility. BUT, it takes time. Egg development is a 3-month process, so seeing real changes in fertility due to endo takes a minimum of four to six months. I promise you will feel better and will notice changes during this time. I can’t guarantee outcomes, but any steps that help your hormonal balance will improve your chances.
For women undergoing IVF, a minimum of 4 months of lifestyle changes can improve the number of healthy eggs and improve uterine lining. For TTC naturally patients, it takes much longer. In either situation, most women will feel better, periods and symptoms will normalize, and your fertility will improve with targeted changes.