The Underlying Drivers of Endometriosis
Endometriosis is often talked about in relation to hormones, and while estrogen absolutely plays a role, there is so much more happening beneath the surface.
Endometriosis is a complex, inflammatory condition that involves the immune system, gut health, hormones, mast cells, environmental exposures, and more.
This is why simply trying to address hormones often isn't enough.
When we work with clients with endometriosis, we're taking a whole body approach and looking at the bigger picture. We go “inflammation hunting”, look at the immune system, digestion, and of course we look at hormones too.
Let's break down some of the underlying factors we look at.
1. Immune System Dysfunction
Endometriosis isn't just a reproductive health condition. It involves the immune system and can create inflammation throughout the body.
Research has found immune dysregulation and inflammatory changes in people with endometriosis, which may impact the body's ability to properly respond to and clear endometrial-like tissue outside of the uterus.
This is one reason we want to look beyond the pelvis.
A question we are looking to dive deeper is: why is the immune system so activated in the first place?
Supporting nutrient status, gut health, inflammation, stress physiology, and other immune-regulating systems can all be important pieces of the bigger picture.
2. Histamine + Mast Cells
There is an interesting connection between histamine, mast cells, estrogen, and endometriosis.
Mast cells are immune cells that release histamine and other inflammatory mediators. Estrogen can influence mast cell activity, while mast cells can also influence estrogen-related signaling from the ovaries.
This can create a feedback loop where estrogen and inflammatory signaling continue to influence one another.
For someone experiencing endometriosis alongside symptoms like:
Histamine intolerance
Flushing
Itching
Headaches
Digestive symptoms
Cyclical symptoms
It's worth considering whether mast cell and histamine regulation may be another piece of the puzzle.
3. Gut Health
The gut-endometriosis connection is one of the areas we pay particularly close attention to in practice.
A large percentage of people with endometriosis also experience IBS-like digestive symptoms, including bloating, constipation, diarrhea, and abdominal pain.
This relationship can go both ways. Gut dysbiosis can contribute to inflammation throughout the body, while endometriosis and the inflammatory environment surrounding it can also impact gut function.
One potential player is lipopolysaccharide (LPS). LPS can be produced by dysbiotic bacteria in the gut. When gut barrier function is compromised and dysbiotic bacteria are elevated, LPS can enter circulation and trigger a strong inflammatory response.
Research has found elevated LPS in the pelvic environment of people with endometriosis, adding another layer to the gut-pelvis connection.
This is one of the reasons we run stool testing with all of our endometriosis clients.
4. Environmental Toxicity
We are exposed to thousands of chemicals through our food, water, air, personal care products, cleaning products, and environment.
Some of these compounds can act as endocrine-disrupting chemicals (EDCs), meaning they can interfere with normal hormone signaling.
Environmental exposures can also place additional stress on the body's detoxification and immune systems.
For someone with endometriosis, this becomes another area worth considering.
It means we can look at the total toxic burden and focus on practical ways to reduce unnecessary exposures while supporting the body's natural detoxification pathways.
Mold exposure can also be an important consideration, particularly when someone has unexplained immune activation, chronic inflammatory symptoms, or a history of potential mold exposure.
5. Gluten Sensitivity
Gluten isn't inherently problematic for everyone, but for some people gluten can trigger an inflammatory or immune response and contribute to changes in intestinal permeability.
If someone with endometriosis also experiences digestive symptoms, food reactions, or signs of impaired gut barrier function, exploring gluten sensitivity may be worthwhile.
This is another example of why we don't want to treat the reproductive system in isolation.
If the gut is inflamed, the immune system is activated, and the intestinal barrier is compromised, that inflammatory burden can influence the rest of the body.
What to take away from this:
Endometriosis is complex, and there isn't one single root cause that explains every person's experience. When working with someone with endometriosis, we want to understand:
Hormones → Immune system → Gut → Histamine → Environment → Nutrient status → Nervous system
These systems are constantly communicating with one another, and it’s our job to help you connect the dots.
If you're dealing with endometriosis and feel like you've been stuck managing symptoms without understanding the bigger picture, our 1:1 Functional C.A.R.E Method™ takes a whole-body approach to uncovering the factors that may be contributing to your symptoms and supporting your body from the inside out.
