What's the Link Between Endometriosis and Gut Health?

Endometriosis is a complex and debilitating condition that affects millions of women worldwide. Traditionally viewed as a gynaecological disorder, emerging research suggests that there is a strong connection between endometriosis and gut health. Let’s delve into this endo-gut connection exploring potential mechanisms, symptom overlaps, and how optimising gut health may offer new avenues for managing this condition.

UNDERSTANDING ENDOMETRIOSIS

Endometriosis is characterised by the growth of endometrial tissue, similar to the lining of the uterus, outside of the uterus. This abnormal tissue growth can lead to painful periods, pelvic pain, fertility challenges, and other symptoms. While the exact cause of endometriosis remains unclear, several factors, including immune dysfunction, genetic predisposition, hormonal imbalances, and inflammation, are believed to contribute to its development.

THE GUT-ENDOMETRIOSIS CONNECTION

Endometriosis and gut symptoms are interlinked. Endometrial lesions can occur directly on the bowel and cause digestive problems, AND up to 90% of women with endometriosis also experience digestive symptoms. So how and why is this a two-way street?

Inflammation and Immune Dysregulation

One of the biggest issues is that digestive problems impact the immune system, and immune dysfunction is a key driver of endometriosis. Our immune system resides within the gut, so anything that upsets our digestion also upsets our immune system and causes the production of inflammatory cytokines. Both endometriosis and gut disorders, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), involve chronic inflammation and immune dysregulation.

Gut Microbiome Imbalance

The gut microbiome, a vast community of microorganisms residing in our digestive tract, plays a key role in maintaining overall health. Emerging evidence indicates that alterations in the gut microbiome composition and diversity are associated with endometriosis. Dysbiosis, an imbalance in gut bacteria, may contribute to inflammation and immune dysfunction, perpetuating the development and progression of endometriosis. Of particular note are gram-negative bacteria that have a cell wall made up of lipopolysaccharides (LPS). LPS’s produce toxins that promote inflammation and endometriosis.

Oestrogen Metabolism

Oestrogen, a hormone primarily involved in the reproductive system, is intricately linked to endometriosis. Interestingly, the gut microbiome plays a vital role in oestrogen metabolism. Imbalances in the gut microbiota can lead to abnormal oestrogen metabolism, potentially influencing the development and growth of endometriosis lesions.

Increased Intestinal Permeability

The integrity of the intestinal barrier is crucial for maintaining gut health. In conditions like endometriosis, there is evidence suggesting increased intestinal permeability or "leaky gut." This heightened permeability allows toxins, bacteria, and other harmful substances to enter the bloodstream, triggering inflammation and immune responses, which may contribute to the progression of endometriosis.

ADDRESSING GUT HEALTH FOR ENDOMETRIOSIS MANAGEMENT

Optimising gut health can be a valuable approach in managing endometriosis symptoms and potentially slowing its progression. Here are some strategies to consider:

Anti-inflammatory Diet

Emphasise a whole foods-based, anti-inflammatory diet rich in fruits, vegetables, healthy fats, and lean proteins. Minimise alcohol, processed foods, refined sugars, and potential food triggers that may exacerbate inflammation and gut symptoms.

Gut-Supportive Nutrients

Certain nutrients, including berberine, probiotics, prebiotics, and gut-healing compounds like glutamine and zinc, can support gut health. Incorporating these nutrients through diet or supplementation may help restore gut balance.

Stress Management

Chronic stress can disrupt gut health and worsen symptoms. Engage in stress management techniques such as mindfulness, meditation, yoga, and adequate sleep to promote a healthy gut-brain axis.

Consider Herbal Support

Herbal remedies like turmeric, ginger, licorice, and chamomile have anti-inflammatory and gut-soothing properties.

Nutrients Beyond the Gut

One nutrient to highlight that has done incredibly well in clinical trials in the reduction of endometrioma cysts and pain scores is N-acetyl cystine (NAC). While this doesn't specifically work on the gut, it is an amino acid that is a precursors to our bodies best antioxidant and immune regulator, glutathione, and it works by decreasing inflammation.

As we better understand the connection between endometriosis and gut health, it opens up new possibilities for managing this challenging condition. By addressing gut-related imbalances and reducing inflammation, we can potentially alleviate symptoms and improve the overall well-being of women with endometriosis. It is essential to have a team of healthcare providers that considers both gynaecological and gastrointestinal aspects of endometriosis, so we can empower women to take control of their health and their lives.

If you are experiencing gut symptoms and would like individualised support, please get in touch by booking in a Discovery Call HERE.

REFERENCES

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8972862/
https://www.mdpi.com/1660-4601/20/6/4686