Endometriosis

Hormone Care
Written By Jennifer Tang

Overview

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It can affect menstrual health, pelvic pain, digestion, sexual health, fertility, energy, and overall quality of life.¹ ² Symptoms can vary significantly from person to person, and the amount of pain someone experiences does not always reflect the extent of the condition.²

At Tangible Health, we take an individualized, integrative approach to endometriosis care. We focus on supporting pain and symptom management, nutrition, digestive health, sleep, stress, and overall well-being alongside appropriate medical and gynecological care.

What Is Endometriosis?

Endometriosis is a chronic, estrogen-dependent inflammatory conditionin which tissue similar to the lining of the uterus grows outside the uterine cavity.¹ ³ Endometriosis is most commonly found within the pelvis and may involve the ovaries, fallopian tubes, pelvic lining, bowel, bladder, or surrounding tissues. In some cases, endometriosis can also occur outside the pelvis, including within the abdomen or chest.¹ These areas of endometrial-like tissue can contribute to inflammation, scar tissue, adhesions, and pain. Depending on where endometriosis is located,  it can significantly impact quality of life, fertility, mental health, and daily functioning.¹ ²

Endometriosis affects everyone differently. Some people experience significant pain and other symptoms, while others may have relatively few symptoms. The severity of symptoms does not always correspond with the extent of the disease.² There is currently no known cure for endometriosis, but medical, surgical, fertility, pain-management, and supportive treatment options can help manage symptoms and improve quality of life.¹ ³

Common Symptoms of Endometriosis

Endometriosis can present differently for each person. Common signs and symptoms may include:¹ ²

  • Painful periods that interfere with everyday activities

  • Chronic or recurrent pelvic pain

  • Pain during or after sexual intercourse

  • Heavy menstrual bleeding

  • Pain with bowel movements, especially around menstruation

  • Pain with urination, especially around menstruation

  • Abdominal bloating or nausea

  • Constipation, diarrhea, or other digestive symptoms

  • Fatigue or low energy

  • Difficulty becoming pregnant

  • Anxiety, depression, or emotional distress associated with chronic symptoms

Not everyone with endometriosis experiences the same symptoms, and symptom severity does not necessarily correspond with the extent of endometriosis.²

Causes & Contributing Factors

The exact cause of endometriosis is not fully understood. Current research suggests that hormonal, genetic, immune, inflammatory, and cellular factors may all contribute to its development.¹ ²

Hormonal Influences
Endometriosis is influenced by reproductive hormones, particularly estrogen. Hormonal activity can affect the growth and activity of endometriosis lesions, which is one reason hormonal therapies are commonly used in medical management.³ ⁴

Genetics & Family History
Endometriosis can occur more frequently within families, suggesting that genetic factors contribute to an individual's likelihood of developing the condition. However, there is no single identified cause or gene responsible for endometriosis.¹ ²

Immune & Inflammatory Factors
Endometriosis is associated with inflammatory processes, and researchers continue to investigate how immune function and inflammatory signalling contribute to lesion development, pain, and differences in symptoms between individuals.¹

Other Proposed Mechanisms
Retrograde menstruation, in which menstrual fluid travels backward through the fallopian tubes into the pelvic cavity, is one proposed mechanism. However, retrograde menstruation alone does not explain why endometriosis develops in some people and not others.²

Other cellular, developmental, and biological mechanisms are also being studied.

Our Approach to Endometriosis

At Tangible Health, we focus on understanding how endometriosis is affecting you individually. Your care plan is developed around your symptoms, medical history, reproductive goals, and the outcomes that matter most to you.

Your Symptoms & Pain
We look at your menstrual cycle, pelvic pain, pain during sex, digestive or urinary symptoms, fatigue, and how symptoms change throughout your cycle. For people experiencing persistent pain, we may also consider the broader factors that can influence chronic pain, including sleep, stress, physical activity, pelvic floor health, and nervous-system sensitization.⁵

Your Digestive & Overall Health
Digestive symptoms such as bloating, constipation, diarrhea, nausea, and abdominal discomfort are commonly reported with endometriosis.¹ We may explore nutrition, bowel habits, nutrient intake, sleep, energy, and other areas of health that may be contributing to how you feel.

Your Goals
Endometriosis care can look very different depending on whether your priorities include reducing pain, improving digestive symptoms, supporting energy and quality of life, trying to conceive, or navigating treatment alongside a gynecologist or endometriosis specialist.

Treatments That May Be Included

Your endometriosis care plan may include a combination of:

  • Acupuncture as a complementary approach to pelvic pain management

  • Clinical nutrition to support nutritional adequacy, digestive health, and sustainable eating habits

  • Digestive health support for symptoms such as bloating, constipation, diarrhea, or abdominal discomfort

  • Botanical medicine when appropriate, taking evidence, medication interactions, and reproductive goals into consideration

  • Nutraceuticals & supplements when there is an individualized nutritional or clinical indication

  • Lifestyle medicine to support sleep, movement, stress, energy, and daily routines

  • Mind-body and chronic pain strategies as part of a broader approach to persistent pelvic pain

  • Collaborative care with gynecologists, pelvic floor physiotherapists, fertility specialists, and other healthcare providers when appropriate

Each treatment is selected to work together, supporting both immediate symptom relief and long-term health improvements.

What to Expect

Initial Assessment
We start by taking a comprehensive look at your menstrual history, pelvic pain, symptoms, health history, digestive health, fertility goals, nutrition, sleep, stress, medications, supplements, previous testing, imaging, and overall well-being.

Targeted Testing
Testing is recommended based on your individual presentation rather than using the same panel for everyone. Endometriosis itself is not diagnosed through routine hormone panels, gut testing, inflammatory markers, or functional medicine testing. Clinical assessment and imaging such as ultrasound or MRI may be used when endometriosis is suspected.¹ ²

Additional laboratory testing may still be appropriate for related concerns. Examples of such tests may include, but are not limited to, functional medicine testing, comprehensive bloodwork, hormone panel, gut health testing, nutrient deficiencies, metabolic health panel, immune system testing, inflammatory markers, etc.

Personalized Plan
Your care plan is developed around your symptoms, priorities, medical care, clinical findings, and health goals. There is no single naturopathic “endometriosis protocol.” Recommendations are selected according to your individual needs.

Ongoing Support
Endometriosis is a long-term condition, and your symptoms and priorities may change over time. Follow-up allows your plan to evolve based on your response to treatment, changing goals, new investigations, and other medical care.

When to Seek Support for Endometriosis

You don't need to wait for symptoms to become severe before getting help. Consider seeking support if you are:

  • Experiencing periods that are painful enough to interfere with work, school, sleep, or everyday activities

  • Living with persistent or recurring pelvic pain

  • Experiencing pain during or after sex

  • Having pain with bowel movements or urination, particularly around your period

  • Experiencing digestive symptoms that consistently worsen around menstruation

  • Managing heavy menstrual bleeding

  • Trying to conceive without success

  • Finding that your symptoms are becoming more frequent or severe

Delays in recognizing and diagnosing endometriosis are common. Current guidance supports earlier clinical assessment and appropriate imaging rather than requiring every patient to undergo surgery before receiving care.¹ ²

Book An Appointment

Frequently Asked Questions

  • Common early signs include painful periods, pelvic pain, pain during sex, digestive symptoms, fatigue, and difficulty becoming pregnant.¹ ² Symptoms can be mild or severe and may change over time.

  • Endometriosis is assessed based on your symptoms, medical history, and sometimes imaging such as ultrasound or MRI.¹ ² There is no single blood test that can confirm the condition.

  • Endometriosis may cause severe menstrual cramping, aching or sharp pelvic pain, lower back pain, pain during sex, or pain with bowel movements or urination.¹ ² Pain can occur during your period or at other times of the month.

  • There is currently no known cure for endometriosis. However, symptoms can often be managed through medical treatment, surgery when appropriate, chronic pain management, fertility care, and supportive therapies.¹ ³

  • No. Naturopathic medicine does not cure or remove endometriosis lesions. Naturopathic care may be used alongside conventional treatment to support concerns such as nutrition, digestive symptoms, sleep, stress, chronic pain, nutrient status, and overall well-being. Evidence for complementary endometriosis treatments continues to evolve.³ ⁴

 

Related Care

Endometriosis is closely connected to broader areas of health. You may also benefit from:

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