What is it?

The endometrium normally resides in the uterus, forming the uterine lining, and is expelled and rebuilt each month during menstruation.  Endometriosis is a condition in which endometrial tissue grows outside the uterus.  In women suffering endometriosis, displaced endometrial tissue is most commonly found on the ovaries, in the fallopian tubes, the outer wall of the uterus, the ligaments of the uterus or ovaries, in the bowel, the ureters or the bladder.  However, endometriosis can occur anywhere in the body.

For women with endometriosis, the displaced endometrial tissue responds and performs in the same way as the endometrium forming the uterine lining.  The displaced tissue builds up as the body moves towards ovulation and then breaks down and bleeds during menstruation.  This bleeding can trigger inflammation and pain and over time can lead to scarring, known as adhesions.  Endometriosis has a significant impact on fertility and is a causative factor in 35 – 50% of fertility issues in women.

The cause of endometriosis is largely unknown and symptoms can vary greatly.  Most common symptoms of endometriosis include

  • Severe period pain (or pain may last all month long)
  • Lower abdominal pain or back pain
  • Heavy bleeding and/or clotting
  • Abnormally long or short cycles
  • PMS (Pre-menstrual syndrome)
  • PMT (Pre-menstrual tension)
  • Painful intercourse
  • Abdominal swelling
  • Infertility

As these symptoms are somewhat vague and can occur without the presence of endometriosis, some women are not aware they have endometriosis until it is discovered during unrelated surgery or when trying to fall pregnant.  Therefore early diagnosis and prevention of endometriosis can be difficult.

Endometriosis does appear to have a genetic connection and is commonly seen in mothers, daughters and sisters.  Endometriosis is also found to be associated with a relative estrogen to progesterone excess.   Speak to your Health Care Professional if you are concerned about whether you may have Endometriosis.


How do I know if I have it?

Although the symptom picture of endometriosis varies greatly, if you are having difficulty falling pregnant and are experiencing any of the below symptoms, you should consult your health care professional.

  • Severe period pain (or pain may last all month long)
  • Lower abdominal pain or back pain
  • Heavy bleeding and/or clotting
  • Abnormally long or short cycles
  • PMS (Pre-menstrual syndrome)
  • PMT (Pre-menstrual tension)
  • Painful intercourse
  • Abdominal swelling

Most diagnoses of endometriosis occur during a laparoscopy, when gynaecologists can see the misplaced endometrial tissue.  During this procedure, small incisions are made between the navel and the pubic bone, through which a thin instrument with fibre optics is inserted so the surgeon can view the inner organs.  The exact location of the incisions depends on your surgeons experience and your unique presentation.  Sometimes a laparoscopy is simply performed as a diagnostic tool, or in more severe cases, endometrial tissue as well as any scar tissue and adhesions can be removed.


Why does endometriosis affect my fertility?

Mild endometriosis may have little, if any, impact on fertility.  In fact some women may never be aware that they have it.  However, more severe endometriosis can have a significant impact on fertility and your ability to fall pregnant.  The displaced endometrial tissue can damage to internal organs including the fallopian tubes, ovaries and uterus.  Scarring can hinder or block the passage of the egg and sperm making fertilization difficult or impossible.  Scarring on the uterus may prevent a fertilized egg from implanting.  If endometriosis is present on the ovaries, eggs may be damaged resulting in decreased ovarian reserve and reduced egg quality and quantity.  The continual bleeding of displaced endometrial tissue also increases inflammation and congestion within the body.


What can I do to help me conceive?

There are three approaches to treating endometriosis.

  • Surgery
  • Balance hormones
  • Reduce congestion and inflammation


In women with severe endometriosis surgical treatment is the most effective.  Surgeons will remove displaced endometrial tissue, where possible, via laparoscopy.  In most cases, after surgical removal of endometriosis, you should try to conceive over the next 3 – 6 months, during which time you will be most fertile.  Unfortunately, removal is not necessarily the magic bullet cure we’d like it to be, as endometrial tissue can grow back over time.  How quickly the tissue regrows differs between individuals and natural approaches can help reduce regrowth.


Balancing hormones


  • The Pill, Gonadotrophin-releasing hormone agonist, Progestin, Danazol
    • These medications are prescribed to women with endometriosis to help to correct hormonal imbalance. The aim of these treatments is to reduce the excess estrogen in relation to progesterone. This helps to slow or prevent further growth of displaced tissue and reduce symptoms.  These medications are also contraceptives, blocking conception, and are therefore not able to be used when trying to conceive.


  • Vitex
    • Vitex is one of the most commonly used herbs, prescribed for its progesterone enhancing action. This helps to rebalance the estrogen dominance associated with endometriosis
  • Natural progesterone cream
    • Natural progesterone creams are generally derived from either wild yam or soybeans. The active ingredient, diosgenin, synthesised into a molecular structure identical to human progesterone.  These are sometimes referred to as ‘human-identical’ or ‘bio-identical’ progesterone.  The cream is rubbed into the skin for absorption into the blood stream.
  • White Peony
    • A great hormone balancing herb.
  • Ladies Mantle
    • Supports progesterone and astringent properties

Hormone balancing herbs should not be self-prescribed.  See your natural fertility specialist or other qualified health care professional for recommendations to best suit your hormonal profile.


Reducing congestion and inflammation

The excess endometrial tissue leads to a great deal of congestion within the reproductive system.  Every month as bleeding occurs scar tissue builds up, further exacerbating this congestion.


  • Calendula
    • Calendula is an excellent herb for improving lymphatic drainage and reducing internal congestion, which can be an issue for those with endometriosis. It also helps to reduce muscle spasms and heavy menstrual bleeding as well as providing beneficial anti-inflammatory action.
  • Turmeric
    • Turmeric supports detoxification pathways to help further reduce congestion as well as imparting strong anti-inflammatory and antioxidant activity.
  • Rheumannia
    • Anti-inflamatory as well as anti-spasmodic to support pain relief.  Rheummania is also an antioxidant which can be of benefit to reduce free radical formation, which has been associated with endometriosis.

For best results using these herbs, consult your natural fertility specialist.


Foods to increase

To help ease the congestion and inflammation associated with endometriosis your diet should focus on

  • Fresh, organic fruits and vegetables
    • For women with endometriosis, fruits and vegetables should form the bulk of your diet. Eating organic where possible maximises the availability of essential nutrients and helps reduce inflammation due to the lack of chemical intervention.
  • Cruciferous vegetables
    • Cruciferous vegetables such as broccoli, kale, cauliflower, bok choy, brussel sprouts, cabbage, collards greens and mustard greens are particularly beneficial for women with endometriosis as they contain a nutrient known as diindolymethane which supports hormone balance by assisting in the breakdown of estrogen.
  • High fibre
    • Fibre helps cleanse the body, reducing congestion and supporting the excretion of excess estrogen
  • Oily fish, nuts, seeds and other sources of essential fatty acids
    • Essential fatty acids help reduce the inflammation and pain associated with endometriosis

The 90 day fertility diet has been specifically designed to help reduce inflammation and congestion and support fertility, conception and the progression of a healthy pregnancy.


Foods to decrease

In cases of endometriosis it’s important to avoid foods that have been shown to exacerbate inflammation and congestion, these include

  • Wheat and gluten
    • Studies have linked high wheat intake with increased pain in endometriosis. Gluten sensitivity and intolerance have also been found to be more common in women with endometriosis.
  • Dairy
    • Dairy can contribute to congestion within the body, with popular homogenised, pasteurised cow’s milk being one of the hardest dairy products to digest and most congestive. The best forms of dairy to consume are organic natural yogurts and where possible choose milk alternatives such as almond, rice or oat milk (soy milk is not recommended due to it’s estrogenic properties).
  • Red meat
    • Red meat can exacerbate inflammation so should be limited to 3 times per week or less. Ideally meat should be organic.  Studies also suggest minimising ham and pork intake.
  • Toxins
    • Toxins of all forms increase the load on detoxification pathways, contributing to increased congestion and inflammation. To help minimise your toxic load you should
      • Eat organic
      • Use organic body products and make-up
      • Use eco-friendly, low chemical detergents and cleaning products
      • Use natural feminine hygiene products
      • Avoid all exposure to pesticides, herbicides and synthetic fertilisers