Integrative | Functional Nutrition For Endometriosis
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Important Factors Connecting Endometriosis to Your Gut Health

You’re probably aware that gut health is related to your immune system. In fact, taking care of your gut can help prevent a number of symptoms and diseases tied to your digestion like leaky gut, irritable bowel syndrome (IBS), constipation, and bloating. But did you know there’s a tie between your gut health and endometriosis? You may be wondering, “Khush, but endometriosis doesn’t have to do with my digestive system. Doesn’t endometriosis have to do with my uterus, not my gut?”   Well, here’s the interesting thing. I’ve found in my practice that most women with endometriosis suffer from common endometriosis symptoms, things like painful periods (AKA dysmenorrhea), extreme abdominal pain, fatigue, and fertility issues. But these same women also suffer from symptoms corresponding to IBS, like:
  • non-stop bloating
  • constipation
  • diarrhea
  • abdominal pains
  • gas
  Your gut, including your small and large intestine, is located right next to your reproductive organs, your ovaries, and uterus. So from a location perspective, it makes sense your gut health could impact your endometriosis.  Sorta like how rowdy neighbors can ruin a good night’s sleep. But what’s the specific connection? Let’s look at three factors connecting your gut health with endometriosis. And stay tuned for an exciting announcement at the end.  

1. Your Gut Microbiome

Your gut microbiome includes all of the tiny microorganisms that live inside your digestive system. These can include viruses, bacteria, and fungi.  Now out of those microorganisms, your body contains about 100 trillion bacteria. That’s even more than the number of people alive on earth right now. You may be wondering, “How is that much bacteria in my body a good thing?” And the answer is: it’s all about balance. You see, there are 300 to 500 different types of bacteria in your gut, and as long as they keep each other in check you won’t get sick. In fact, your microbiome keeps you healthy by helping you digest your food, absorb nutrients, and even produce vitamins.  So what does your gut microbiome have to do with endometriosis? Studies are showing that endometriosis can increase certain kinds of gut bacteria. One species of bacteria that’s increased in women with endometriosis is Escherichia coli (E. Coli). Yes, that E. Coli – the one you hear about on the news then throw all your lettuce away, just in case. 
  1. E. Coli produces lipopolysaccharide (LPS), a toxin that causes inflammation. Endometriosis is already an inflammatory disease, so increasing inflammation in the body can cause even more pain.
  Now let’s dive deeper into your gut microbiome and how that ties in with hormones and endometriosis.

2. Your Serotonin Levels and Mood

Serotonin is a hormone and neurotransmitter that helps regulate your mood and gives you feelings of calmness and happiness. While serotonin transmits messages between brain cells, about 90% of serotonin is produced in your gut. Now, what does serotonin have to do with endometriosis? If you have endometriosis, you’ll also suffer from high amounts of estrogen (AKA estrogen dominance). Side note: Estrogen may also be referred to as oestrogen.  The higher your estrogen levels, the more severe your endometriosis symptoms will be. This is because estrogen can influence the growth of your endometrial tissue. So what’s the link between your estrogen levels and serotonin? In individuals without endometriosis, estrogen helps increase serotonin production and serotonin receptors in the brain. But if you have endometriosis, you’ll experience inflammation that blocks estrogen from increasing serotonin and its receptors. This means you’ll experience low levels of serotonin. Low levels of serotonin can lead to symptoms such as:
  • Depression
  • Carbohydrates and sugar cravings
  • Digestive issues, such as constipation
However, there are ways you can increase your serotonin levels. Things like exercise, exposure to sunlight or bright light, and certain eating foods (such as eggs, pineapples, tofu, salmon, nuts, and seeds) will help give your body the serotonin boost it needs. You can also ask your health provider to test your serotonin levels to confirm if low serotonin levels are causing your symptoms.  

3. Estrobolome

Now you know the impact that your gut microbiome and serotonin levels have on endometriosis. But what about specific types of bacterial genes in your microbiome? One group of bacterial genes that specifically affect endometriosis is estrobolome.  Estrobolome wears a number of hats. First, it acts like your body’s traffic controller by controlling the amount of estrogen that’s circulating in your body. Second, estrobolome produces beta-glucuronidase (AKA 𝛃-glucuronidase). 𝛃-glucuronidase is an enzyme that converts estrogen from its nonactive to its active forms. Why is that important? This can control the amount of estrogen in your body. In a healthy gut, estrobolome is just like Goldilocks: the gut produces just the right amount of estrogen. But what about estrobolome in women with endometriosis? Estrobolome will have higher amounts of 𝛃-glucuronidase leading to more estrogen in women with endometriosis. This is because when you have high amounts of 𝛃-glucuronidase, estrogen doesn’t get taken to your liver, packaged up, and pushed out of your intestines and leave your body through your stool. Instead, estrogen gets recirculated in your body. And remember how women with endometriosis already have elevated amounts of estrogen? You’ll be increasing the amount of estrogen in the body even more. This will lead to severe symptoms of estrogen dominance like low libido, depression, irritability, weight gain, and insomnia. You may experience more severe symptoms of endometriosis as well.   So, what can you do to balance your estrobolome and control 𝛃-glucuronidase?  You can adopt simple lifestyle changes! Here are some examples.
    • Manage stress levels: I recommend my clients perform a calm physical activity like walking or yoga. Yoga can also help with the cramping you’re experiencing with endometriosis.
    • Focus on gut microbiome balance through probiotics: I normally recommend starting with a probiotic that contains Lactobacillus Acidophilus and Lactobacillus Gasseri to rebalance your gut dysbiosis. But remember: Talk to your medical provider to determine which probiotics would be best for you to take.
 
  • Consume fiber: Fiber can help your gut microbiome to stay balanced. 
 
  • Lower or eliminate refined foods containing sugar: Stay away from processed foods such as white pasta, rice, and bread. Not only will this help with your gut health, but it can help reduce inflammation as well. Check out this resource to learn about anti-inflammatory foods to eat.
  • Eat organic fruits and vegetables: Our foods contain pesticides that are xenoestrogens. If you reduce xenoestrogens, you’ll also reduce 𝛃-glucuronidase levels leading to improved estrogen levels and gut microbiome.
      The more I study the human body, the more fascinated I become. While the concepts of endometriosis tying in with gut health through your gut microbiome, serotonin, and estrobolome may be a little complicated, hopefully you can see how our bodies are interconnected.    There’s no cure to endometriosis, but by prioritizing your gut health we can reduce your symptoms.

Want to Take Control of Your Gut Health and Beat Your Endometriosis?

I want the same for you!    And here’s my exciting announcement – I’m holding a FREE 7-day challenge to help you beat your endometriosis! You’ll be surrounded by a strong and supportive community of women who are ready to implement lifestyle changes to overcome their endo. I believe that we’re successful when we help others, and this is exactly what this community is about.   Want to implement lasting changes by taking care of your gut health and endometriosis?  

Join us in my free 7-day challenge! It begins on Monday, May 10. For more information and to sign-up, click here.

  I’m rooting for you and your health! Khush Sra P.S. If you have any questions before the challenge begins, feel free to DM me on Instagram: @endonutrition.

FAQ

How does gut health affect endometriosis?

The gut microbiome directly influences estrogen metabolism. An imbalanced gut (dysbiosis) can increase estrogen recirculation in the body, which fuels endometriosis growth and worsens pain. Supporting gut health through diet, probiotics, and reducing inflammatory foods is a key part of an integrative endometriosis treatment approach.

What foods help with endometriosis gut health?

Anti-inflammatory foods that support gut health in endometriosis include fiber rich vegetables,
fermented foods (like sauerkraut and kimchi), omega-3 fatty acids from wild fish, and leafy greens.
Avoiding gluten, dairy, alcohol, and processed sugar can significantly reduce gut inflammation and endo symptoms.

Can healing your gut put endometriosis in remission?

While gut healing alone won’t cure endometriosis, addressing gut dysbiosis is a foundational step in a whole-body approach that has helped many women significantly reduce their pain and symptoms. Combined with nervous system regulation, hormone balancing, and lifestyle changes, gut healing can contribute to long-term symptom relief and even remission in some cases.

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