Endometriosis: Endometriosis is a whole-body inflammatory and immune disease—it has a pathological presence, and it doesn’t go away on its own.
Menopause does not cure endometriosis.
Pregnancy does not cure endometriosis.
Birth control does not cure endometriosis.
Ablation does not cure endometriosis.
Imaging ‘can help’ diagnosis, but it cannot rule out endometriosis just because it’s not visible.
Endometriosis is not caused by reproductive hormones, though it is heavily influenced by them (there’s a difference). Endometrial lesions can actually make their own estrogen—but don’t confuse this with replacing the estrogen your ovaries make.
Rebound endometriosis is very real.
At this present time (2025), health coaches cannot cure endometriosis, but we sure as hell can support our clients by providing education, support, and accountability. There comes a time when DIY will require professional guidance to level up.
Endometriosis is most commonly located in the pelvic region (ovaries, fallopian tubes, and the peritoneum), but it can show up in places like the rectum,bladder, lungs, kidneys, appendix, colon, liver, brain, heart and I think you get the idea. These locations may seem rare, but they’re not. The ability to diagnose is simply getting better (as it should), although sadly the access to that ‘better’ is not. This should make one thing clear: Endometriosis can affect nearly any organ in the body, and it highlights how reproductive hormones (yes, those hormones) can affect more than just your reproductive system.
If you want to skip around you can, although I'd suggest start to finish reading as I paint some very important connections. This this blog will cover:
The Gut-Immune Connection: How an inflamed gut can worsen endometriosis symptoms through systemic inflammation.
Gut Dysbiosis and Endometriosis: How bacterial overgrowth and sluggish digestion fuel the growth of endometrial lesions.
Celiac Disease and Endometriosis: Why many women with endometriosis also have celiac and how both are linked by chronic inflammation and immune dysfunction.
Side Tangent on the Gluten Debate.
Gut-Thyroid and Endometriosis: Because can we talk about the gut without the thyroid?
Gut Health and the Immune System: And I don’t mean the sniffles, although… well that is a deeper talk.
Since the gut is home to 70-80% of the body’s immune system (specifically, the gut-associated lymphoid tissue, or GALT), gut imbalances can directly affect how the immune system functions. Damn, makes gut health look pretty different, huh?
An inflammatory gut can activate the immune system in ways that increase the production of inflammatory cytokines, which can directly influence the growth and activity of endometriotic lesions. Here's how:
Bacterial Overgrowth: When digestion slows down, it creates an environment where harmful bacteria, like in Small Intestinal Bacterial Overgrowth (SIBO), thrive. This leads to gut inflammation, which often spills over into systemic inflammation. This systemic inflammation can aggravate the immune system, fueling the proliferation of endometrial tissue.
Immune System Activation: Chronic gut inflammation can trigger immune system dysregulation, increasing systemic inflammation. Since endometriosis is an inflammatory condition driven by the immune system, any increase in this inflammation can worsen symptoms (pain, scarring, and adhesions) and the roller coaster continues.
Celiac and Endometriosis:
It’s worth noting that Celiac Disease is often associated with women who have endometriosis. As I sit writing, I feel like the connections are just clicking—and I hope they are for you too. Celiac is an autoimmune condition where the immune system attacks the small intestine in response to gluten, causing inflammation and damage to the gut lining. Interestingly, women with endometriosis often experience similar immune dysfunction. The link between the two lies in the gut-immune relationship—both conditions involve chronic inflammation, which leads to systemic immune activation.
So, why is celiac more common among women with endometriosis? Both conditions can have genetic predisposition but both are influenced by immune system irregularities and chronic inflammation. Women with endometriosis often struggle with gut imbalances, like bacterial overgrowth or leaky gut, which worsen immune system dysfunction. When the gut becomes inflamed, as in celiac disease, it triggers systemic inflammation that amplifies the inflammatory processes at the heart of endometriosis. This ongoing inflammation can overwhelm the body, perpetuating the cycle.
This brings us to the Endometirosis= Gluten Free
The Gluten Debate:
It is often suggested to avoid gluten. And we actually agree with how this could help by improving food quality and assisting calming inflammation, gut burden and the incredibly likely intestinal permeability. However, how you communicate this with clients is key. Gluten removal can be seen as restrictive, so framing it as an addition of nutrient-dense foods may be a better approach. We also need to keep this in perspective as changing food quality and having an actual allergy (which we of course never want) is vastly different. Bottom line we need to cater suggestions to the client. In most cases have my clients noticed they did feel better by removing gluten? They did. Could this be placebo? Sure. Were any of them petrified of gluten? Nope, they were observant in a curious way on how foods made them feel and they made choices that aligned with them.
Some facts for those who are into it. A study by Marziali et al. in 2012 reported that 75% of women experienced significantly less pain after following a gluten-free diet for one year. They found reductions in pelvic pain, pain during intercourse, and period pain. However, it’s important to note that the study had significant limitations (most studies do, so I am not poking holes in this one–some are just better than others):
Participants were not tested for celiac disease before enrollment.
88 participants withdrew early because of symptoms of being gluten free (kind of questionable in my humble opinion)
Only those showing improvement were allowed to continue.
So, yeah, a bit of bias there
Gut Health and Estrogen Detoxification:
The gut also plays a role in estrogen metabolism. A healthy gut microbiome helps metabolize and clear excess estrogen from the body. When there’s gut dysbiosis (an imbalance in gut bacteria), it can impair the liver’s ability to detoxify estrogen properly. This imbalance can lead to the overproduction of beta-glucuronidase, an enzyme produced by certain gut bacteria. Beta-glucuronidase can deconjugate estrogen metabolites, preventing them from being excreted and allowing them to be reabsorbed into the bloodstream. This process is regulated by the Estrobolome, a group of gut bacteria responsible for metabolizing estrogen. When the Estrobolome is disrupted by dysbiosis, the body may struggle to clear estrogen efficiently, leading to higher circulating estrogen levels. This can worsen symptoms of endometriosis.
I won’t dive deeper into estrogen or reproductive hormones in this blog (but that’ll be coming in a future post—if you're still with me here).
Gut Health and Thyroid Function:
Supporting digestion is also vital for thyroid health, which is often interconnected with endometriosis. The gut plays a direct role in converting thyroid hormones, particularly converting T4 (inactive thyroid hormone) to T3 (active thyroid hormone). If digestion is sluggish, or if there’s gut dysbiosis, thyroid function can be disrupted, leading to hypothyroid symptoms like fatigue, weight gain, and mood changes. This can make the hormonal imbalance in endometriosis worse.
It’s also a vicious cycle: Poor thyroid function slows digestion, which further impacts your thyroid, and so the ride continues.
The gut is essential for metabolizing and clearing thyroid hormones. If there are digestive issues like low stomach acid, poor enzyme function, or poor bile flow, thyroid hormone conversion can be hindered, exacerbating thyroid dysfunction—and ultimately, the estrogen imbalance at the heart of endometriosis.
Gut Health Actionables:
Read both of our Free Resources and any Blog we have written about Digestive Health (be active part of your answers)
Meal Hygiene: This is not sexy but slow your roll!
Chew your darn food A LOT. If you want me to say a specific number you are going to see 20-30 chews floating around. If you have actually ever stopped to count that is so much but hey it gets you to chew. I’d say shoot for a solid 10 and see where you are at.
Take 30 seconds before you eat, be grateful, pray, or just exist by breathing deeply. Yep, I went there.
This 30 seconds allows your cephalic phase of digestion to shine. The cephalic phase (see the reel I did HERE) which involves sensory stimuli that get your body ready to break down food. It’s not just about eating—it begins the moment you see or smell food. This triggers a response in your brain, which sends signals to your digestive system, preparing it for action. You might start salivating or even feel a bit hungrier just by thinking about food—that’s the cephalic response in action.
When you see, smell, or even think about food, your brain activates the vagus nerve and stimulates the production of saliva and digestive enzymes. This process primes your stomach and intestines to receive, break down, and absorb nutrients efficiently. So, digestion starts long before you even take your first bite—it all starts with your senses.
A final thought:
Many forget that you have power—even when your body feels out of control. Your Health and the support it needs throughout your life span isn’t a linear. During active flares, stay focused on what you can control. What do you need right now? Focus on the present.
As coaches, it’s our role to educate and support our clients, but we must also guard against fear-based decision-making that leads them to believe that one single dietary strategy is their lifelong "savior." Yes, we’re here to improve the present and arm them with the right tools, but it’s crucial they understand that having a flare-up while following best practices does not mean they’ve failed. Healing and progress are not linear, and setbacks are part of the journey. That said, it’s equally our job to offer kind honesty—if a client is consistently neglecting their fueling needs or engaging in behaviors that don’t support their goals, it’s our responsibility to address it. We need to help them see the bigger picture with compassion, but we also need to be real and ensure they understand their daily choices are choices.
This blog was inspired by our Group Mentorship Call and an Inquiry driven for Education and support (big yes!). If you are a coach and would like to be a part of just these conversations or someone who is interested in a professional consultation. Reach out below.