Hormones — such as estrogen, testosterone, adrenaline and insulin — are extremely important chemical messengers that affect many aspects of your reproductive health.
When these so-called ‘sex hormones’ are out of balance, they can create and/or worsen a variety of conditions that are linked to reproductive health, such as endometriosis.
Hormone imbalance
Hormones are chemical messengers in the body that control and influence metabolism, reproduction and other central functions.
Hormone imbalance is when your body produces too much or too little of a given hormone.
There are hormone receptors all over our bodies: from our brains to our ovaries.
As well as being involved in every part of our bodies, hormones are also highly interactive so a disturbance to any hormone in the body can have a knock on effect to others, including reproductive hormones.
These hormones have a knock-on domino effect on our thyroid, sleep and ovarian hormones because they can disrupt how thyroid hormones, estrogen, progesterone, testosterone, and melatonin work in the body.
Reproductive hormones
According to the Endocrine Society, “The main reproductive hormones estrogen, testosterone, and progesterone are instrumental in sexuality and fertility. They are responsible for pregnancy, puberty, menstruation, menopause, sex drive, sperm production and more.”
But, when these reproductive hormones are out of whack, they can affect far more than just your biological ability to procreate, they can have a profound effect on other aspects of your health, physically and mentally. This is of particular importance for people with endometriosis.
Endometriosis and its estrogen dependence
When hormones become unbalanced, the body can develop estrogen-dominant conditions such as endometriosis, polycystic ovary syndrome (PCOS), breast cancer, uterine cancer, and fibroids.
Endometriosis is a condition that causes cells similar to those in the endometrium to form elsewhere in the body, usually around the ovaries and fallopian tubes, but it can spread to other pelvic organs and, though rarely, beyond this.
This tissue acts just as it would inside the womb: thickening, breaking down, bleeding each month, and causing severe pain.
Those with endometriosis will likely experience very painful and heavy periods, pain before the period starts, fatigue, fertility problems, pain during or after sex, and painful bowel movements.
Some endometriosis sufferers may also experience pain during ovulation, spotting between periods, back and leg pain, and depression.
Endometriosis sufferers often have a high level of estradiol (a type of estrogen) in their body, which causes the inflammation and pain associated with this condition; it is also linked to weight gain, acne and loss of libido.
Estrogen dominance can be caused by toxin-containing products we consume (plastics, food, water), obesity, and issues with how our bodies detox estrogen.
Hormone balancing: a medical approach for endometriosis
Conventional treatments include:
Birth control pill
Gonadotropin-releasing hormone (GnRH) blockers
Mirena coil
Laparoscopy
Hysterectomy
Hysterectomy is a drastic option for the treatment of endometriosis, but is sometimes explored if all other treatments have failed and the symptoms of the conditions are persistent and severe.
It will also induce a surgical menopause, which comes with long-term hormonal deficiency problems which will need to be treated with hormone replacement therapy.
The root cause of endometriosis involves metabolic processes within the body, like inflammation, estrogen dominance and an abnormal immune response.
These are, unfortunately, not addressed in conventional treatments, which can mean that symptoms persist and women feel frustrated and like they are at a dead-end with treatment.
But don’t lose hope, effective treatment is available, without having to resort to life-changing surgery.
Are there different types of hysterectomies?
Yup, there are 3 different types of hysterectomies.
If you find yourself needing the procedure, you can talk to your healthcare provider about which is right for you.
A total hysterectomy removes both the uterus and cervix. It’s the most common type.
A supracervical hysterectomy removes the uterus but leaves the cervix intact. This is also known as a “partial” or “subtotal hysterectomy.”
As the name suggests, the radical hysterectomy procedure is the most thorough — removing the uterus, cervix, upper part of the vagina, and supporting tissues. This is usually performed to treat gynecological cancers when other treatments haven’t been successful.
Sometimes, people will have one or both of their ovaries removed during a hysterectomy; ovary removal is called an oophorectomy.
As for how exactly the procedure is performed, there are various methods depending on your reason for the procedure and your health history.
Vaginal hysterectomy: Removing the uterus through the vagina is the first choice for many healthcare professionals because there are generally fewer complications and a shorter recovery time. But it isn’t always possible for people who have a very large uterus or have adhesions from previous surgery.
Abdominal hysterectomy: Here, the uterus is removed through an incision in the lower abdomen; this is typically made horizontally along your bikini line or through a vertical incision tracing from belly button to bikini line. It’s associated with a greater risk of complications (infection, bleeding, blood clots, and nerve and tissue damage) and usually requires a longer hospital stay.
Laparoscopic hysterectomy: After a few small incisions in your abdomen, a surgeon will insert a thin metal camera in order to view the pelvic organs and remove the uterus in small pieces. It’s a minimally invasive procedure and comes with a quicker recovery period.
Robotic surgery: This is similar to a laparoscopic hysterectomy but is performed with the help of a robotic machine controlled by the surgeon.
What happens to hormones after a hysterectomy?
Hormones are involved in basically everything our bodies do, and they’re constantly changing and evolving to keep up with what’s happening at any given moment.
This process is controlled by the endocrine system: the series of glands that create and secrete hormones, releasing them into the bloodstream so they can reach other tissues and organs throughout the body.
Your endocrine system continuously tracks the amount of hormones in your blood to ensure that there’s the right balance to keep your body healthy.
Afterall, hormones affect pretty much everything — from growth and development to mood and emotions to sexual function and fertility.
For the purpose of this piece, we’re mostly interested in the hormones estrogen and progesterone, which are produced by the ovaries and control menstrual cycles and menopause.
Estrogen enables the development and maintenance of things like breast growth, menstruation, and pregnancy.
Progesterone plays an important role in the menstrual cycle and helps the uterus maintain early pregnancies.
Hormone balancing naturally: Getting to the root cause of endometriosis
We know that lifestyle strategies which decrease inflammation, improve the immune system, support the liver and hormonal balance can go a long way in treating endometriosis. In addition to exercising regularly and getting plenty of sleep, a large portion of these lifestyle changes are linked to diet.
To ensure that we are giving our bodies a fighting chance at treating endometriosis, we should be consuming a diet that ticks the following boxes:
Improves immune function – foods containing phytonutrients such as leafy green vegetables; berries; and seeds such as flaxseed.
Supports general detoxification – fibrous foods such as beans; wholegrains for B vitamins; leafy green vegetables; other nutrient-rich vegetables such as artichokes, beetroot and carrots; healthy, clean proteins such as those found in salmon (this also contains omega 3, which contributes to the improvement of immune function).
Supports estrogen detoxification – sulforaphane-containing vegetables and cruciferous vegetables such as broccoli, sprouts, cabbage, kale and cauliflower.
Diagnosis of endometriosis
Unfortunately, diagnosis of endometriosis is often delayed by an average of eight to 12 years from the onset of symptoms.
This is, in part, because endometriosis sufferers often believe that their condition is just severe period pain, rather than endometriosis.
But it can also be misdiagnosed due to the similarities between its symptoms, and symptoms of other conditions, including irritable bowel syndrome (IBS), ovarian or uterine cancer, polycystic ovary syndrome (PCOS) and pelvic inflammatory disease (PID).
Dr Ghazala Aziz-Scott, Hormone Doctor at Marion Gluck Clinic, says, “It is my mission to raise awareness of endometriosis. In public healthcare, knowledge about endometriosis exists on a very simplistic level, and it is largely about symptom relief. There is little thought given to the underlying immune mechanisms and genetics. I think if women knew more about these connections and generally had more awareness of the condition, it would encourage them to tackle it from a younger age, rather than waiting years for a diagnosis.”
The only way to fully diagnose endometriosis is through a laparoscopy, which is a keyhole surgery that allows a surgeon to see if there are any endometrial deposits within the pelvic area.
These deposits cannot be detected with a pelvic ultrasound scan.
A scan will reveal the structure of the uterine wall, fibroids, the structure of the ovaries, follicles within the ovaries, and sometimes ovarian scar tissue, but not endometrial deposits.
Without a laparoscopy, a confident (but not full) diagnosis for endometriosis can be obtained through symptom analysis, and if investigations (such as a pelvic ultrasound) have ruled out other conditions such as cancer, fibroids or PCOS.