Navigating Endometriosis: Understanding, Diagnosing, and Managing the Journey


Endometriosis is a chronic immune system and inflammatory condition where endometrial-like tissue grows outside of the uterus.

It can affect a whopping 10 to 15% of women of reproductive age, 50% of those women will experience fertility problems. Around 10% of women don’t experience symptoms, yet it could be contributing to fertility problems. 90% of people with endo experience pelvic pain.

Endometrial lesions can grow on the intestines, bladder lungs and diaphragm, not just in and around the reproductive organs. These lesions can cause debilitating pain. It is not a disease of hormones, although high oestrogen can be a characteristic when the lesions begin to produce oestrogen themselves. 

Pelvic pain caused by endo can lead to medical gaslighting and delay of diagnosis - which can be 8-12 years! Women with infertility are 6-8 times more likely to have endometriosis and the symptoms do not always match the severity of the condition.

How it can affect fertility:

  • Associated with ovulatory dysfunction
  • Chronic inflammation affects endometrial receptivity and effects egg quality
  • Endometrial lesions can cause physical changes on reproductive organs hindering their function
  • Adhesions can block fallopian tubes and affect the movement of sperm, eggs and embryo
  • Chronic inflammation leads to oxidative stress
  • Endo is associated with immune system dysregulation which can mess with implantation and promote inflammation

Women with endometriosis can get pregnant naturally, and have healthy babies.

A diagnosis is helpful because then we know what we are dealing with and all the factors involved, when we are preparing for conceiving or working with fertility problems. In saying this, Chinese medicine does not require the western medicine diagnosis when we are working with these women because each person is diagnosed on their specific signs and symptoms and treated accordingly.

In my experience with working with women with pelvic pain and infertility, getting a diagnosis is quite frankly hard, or impossible.

Laparoscopic surgery is still considered the gold standard when diagnosing, but many doctors are moving to less invasive means such as MRI (magnetic resonance imaging) and TVUD (transvaginal ultrasound), though these may not yet be sensitive enough to confirm a diagnosis. Studies have found that endo found via laparoscopic surgery had been missed on previous imaging.

It is important to seek help from medical providers who specialise in endometriosis. Skill levels do vary with surgery, so finding an experienced practitioner is crucial.

It is important to address the underlying inflammation and immune function aspects. While there is no cure, diet and lifestyle can impact endo massively.

Top Tips to Tackle Endo

Research is fairly limited around endo, but that is thankfully changing.


Research does support that the Mediterranean and gluten free diet has shown a reduction in pain. These diets support the body’s ability to reduce inflammation and improve oestrogen metabolism.

Concentrate on a nutrient dense diet by eating more omega-3 fats, more fresh fruit and vegetables. Eat less red meat, trans fats, sugar and alcohol and minimise your exposure to toxic chemicals.

Supplement Support

Supplement Support to reduce inflammation and support the body:

  • Omega-3s
  • Magnesium
  • Zinc
  • Vitamin D
  • NAC

These supplements all have strong evidence supporting their benefits to reduce signs and symptoms and those with good levels having lower chance of developing endo.


Movement, even gentle stretching improves circulation and helps mood. It releases endorphins that can lower pain awareness. Do whatever feels good to you, so why not try rolling out your yoga mat.

Castor Oil Packs

Castor oil really moves things!

A cloth soaked with organic castor oil is placed on the skin and gently heated with your hot water bottle or wheat bag.

The aim being, to reduce inflammation, cleanse, detoxify and nourishes damaged tissue. It helps with repair and dissolve adhesions associated with endometriosis.


Of course, acupuncture is the best (🤭my opinion).

Our goals with treatment are to reduce inflammation, reduce stress and support the body to do its best to heal and relieve symptoms. It can also promote an environment conducive for conception – if that is what we are working towards.

Chinese Herbs

Chinese herbs are intelligently formulated to move stagnated blood, which in Chinese medicine is the cause of pain, and calm inflammation, and address symptoms.

Endometriosis is a multifaceted journey that requires a nuanced understanding and a holistic approach to management. Beyond the confines of traditional diagnoses, the integration of lifestyle and diet changes, body work, and targeted supplements and herbs can empower those with endometriosis to regain control and lead fulfilling lives.

Work with me online or in-person to get diet, lifestyle, herbal and supplement advice and a treatment plan designed especially for you and your unique body.

Research Notes

  1. Mehdizadehkashi, A., et al. “The effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis.” Gynecological Endocrinology, 37(7) (2021): 640–645.

  2. Seifert, B., et al. “Magnesium — a new therapeutic alternative in primary dysmenorrhea.” Zentralblatt für Gynäkologie, 111(11) (1989): 755–760.

  3. A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Maria Grazia Porpora 1, Roberto Brunelli, Graziella Costa, Ludovica Imperiale, Ewa K Krasnowska, Thomas Lundeberg, Italo Nofroni, Maria Grazia Piccioni, Eugenia Pittaluga, Adele Ticino, Tiziana Parasassi

  4. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? M Marziali 1, M Venza, S Lazzaro, A Lazzaro, C Micossi, V M Stolfi 2013 Mar 1;177(5):420-30. doi: 10.1093/aje/kws247. Epub 2013 Feb 3.

  5. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study Holly R Harris 1, Jorge E Chavarro, Susan Malspeis, Walter C Willett, Stacey A Missmer

  6. 2023 Dec;12(4):101003. doi:10.1016/j.imr.2023.101003. Epub 2023 Oct 28. Acupuncture for endometriosis: A systematic review and meta-analysis
    Nora Giese 1, Ki Kyung Kwon 2, Mike Armour 2 3 4

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Nicola Douglas

I have a background in nursing and graduated from the Perth Academy of Natural Therapies in 2002. I have a passion for woman’s health, particularly fertility and pregnancy.