Endometriosis – Symptoms And Treatment

Dr Sandra Cabot and naturopath Margaret Jasinska discuss the symptoms of endometriosis that are often overlooked leading to many women not being diagnosed straight away, such as painful, heavy menstruation. Left unmanaged, endometriosis can cause serious problems such as bowel obstruction or infertility. There are many medical treatments which are discussed in this podcast, but more importantly we need to address the cause to prevent it coming back. Dr Cabot and Margaret outline supplements and dietary changes that help help to manage endometriosis.

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DR CABOT: Hello. My name is Dr Sandra Cabot, and I’m talking to you today about a very common problem that afflicts women, that of endometriosis. And I’m joined by our naturopath and author, Margaret Jasinska.

MARGARET: Hi, Dr Cabot. Thank you. It is an interesting topic.

DR CABOT: Yes, it is. Because a lot of people struggle with endometriosis for years before they get a proper diagnosis.

MARGARET: Well, yes! Endometriosis typically causes painful, heavy menstruation. But heavy, painful menstruation is quite common. So, a lot of women don’t know they’ve got it until they have trouble falling pregnant and have investigations and then realize they’ve had it for a long time.

DR CABOT: That’s right. And it’s not normal for menstrual pain to last more than one day. So, 24 hours is considered normal. So, if you have menstrual pain for 2 or 3 days and it’s severe, something’s going on. That’s not normal.

MARGARET: Exactly. And the kind of pain, someone can faint from menstrual pain. So, that’s intense…

DR CABOT: It’s very severe because in endometriosis you get internal bleeding. And sometimes there’s very large cysts full of blood that burst. So, it’s unbearable. But the sad thing is, women go to GPs and they may be told, “Well, what do you expect? You’re a woman. It’s normal to have menstrual pain. It’s normal.” It’s not normal to have severe pain for more than 24 hours. And even then, if it’s very severe, there could be something going on. So, I always say go and see a specialist gynecologist. Don’t muck around. Because they have the right technology to diagnose it. They have transvaginal probes, which use ultrasound waves and can often pick it up without needing a laparoscopy. But even if you do need a laparoscopy, that’s no big deal, because you want an accurate diagnosis. And you want to get that done early before the endometriosis starts to block your tubes and cause scarring. And of course, with continued bleeding, you can get adhesions building up on the bowel. And then long term, that can cause the bowel to twist and you can get bowel obstructions. And in very severe cases, it can even travel up to the liver.

MARGARET: Yeah. It has the potential to be a horrific disease.

DR CABOT: It does. So, the conventional treatment is laser, which is done through a laparoscope. And that gets rid of the endometriotic tissue, which is growing on the ovaries and on the tubes and outside the uterus and on the bowel. But, I say endometriosis is like a weed. So, unless you treat the cause, it’s going to grow back. It’s gonna grow back, it’s gonna grow back… And you can end up having 4 or 5 laparoscopies and laser treatments, and then you’re going to get more scar tissue.

MARGARET: Yes, exactly. And that’s the typical patient that comes to see us, usually. We get the people down the end of the line, who have been through that a lot, already.

DR CABOT: And so, what can you do if you’ve got endometriosis? Well, the conventional treatment is you can take the oral contraceptive pill without a break, so you don’t have a menstrual bleed. And that’s suitable, if you do need contraception, as well. Or you can go into a medical menopause. There’s various medications that will put you into temporary medical menopause, so that there’s no estrogen produced in your body and all the endometriosis shrinks. And that’s very effective. But you will get the symptoms of menopause, like hot flushes, sweating, things like that.

MARGARET: Yes. And what about future bone density? Is that a concern?

DR CABOT: Well, we can’t take these things for more than 6 months, so it’s not a long-term cure. But it’s a stop gap, if you like. Then you can look at taking synthetic progestogens. Either the Implanon, which is a rod put into your arm. Or you can have a Mirena (M-I-R-E-N-A), Mirena intrauterine device, which is really only suitable if you’ve had children. And that will shrink up a lot of the deposits. Or you can have the Depo-Provera injections, and that is a progesterone. And they’re given every 3 months. And that also gives you contraception.

But there’s a lot of women who want to try a more natural approach.

MARGARET: Yes. Or they’ve had so many repeated negative experiences with the conventional approach…

DR CABOT: They have.

MARGARET: …and they’re just tired of it.

DR CABOT: That’s right. They might get side effects from the Implanon. It might make them moody. It might make them put on weight. The Mirena, it may aggravate their pain. So, once again, it’s trial and error. But no matter what approach you take, whether you’ve had surgery or you’ve got a Mirena or you’ve got an Implanon, you still need to treat the cause. Because like a weed, it will tend to come back. So, we’re going to look at how you can do that.

Now, one of the most important things is to make sure you’ve got plenty of progesterone happening in your body, because progesterone controls the growth of the abnormal tissue. So, it feathers like a weed. It tends to keep growing in the wrong places. So, the progesterone will help to shrink that and to prevent it growing back. And a lot of women feel better on the natural progesterone. We call it bioidentical because chemically, it’s exactly the same as your body’s own progesterone. And we use it in the form of a cream. It’s most effective that way. Or vaginal pessaries, or a trochee, or capsules. I find, generally, the cream works quite well, natural progesterone cream, and you do need a prescription for that. It also helps to reduce any premenstrual tension, moodiness, it helps libido. And it helps the immune system.

MARGARET: Yes. And low progesterone is just such a common problem  these days.

DR CABOT: Very common.

MARGARET: You can read articles on the internet. How can you raise your progesterone yourself naturally without using a cream?


MARGARET: Doesn’t really work.

DR CABOT: Not really.

MARGARET: Doesn’t really work. Most people, to get results, you need actual progesterone. Because so many things stand in the way of being able to make enough of your own progesterone. Stress, for example. You can turn your progesterone into cortisol when you’re stressed. If you’ve got poor gut health, and many endometriosis patients do. I find that quite typically they are constipated women. They get constipated, they get bloated, which then gives them a sluggish liver. So, they’re not breaking down their estrogen well enough. And then they’re getting higher estrogen relative to their progesterone. So even if their progesterone was sort of reasonable, they’ve got such high levels of estrogen in comparison, that they still need the natural progesterone.

DR CABOT: Yeah. Natural progesterone can be a miracle. It really can.


DR CABOT: We’ve been using it for about 30 years. We’ve had a bit of experience.

But Margaret mentioned the liver. Very important, because most women with endometriosis have too much estrogen, not enough progesterone. And their liver is not breaking down the estrogen because they might have a fatty liver or liver that’s overloaded with plastics and toxic chemicals. So often a cleanse will help the liver.

MARGARET: Yes, exactly. And the gut. And in some recent research, some antibiotics that are used for small intestinal bacterial overgrowth and also dysbiosis – so just an overgrowth of bad bugs. So, some antibiotics that stay in the gut and just work in the gut, have been shown to give significant relief for endometriosis sufferers. And so, it’s not the bacteria that was causing the endometriosis. It’s just these women had an unhealthy gut environment. So, we break down estrogen and get rid of it through the gut. But if you’ve got the wrong gut bugs, you’ll actually turn the estrogen into like a mutant, extra potent form. And then so it magnifies the effects of excess estrogen, not enough progesterone. So, cleaning up the gut – and there are various ways to do that – can be enormously helpful.

DR CABOT: Yeah. And we have a free e-book on the gut called Ultimate Gut Health. So, you can download that from Sandra Cabot or liverdoctor.com. Your gut health is extremely important. It’s like a jigsaw puzzle. You’ve got to have all the missing pieces, and the gut is one of them, the progesterone is one of them. And also, you have to have a strong immune system, because if you’ve got tissue growing where it shouldn’t be growing, then that means your immune system is not controlling the abnormal cells.

MARGARET: Absolutely! It’s a good indicator that something is amiss with your immune system.

DR CABOT: That’s right. Because part of the immune system, you have these macrophages, which clean up cells that are unhealthy or growing where they shouldn’t be growing. And we call that cellular immune health. And for that to be working properly, you need adequate selenium, iodine, zinc and vitamin D. And we find that deficiencies of selenium, zinc, iodine and vitamin D are very common.

MARGARET: Absolutely! The new normal. The kind of expected in patients.

DR CABOT: Yeah, you do. It’s so sad because people eat enough food. Often, they’re a bit overweight today. But they still have these deficiencies and they haven’t got a clue that they’ve got them.


DR CABOT: So, taking a supplement, such as Thyroid Health capsules, which has got your selenium, your iodine, your vitamin D and your zinc, 1 or 2 a day, can make a big difference to improve your cellular immune system, so that it can start to clean up this abnormal tissue.

And also, there’s another supplement that has been studied and is used by women, called serappeptase, which is an enzyme that can clean up tissue that’s unhealthy or growing in places it shouldn’t. So, that’s another natural thing you can try, serappeptase.

MARGARET: Also, N-acetyl cysteine has fantastic effects for endometriosis, because it detoxifies and reduces inflammation. So, I wrote an article about that on our liverdoctor.com website.

DR CABOT: Yeah, well, that’s true. N-acetyl cysteine is a very good anti-inflammatory and a very good detoxifier. So, you’ve got your Thyroid Health capsules, you’ve got your NAC, your serappeptase, a healthy diet. What would you recommend for endometriosis? Avoiding drinking cow’s milk, for example?

MARGARET: Yes. Because cow’s milk can make menstrual periods heavier and more painful. Even women who don’t have endometriosis.

DR CABOT: Yes, I found that too. And don’t eat too much carbohydrate, because that will elevate your insulin. And insulin promotes the growth of things we don’t want in our body.

MARGARET: Absolutely! Insulin is a fertilizer. It’s a growth-promoting hormone. But also eating carbs and sugar is a fertilizer for all the wrong gut bugs and yeast and fungi, Candida in your gut. So, basically, a diet of protein and veggies and natural fats and some fruit and some nuts and seeds. That kind of food is usually most appropriate for women with endometriosis.

DR CABOT: Yes. And we have a free e-book on endometriosis, called Endometriosis – Your best chance to cure it. And you can download that from Sandra Cabot or liverdoctor.com.

So, if you’ve listened to this and found it helpful, that’s great! Because we’ve been talking about a very nasty problem. And once again, if you have any questions, please email us. We’re here to help you. Thanks for listening.

MARGARET: Thank you, everybody.