The true cause of endometriosis?

The true cause of endometriosis?

Endometriosis can be a devastating, painful and life-altering condition affecting women. Endometriosis develops when the tissue that normally lines the uterus develops outside of the uterus, growing on ovaries, fallopian tubes and the exterior of the uterus. Aside from surgery, hormone therapy and prescriptions, there are few answers, options or known causes to offer the estimated 190 million women that suffer from this condition. In any condition, if there is not a known cause, prevention and treatment is limited. That said, our bodies are brilliant, and nothing happens without a reason, so what is behind this epidemic that is causing so many women to suffer?


A few years back, I had a patient with recurring endometriosis.  She came to me with countless tests that had been performed by another provider, including stool testing. I noted that she had high levels of E. coli but she shared that no one had treated her for that finding. I suggested she go back to her physician and discuss the pros and cons of treating E. coli, however, without any gut symptom, her doctor didn't believe there was a reason to treat.

As the years have passed, I've seen over a dozen women that have suffered from endometriosis and in every case that I've run a stool test, we've seen either elevated E. coli or elevated Klebsiella, another bacteria linked to endometriosis.  It's important to note that both E. coli, Klebsiella and other bacterial species can live within the digestive tract without causing harm to the host, but research indicates that if those microbes make their way into the bloodstream and translocate to other areas of the body, the host (that's you) is at risk.  Research indicates that elevated levels of these bacteria in a dysbiotic gut can lead to increased risk of intestinal permeability (leaky gut) and the translocation of bacteria.

Even with the connection I was seeing between elevated bacterial levels and endometriosis, it wasn't until recently when I had a very severe presentation in a patient that was suffering endometriosis that I began to look at the research to see if there was a connection reported in the literature.  Incredibly, there were studies showing many bacterial strains in the endometrial tissue and intrauterine lining of women with endometriosis. BINGO! So, now what?


Although recent research is making these connections, there are not standard screenings, treatments or preventative measures to support women that are at risk for or suffering from endometriosis. And bacterial infection has not been found in 100% of these cases so there are likely other causes that trigger endometrial growth, as well.

Without a standardized protocols for investigation, we have to use logic.  Optimizing hormone regulation and detoxification (something our female bodies are doing 24-7), testing for and treating gut bacterial overgrowth and engaging in strategies to keep the intestinal barrier intact are a good start. 

It can take an average of 30 years for research to become mainstream in conventional healthcare, but women that are managing this condition don't have that kind of time. If you or anyone you love is suffering from endometriosis, you may be forced to advocate for a deeper investigation into the root cause. If you need support, reach out.