Natural Ways to Manage Endometriosis Beyond Surgery

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0:42Gemini and Chrome is here for it. Ready to make anything online make sense? There's no place like Chrome. Check responses set up required. Compatibility and availability varies 18+. women with endometriosis wait on average seven to ten years for a diagnosis i waited 29 and as a teenager who couldn't get out of bed due to pain and who was missing school i was told what millions of women hear every single day that debilitating period pain is normal to just take the birth control pill i was told at 14 that pregnancy would fix it like thanks that was super helpful There was also a time when I was told that stress was the problem.

1:20If I could just stop stressing so much, my period pain would get better. Meanwhile, the disease was progressing inside my body. And while I was able to get pain-free and live that way for almost two decades with some of the things that we're going to talk about today, it didn't mean that the disease wasn't there. And listen, I will not disagree that surgery can be life-changing for some women when it's done well. But even with surgery, women are left asking questions about what they can do to manage the disease because the inflammation and the immune dysregulation can still persist. The nervous system changes that happen because of endometriosis aren't magically just addressed with surgery.

2:02And I know this because I've lived it, but also because I've helped so many women with endometriosis as well. And I want to be clear, I'm not dissing surgery. If you've been on the Dr. Brighton show with me for a while, you know I've interviewed many endometriosis excision specialists. But the thing that I'm hearing, and you all have been loud and I hear it, so I'm here today to give you something different. Because what I've been hearing is, I'm so sick of hearing, just have surgery. All I'm being told is just have surgery. Now, medicine treats endometriosis like it's a surgical condition. That means that the goal is to have surgery to treat the disease.

2:42That's how medicine is focusing on it. But it neglects some really serious issues we have in women's health care. One, there's a lot of incompetent doctors who should not be doing endometriosis surgery. They'll probably come for me in the comments. But listen, if you want to out yourself, raise your hand and say, yeah, I'm basic. I do mediocre medicine and I shouldn't be doing it. Then go off. Then go off. But that's a problem is that not everybody's competent to treat this disease. So the access to surgeons is limited. A lot of women have to travel for surgery and it's expensive. I had to choose to pay cash for my endometriosis surgery and save up for that because that was more affordable than using my insurance.

3:24My insurance co-pay and then the like, who knows what they're going to actually charge you from the anesthesiologist and the IV bag and whatever else they're giving you in the hospital, you know, and the like$10 ,000 they have to charge for like an Advil, right? Like that unknown cost plus the known cost was more than what it was going to cost me to just go to a surgeon who was cash pay only. But not everybody has the means to do that, the access to do that, the flexibility to do that, the ability to recover from their job. So I want to acknowledge all of that in this episode as we move into natural ways to address your endometriosis.

4:00And look, before somebody jumps in and says, diet is not a cure, I am not claiming cure. Okay, let's just like be straight up about that. At this point in time, I don't see anything that's a cure for endometriosis. What I see is the need for a multidisciplinary team and a holistic approach to your body and the limitations of every single one of the things we're going to talk about plus surgery have to be acknowledged because when we say to women, hey, just have surgery, everything's better, and then it's not. They feel like they failed. They feel like there's something wrong with them. And that's not the truth.

4:34The truth is this is a complex inflammatory condition that affects your entire body. We have to then address your entire body, not just the lesions. Okay, so where are we going in this episode? In this episode, I'm going to walk you through the six biological systems that influence endometriosis symptoms and simple things that you can start doing to get day to help you support those systems. These are the exact foundations I teach inside my endometriosis program because women deserve a roadmap. They don't deserve guesswork and Dr. Google late at night, which by the way, I'm a fan of you researching your own conditions.

5:14Make no mistake, but it can be scary on Dr. Google sometimes. Now stick around until the end because I'm going to share one supplement that I do think every woman with endometriosis should consider taking. And before we dive in, you've been asking, I want to share something exciting. Last week, I asked you all, if you wanted me to teach the exact strategies I use with my patients to help them get relief for endometriosis, and more than 2 ,000 of you said yes. So I'm building it. I'm creating the first endometriosis reset, and it is officially open for you to sign up. In this program, I'm going to walk you through the exact systems that we target in clinic to help reduce flares, calm inflammation, support your body so you're not constantly living in survival mode and to support you, whether you are pre-surgery, you just had surgery, you never want to have surgery.

6:07I want to support everyone that's on the spectrum. And listen, because this community is the reason this program exists, I am including early bird pricing and special bonuses, which is going to include bi-weekly group calls with me so that I can help guide you through the process. Now, if you want to get in on this, drbrighton.com slash endocourse. That's d-r-b-r-i-g-h-t-e-n.com slash e-n-d-o-c-o-u-r-s-e. You can claim your seat. We start April 4th. So if this is something that you've been waiting for, you saw my post, you saw my email, you're like, I'm in. Now is the time. All right. So with all of that said, let's not hold up this podcast any longer.

6:48Let's get into it. Now, let me just say real quick, if you don't know who you're listening to, because this is your first time with me, I'm Dr. Jolene Brighton, board certified in naturopathic endocrinology, nutrition scientist, endometriosis, adenomyosis, gal. Took me 29 years to get diagnosed. I had a whole lot of heartache and had a whole lot of miscarriages through this. So this is something that I like to say I'm in my villain era. I'm in my villain era because when it comes to ACOG, mediocre medicine, the way doctors have been dissing this disease, I'm going to be a thorn in your side because I'm going to educate so many women to take care of their bodies and to question you.

7:24that like you're going to see me as problematic. So welcome to my villain era if you're new. Now, the first thing that I want to say to you, take a deep breath, but women with endometriosis have a higher long-term risk of cardiovascular disease. And I'm going to tell you one nutrient you need to prioritize in your diet to address this. But first, I want to talk to you about why this is because we're not talking about it enough. Endometriosis is associated with chronic systemic inflammation. Heart disease is the number one killer of women. And now we got to start questioning how much endo have we been missing that's been leading to this.

7:55So if you're not aware, endometriosis lesions release inflammatory compounds. That's what's driving our pelvic pain. That's what's driving our fatigue, the most reported symptom among all of us. The brain fog, we're literally seeing brain changes in women who have endometriosis, and then increased pain sensitivity that persists even after we have the lesions removed. So one of the most powerful natural strategies is going to be lowering the body's inflammatory load. And here are three places I want you to consider starting. First, prioritize omega-3 fatty acids daily. Omega-3s help counterbalance inflammatory prostaglandins, and that is going to help with the pain.

8:37But we also know this is going to support brain health and heart health. Now, you can get omega-3s from fatty fish. So salmon, sardines, mackerel, they're the winners. anchovies if you can eat them do it chia seeds flax seeds walnuts um those those are pretty good but they're not like the highest most bioavailable sources of omega-3s but they have other nutrients they're definitely worth eating and then considering high quality omega-3 supplements nothing from a big box store because if they don't cut it with canola oil it may be rancid like there's a lot of problems in the supplement industry um and as you guys know i have dr brighton essentials.

9:16I have a supplement company and our omega-3s, I insisted on the e-packs omega-3s because I was like, I got endo. I don't need any risk of rancid, nasty fish oil making anything worse. So check how the company manufactures it. Check for third-party testing. Make sure they're doing smaller batch. If they are just pumping out huge batches to send it to your favorite box store, Like that's not worth your money. Now, the other thing that we want to do is we want to build your meals around protein and fiber. And you may be thinking like everybody's always talking about protein and fiber. So I call it the PFF, protein, fat, fiber.

9:59You want the healthy fats. So those omega-3s, we want protein. We want lots of plants. That's going to help stabilize blood sugar. And that actually helps with inflammatory spikes. So there's a whole lot of reasons to make sure you're getting protein, fat, and fiber at every meal. Now, the third is sleep consistency. Sleep deprivation increases inflammatory signaling dramatically. So you've got to go to bed within the same 60-minute window each night. And if you have a night out with your girls, like, no big deal. But for the most part, we want to keep it consistent because that's been shown to help lower inflammatory markers.

10:38And if you're having trouble sleeping and you're like, is it easier said than done? I will link in the show notes at drbrighton.com the episodes I have done on sleep to help you get a better night's sleep. I know all of these might seem simple, but it's the consistency of these foundations that make a real difference here. Now, as we're talking about food, I wanna switch into the gut and estrogen metabolism conversation because endometriosis lesions can actually produce their own estrogen. I'm going to give you some tips to get around this, but I first need you to understand what this means for your endo.

11:14So estrogen signaling can continue even when your ovarian hormones are suppressed or you enter menopause. And one of the biggest regulators of estrogen metabolism is the gut microbiome. Yes, your liver, but most of the time people forget about the gut microbiome. Now, I don't know if you're aware of this, but like up to 60 % of women with endometriosis also meet the criteria for IBS. And that is because the prostaglandins, the lesions, the stress, the way we have to change our eating because we're in pain, that can all shift the gut microbiome, gut function, gut motility. And then it looks a lot like IBS.

11:54And doctors just love to call things IBS, but not everything is IBS. And if somebody has IBS and they have period pain, pain with sex, pain with urination. They have pain with a bowel movement. They have severe fatigue. We got to start asking questions. Is this endo? We also need to take into account that like 70 % of your immune system is in your gut. So we need to improve gut function to help reduce inflammation and support hormone metabolism. Now here are three things you can start doing today. So we talked about fiber. We want diversity of fiber. So not just more fiber, but diversity of fiber.

12:32Your gut bacteria, they're going to thrive on fiber. So if you can, you want to aim for like 20 to 30 different plant foods per week. Herbs totally count. You grind it up some turmeric, you add in some fresh oregano, like that counts. And so I don't want you to get overwhelmed that like, oh my God, that's like so many plants to be eating and start first take inventory. How many plants are you eating? You'll probably be surprised. It's more than what you would think. And then you look at, okay, can I just add two to three different things in my week so that I can improve the microbiome, I can improve diversity of fiber?

13:11And you just do that until you work yourself up to that 20 to 30 different plants in a week. So when you do your inventory, look at herbs, spices, fruits, vegetables, nuts, seeds, they all count. Now, the second thing is we got to support regular bowel movements. If you are not pooping daily, estrogen metabolites have the potential to recirculate in the body. Gastroenterologists, cancer researchers, they've been well aware of this. I don't know why in women's health they've been so slow to recognize this. Now, how can we support daily bowel movements? Hydration, because we also move estrogen out through our urine.

13:50You might need to use something like magnesium citrate to get things moving. We already talked about fiber, but one of the biggest things you can do is movement. And if all you can do is walk 5 to 10 minutes after meals, that can help with gut motility. Now, the third thing I want you to do is pay attention to foods that personally trigger your symptoms. Not everyone with endometriosis needs to be gluten-free or dairy-free. Everybody does need to be alcohol-free as much as possible. We know this from the research. One alcoholic drink can bump your estrogen by like 66%. So when we talk about an estrogen-dependent condition, we got to look at like dialing back on the alcohol.

14:30Now, alcohol is one, but people also notice significant improvements when they reduce ultra-processed food and highly refined sugar. And we've seen this in the research. I've seen it clinically. And inside the endometriosis reset course, we're going to walk through how to improve gut health and address the underlying cause of inflammation without creating restrictive food rules. Because the last thing women with endometriosis need is to feel like they can't even go out to eat, right? Because like this disease takes enough of our life. We already are planning around our periods sometimes. So I want to help you stop the guesswork, stop the restriction and eat in a way that actually supports your body that works for the majority of women with endometriosis without feeling like they've lost all joy of life.

15:19And you guys know I'm a foodie. I love to eat. I love good food. So I don't like to be super restrictive with people's diets. Okay, so we've covered two. Now the third one is the stress physiology and the HPA axis. We got to talk about this because women with endometriosis have significantly higher rates of anxiety and depression, which is why there is one thing I recommend you never do or at least try to avoid if you have endo. Now, before I explain what that is, I want to explain what is happening with the HPA access. If your periods knock you out, if sex is painful, if you're told your scans are normal, but your pain isn't, listen up.

16:01That's not something you have to just live with. Endometriosis is often missed, misdiagnosed, or managed without a full evaluation of what's actually happening. Endoglobal specializes in advanced endometriosis review, including imaging assessment, multidisciplinary evaluation, and excision-focused surgical planning. They offer affordable options and a complimentary consultation to review your case and determine whether surgery is even right for you. If you're tired of guessing or gaslighting, start with answers. Go to drbrighton.com slash endoglobal to schedule your complimentary consultation.

16:46That's d-r-b-r-i-g-h-t-e-n.com slash e-n-d-o-g-l-o-b-a-l. So chronic inflammation in the body affects the body's stress response. The hypothalamic pituitary adrenal access is how your brain and your adrenal glands speak. That cortisol that this system controls actually helps dampen inflammation. So this system's about cortisol, energy levels, immune signaling, pain sensitivity. We're supposed to get a cortisol pulse. It's supposed to put our immune system in check. And so what I need you to understand about endometriosis is when the body is constantly in stress mode, because that's what inflammation is.

17:31It's a chronic stressor, it becomes harder to regulate. So I want to give you some simple ways to support the stress response. I want to make this podcast actionable for you. And the first thing I would say is never skip breakfast if you are the type whose energy crashes later in the day. Protein-rich breakfast helps stabilize cortisol rhythms. It helps your blood sugar. It helps send a safety signal. The other thing I would never do is push through exhaustion. And I say I would never do it, but I've done it and it's horrible. And now that I have entered my 40s, I can no longer do it. So like if I can give you any advice, don't do that.

18:13Because when your body is tired, it's asking for recovery. It's giving little signals of like, hey, something's going on. We need rest, we need recovery. So pacing your energy is a super important skill when you are living with chronic illness. And that might mean scheduling rest before your body forces it. Please, like, learn from Dr. Brighton's example, because if you don't choose to rest, your body will force you to rest. And then it takes way longer, way longer to recover. Now, the third thing I'd encourage you to do, this is not a never, this is a let's try to do this, is a nervous system reset every single day.

18:49Maybe it's five minutes of slow breathing. Maybe it's going out into nature. Maybe it's taking a short walk. Maybe it's grounding. You go out in some grass, barefoot for a while, gentle stretching, meditation, whatever helps you just do a little nervous system reset throughout the day is going to reduce the cumulative stress load. So if you imagined that you had a cup, your cup is three quarters of the way full when we're talking about stress load, just by having endometriolysis. So every drop in there is filling up that cup. What you need to do is consider how to empty out that cup just a little bit every day so that you don't spill over.

19:27When we spill over, we get a flare. We get depressed. We get anxious. We stop sleeping. Our bowel movements change. We get flatline fatigue, like you're crawling out of bed in the morning and just being like, Ivy, drip me some caffeine because I can't even function. I want to help you prevent that. So that's one thing that I would recommend doing is just looking at the stressors in your life, recognizing some of them are just non-negotiable, like, you know, when endometriosis decides to pop off, and then thinking about how can you support your nervous system? Because you absolutely deserve that.

20:01And just a quick reminder, everything we're talking about today is actually a preview of what is inside the endometriosis reset. So if you're feeling overwhelmed, I want you to know the program will break this down. little tiny steps, very actionable, helping you reset and helping you create change. Because honestly, the biggest challenge women face isn't lack of information. It's like what to actually do with that information, what information actually applies to you, and how to implement it into your life. So before I move on to the next one, if you want to join the course, if you just want to check it out, enrollment is open right now, drbrighton.com slash endocourse.

20:42Now I want to talk about another system that plays a huge role in endometriosis symptoms and can be why even after excision surgery, your pain persists, you still just feel like things are not quite right. And that is the nervous system and the way it's involved in pain amplification. So up to 70 % of women with endometriosis experience chronic pelvic pain, not just pain with their period. There's one therapy that every woman with endometriosis should consider in my opinion. I'll let you know what that is. I want to talk first though about what's going on with the nervous system and pain and the repeated inflammation.

21:24So, well, let me just put that together. So, So pain, repeated inflammation can lead to central sensitization. That means your nervous system becomes more reactive to pain signals. And it's almost like you just have a memory of pain. And even when there is no pain signal, like there's nothing causing the pain, you can still have pain. So I want to give you three ways that you can support your nervous system. Now, the first, the therapy I think every woman should have is pelvic floor physical therapy. Many women with endometriosis develop pelvic floor tension for years of guarding against pain.

22:02They can sometimes also have concomitant Ehlers-Danlos syndrome, EDS, Ehlers-Danlos syndrome. When you have that condition, you're sometimes more likely to have endometriosis. And if you have that condition, you can develop more trigger points and muscle hypertonicity, super tight muscles, because you're protecting all the time. So often, I feel like medicine looks at women's bodies and is like, your body's betraying you. Your body's the problem. Your body has to get out of the way so that we can fix you. And the reality is that your body's often protecting you. It's a protection response. And so pelvic PT, if you've had surgery, if you've not had surgery, it's a good idea to consider it.

22:45Starting pelvic PT months before surgery can result in better outcomes. If you've had surgery, you still have pain, I would definitely meet with a pelvic floor physical therapist because there are doctors out there who will say, recurrent endometriosis, it just came back. But they never think about, well, maybe there are trigger points that haven't been addressed. They don't think about all the other things that could be going on and that we should address those things before we just jump to another surgery. I would also say that if you have pain with sex, pelvic PT can dramatically help with that.

23:17So improving pain across the board throughout the body and definitely sexual function is something that PT, pelvic PT shines at. Now, the second thing is doing breath work for pelvic floor relaxation. So doing diaphragmatic breathing, inhaling into your belly and then exhaling very slowly. These are connected to your pelvic floor. It can help relax your pelvic floor just doing that type of breathing. Thirdly, gentle movement instead of super intense workouts when you have flares is something I'd recommend considering. So walking, yoga, mobility work to help maintain circulation without triggering more inflammation.

23:59So, you know, I will say like, you know, when I'm not feeling well around my period, you know, especially as going through IVF, I would go like intense. So like heavier weights and I would do, you know, cardio, but I would never do HIIT. What is so interesting to me is that I see exercise physiologists out there saying there's absolutely no reason whatsoever every woman like can't do HIIT. And that's a little bit of an exaggeration, right? Because disabled people exist. Like clearly there's people who can't, but they'll say like you can't just tell women they can't do high intensity interval training.

24:37So that's what I'm talking about when I say hit. Every endometriosis surgeon that I have interviewed has said, my patients who do hit, their inflammation is so much worse. Their pain is so much worse. And I have also seen this and I echo this. I'm not saying high intensity interval training is bad. I don't think it is. I think it's great. But what I am saying is that if you're in a flare, your body needs more restorative work, then it needs to go like pushing full throttle. So when we do HIIT, that can be a great way, like when you're feeling great, a great way to like help with cortisol, reset the immune system.

25:16But if you're not feeling well already, definitely don't want to be engaging that. But the other thing is, if you have a chronic inflammatory condition, if you're, you know, one of the women who also has autoimmune disease, because that goes along with endometriosis, and then you're pushing most days of the week as hard as you can, you are setting yourself up for burnout. And that is not because you are weak. It is because your needs are different than what, I mean, these exercise physiologists that are out there talking about this stuff and these researchers, do you think they're studying endometriosis women?

25:51No, they're not. It's something I always say, I get really freaking pissed off about. Endometriosis, neurodivergent women like ADHD, autism, like none of the protocols in women's health are like really thinking about us. And so they're going out there and they're saying all this stuff and they're putting these blanket statements out into the world, but they never stop to ask us, what is our experience like? What are our actual needs like? And I'm sick of it because I don't think they're trying to do harm, but it does do harm because then it leaves women thinking, oh, I'm the problem. It's me. Like something's wrong with me.