Endometriosis is far more than just a hormonal condition—it’s a complex, inflammatory, immune, and microbiome-driven disorder. In my clinic, I see firsthand how addressing the vaginal, endometrial, and gut microbiome can make a significant difference in pain levels, inflammation, and overall symptom severity.
If you’ve been diagnosed with endometriosis (or suspect you have it), you’ve probably heard about hormone imbalances. But what’s often missing from the conversation is how your microbiome—especially in the gut and reproductive tract—can drive inflammation, pain, and disease progression.
The Endometrial & Vaginal Microbiome: Their Role in Endometriosis
We often think about the gut microbiome, but the vaginal and endometrial microbiome are just as important—especially in conditions like endometriosis.
Research has shown that the endometrial microbiome in women with endometriosis is different from those without the condition.
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Lower levels of Lactobacillus species (which normally help keep inflammation and infection at bay).
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Higher levels of pathogenic bacteria (linked to inflammation, dysbiosis, and implantation issues).
This imbalance can create a pro-inflammatory environment, worsening endometriosis symptoms, increasing pain, and even contributing to infertility.
What about the vaginal microbiome?
The vaginal microbiome plays a key role in:
✔ Protecting against infection & inflammation
✔ Regulating immune function
✔ Maintaining hormonal balance
An imbalance, known as vaginal dysbiosis, can lead to:
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Increased susceptibility to infections (BV, thrush, UTIs)
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More pain and inflammation (especially during menstruation and intercourse)
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Higher estrogen metabolism issues, affecting hormone balance
Testing the vaginal and endometrial microbiome can help pinpoint imbalances and guide treatment. In my clinic, I often use vaginal and gut microbiome testing to identify underlying microbial issues in women with endometriosis.
The Gut Microbiome, LPS & Inflammation in Endometriosis
The gut microbiome plays a huge role in immune regulation and inflammation. In endometriosis, we often see:
Dysbiosis (an imbalance in gut bacteria)
Increased intestinal permeability ("leaky gut")Higher levels of endotoxins, such as lipopolysaccharides (LPS)
What’s LPS & Why Does It Matter?
LPS is a toxin released by certain bacteria in the gut. When the gut barrier is compromised (as is often the case in endometriosis), LPS can leak into the bloodstream, triggering an immune response and increasing systemic inflammation.
Studies have found that LPS is elevated in women with endometriosis, and it may contribute to:
✔ Increased pelvic pain & inflammation
✔ Worsening of immune dysregulation
✔ Potential endometrial tissue growth outside the uterus
This is why gut health is critical in endometriosis management. We need to support the gut lining, reduce inflammation, and rebalance the microbiome to prevent LPS-driven immune activation.
How to Support the Microbiome in Endometriosis
Support Vaginal & Endometrial Microbiome Health
✔ Consider probiotics containing Lactobacillus species to help restore balance
✔ Avoid excessive use of antibiotics, douches, and synthetic fragrances in intimate products
✔ Use low-tox period products to reduce irritation and inflammation
Heal the Gut & Reduce LPS
✔ Increase prebiotic & fibre intake to feed beneficial bacteria (flaxseeds, artichokes, garlic, leeks)
✔ Support gut barrier integrity with gut-healing nutrients (glutamine, zinc carnosine, collagen peptides)
✔ Reduce processed foods & excess sugar to prevent dysbiosis
✔ Consider gut microbiome testing to assess bacterial imbalances and inflammatory markers
Need Personalised Support for Endometriosis?
Endometriosis is complex, and the microbiome is often overlooked as part of treatment. If you feel like you’ve tried everything and are still struggling with symptoms, it might be time to look deeper into your gut, vaginal, and endometrial health.
At Her Earth Medicine, I work with women to uncover and address the root causes of endometriosis—including microbiome imbalances, hormone metabolism, and immune system dysfunction.
If you're waiting for an appointment, you can start today by:
✔ Adding gut-healing foods & prebiotics to your diet
✔ Avoiding harsh vaginal products & fragranced intimate care
✔ Tracking symptoms & triggers to understand your unique patterns
We offer tailored treatment to support your endo. Book a consultation if you're ready for a tailored endometriosis plan that fits your body and lifestyle.
Endometriosis & Hormones: Why Proper Testing & Safe Oestrogen Clearance Matter
One of the biggest misconceptions about endometriosis is that it’s simply a hormone issue—too much oestrogen floating around, causing symptoms to flare. But the truth is, it’s more complex than that. Yes, oestrogen plays a role, but it’s not just about high vs low levels. It’s about how the body processes and clears oestrogen, and whether those pathways are working properly.
I see this all the time in clinic. Women with endometriosis often get told they have “oestrogen dominance,” and they’re put on herbs or supplements to lower oestrogen, when in reality, that’s not always what’s needed. The real issue is often how their body is metabolising oestrogen and whether it’s being cleared safely or recirculating and contributing to inflammation.
How the Body Clears Oestrogen & Why It Matters for Endo
Oestrogen isn’t just produced and then magically disappears—it has to go through specific detoxification pathways in the liver before being eliminated through the gut. If this process isn’t working properly, oestrogen can build up, create inflammatory metabolites, and fuel endometriosis symptoms.
There are three main pathways for oestrogen metabolism:
1️⃣ The 2-OH Pathway (The “Safe” Pathway)
This is the pathway we want to encourage. It produces weaker, non-inflammatory oestrogen metabolites that are easier to detoxify.
2️⃣ The 4-OH Pathway (The Inflammatory Pathway)
This is where we run into problems. If too much oestrogen is shunted down this pathway, it creates metabolites that can damage DNA, increase oxidative stress, and contribute to inflammation—all things we want to avoid in endometriosis.
3️⃣ The 16-OH Pathway (The Proliferative Pathway)
This pathway creates stronger oestrogen metabolites that can promote tissue growth and cell proliferation. While not always a bad thing, in endometriosis, excess activity here can contribute to more endometrial growth and worsening symptoms.
💡 This is why proper hormone testing is crucial—it’s not enough to know whether oestrogen is “high” or “low.” We need to see where it’s going and whether detoxification pathways are working properly.
The Best Way to Test Hormones in Endometriosis
Standard blood tests will tell you your total oestrogen, but they won’t tell you how your body is processing it. This is why I prefer:
✅ DUTCH Hormone Testing – This is a dried urine test that shows exactly how your body is metabolising oestrogen and whether it’s going down inflammatory pathways. It also measures progesterone, cortisol, and androgens, all of which play a role in endometriosis.
✅ Comprehensive Gut Testing – Since oestrogen is eliminated via the gut, dysbiosis or poor gut function can lead to oestrogen recirculation and increased inflammation. Testing helps identify bacterial imbalances that might be impacting hormone clearance.
How to Support Healthy Oestrogen Clearance Naturally
Even before testing, there are some simple but effective ways to encourage safe oestrogen detoxification and support the liver and gut.
1. Prioritise Cruciferous Vegetables 🥦
Cruciferous veg like broccoli, kale, Brussels sprouts, and cauliflower contain sulforaphane and indole-3-carbinol, which help push oestrogen down the safer 2-OH pathway.
🔹 Aim for at least one serving per day (steamed or lightly cooked for better absorption).
2. Support Liver Detoxification 🌿
The liver needs the right nutrients to metabolise oestrogen efficiently.
✔ B Vitamins (especially B6, B9, B12) – Found in leafy greens, eggs, and liver
✔ Magnesium – Found in almonds, cacao, and leafy greens
✔ Curcumin (Turmeric) – Anti-inflammatory and supports liver detox pathways
3. Optimise Gut Health for Oestrogen Elimination 🦠
Once oestrogen is metabolised, it’s eliminated through the gut—but only if the gut is working properly. If there’s dysbiosis or constipation, oestrogen can be reabsorbed, leading to hormonal imbalances and worsening endo symptoms.
✔ Increase fibre intake – Flaxseeds, chia seeds, and leafy greens help bind excess oestrogen.
✔ Address gut dysbiosis – If there’s bloating, constipation, or loose stools, microbiome testing can help identify imbalances.
✔ Stay hydrated – Proper hydration helps flush out toxins and excess hormones.
The Role of Xenoestrogens & Why Going Low-Tox Matters
It’s not just about the oestrogen your body produces—we are constantly exposed to xenoestrogens, synthetic compounds that act like oestrogen in the body. These can overload the system and worsen endometriosis symptoms.
🚫 Common sources of xenoestrogens to avoid:
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Plastics (BPA in food containers, water bottles, receipts)
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Conventional skincare, perfumes & cleaning products (look for endocrine disruptors like parabens & phthalates)
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Non-organic meat & dairy (can contain synthetic hormones)
✅ Simple swaps to reduce xenoestrogen exposure:
✔ Use glass or stainless steel for food storage
✔ Switch to low-tox skincare & makeup (brands like Mukti, Eco Tan, and Biologi are great options)
✔ Choose organic where possible to reduce pesticide exposure
Personalised Support for Endometriosis
If you’ve been told you have “oestrogen dominance” but haven’t had proper hormone testing, or if you’ve been put on generic hormone-balancing supplements without seeing results, it might be time to dig deeper.
At Her Earth Medicine, I work with women to:
✔ Test hormones properly using DUTCH and gut microbiome testing
✔ Support safe oestrogen clearance through targeted nutrition and lifestyle changes
✔ Reduce inflammation and balance hormones naturally
If you’re waiting for an appointment, start today by:
✔ Eating cruciferous veg daily for oestrogen detox
✔ Switching to low-tox products to reduce xenoestrogen exposure
✔ Addressing gut health to support proper hormone elimination
We offer a tailored endometriosis plan that works alongside your medical care if you need to book an appointment with one of our naturopaths.
Endometriosis & Diet: The Most Effective Foods & Lifestyle Changes for Managing Symptoms (Part 3)
Endometriosis is a complex condition, and while hormone balance, detoxification, and microbiome health play significant roles, diet and lifestyle are equally important. In my clinic, I see the impact that specific anti-inflammatory foods, key nutrients, and daily habits can have on reducing pain, inflammation, and hormone imbalances.
Many women with endometriosis feel like they have no control over their symptoms, but food is one of the most powerful tools for influencing inflammation, immune function, and hormone balance.
Why Diet Matters in Endometriosis
Endometriosis is not just a hormonal condition; it is an inflammatory disease influenced by immune dysfunction, gut health, and environmental factors. A well-designed diet can help:
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Reduce chronic inflammation and oxidative stress
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Support hormone metabolism and oestrogen detoxification
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Improve gut health and reduce endotoxins like LPS
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Minimise pain and flare-ups
The Best Diet for Endometriosis
The goal is to lower inflammation, improve hormone clearance, and support immune function. The best way to do this is by focusing on whole, nutrient-dense foods while avoiding inflammatory triggers.
1. Anti-Inflammatory Omega-3s
Omega-3 fatty acids help reduce prostaglandins, which are inflammatory compounds that worsen endometriosis pain. Most women with endometriosis have an imbalance between pro-inflammatory omega-6 fats (from processed foods and vegetable oils) and anti-inflammatory omega-3s.
Best sources of omega-3s:
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Wild-caught salmon, sardines, and mackerel
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Chia seeds, flaxseeds, and hemp seeds
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Walnuts and algae-based omega-3 supplements
What to avoid:
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Seed oils (canola, soybean, sunflower)
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Fried and ultra-processed foods
2. Cruciferous Vegetables for Oestrogen Clearance
Cruciferous vegetables contain sulforaphane and indole-3-carbinol, which help the liver detoxify oestrogen safely. This prevents harmful oestrogen metabolites from accumulating and worsening endometriosis symptoms.
Best sources:
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Broccoli, kale, Brussels sprouts, cauliflower
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Cabbage, rocket, bok choy
Try to include at least one serving per day, either steamed, sautéed, or raw in salads.
3. Curcumin for Pain and Inflammation
Curcumin, the active compound in turmeric, is one of the most powerful natural anti-inflammatories. It has been shown to reduce inflammatory cytokines, regulate immune function, and help with pain management in endometriosis.
Best ways to use curcumin:
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Cook with turmeric and add black pepper to enhance absorption
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Take a curcumin supplement (look for bioavailable forms like Meriva or BCM-95)
4. Phytoestrogens for Hormonal Balance
Phytoestrogens are plant compounds that have a balancing effect on oestrogen. They can help modulate oestrogen levels by binding to oestrogen receptors and preventing stronger, more inflammatory oestrogens from exerting their effects.
Best sources:
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Flaxseeds (also great for gut health and fibre)
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Organic fermented soy (tempeh, miso)
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Lentils and chickpeas
5. Fibre for Gut and Hormone Health
Fibre is essential for eliminating excess oestrogen and maintaining gut health. Since oestrogen is metabolised in the liver and excreted through the gut, constipation or poor gut function can lead to oestrogen recirculating.
Best fibre sources:
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Ground flaxseeds and chia seeds
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Leafy greens, artichokes, leeks
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Psyllium husk (if tolerated)
Foods to Avoid for Endometriosis
Certain foods can increase inflammation, disrupt gut health, or interfere with hormone balance, worsening symptoms.
1. Dairy and Endometriosis
Many women with endometriosis find that dairy worsens their symptoms, especially if they have an immune component or gut permeability issues. Dairy proteins and hormones can contribute to inflammation, bloating, and cramping.
If reducing dairy, consider:
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Plant-based alternatives like almond, coconut, or macadamia milk
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Organic, grass-fed butter or ghee if dairy is still tolerated
2. Gluten and Gut Inflammation
There is increasing evidence linking gluten sensitivity to endometriosis. Many women report that reducing or eliminating gluten leads to less bloating, reduced pain, and better gut health.
If removing gluten, focus on:
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Whole-food gluten-free options like quinoa, buckwheat, and brown rice
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Avoiding ultra-processed gluten-free products with additives
3. Processed Sugar and Refined Carbohydrates
Excess sugar increases inflammation, insulin resistance, and gut dysbiosis, all of which can drive endometriosis progression. Keeping blood sugar stable is key for hormonal balance and reducing inflammatory pathways.
Better sweetener options:
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Raw honey or pure maple syrup in moderation
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Stevia or monk fruit for a sugar-free alternative
Lifestyle Factors That Help with Endometriosis
Diet alone isn’t enough—stress, movement, and environmental toxins all play a role in managing endometriosis symptoms.
1. Regular Movement
Exercise helps with circulation, lymphatic drainage, and pain management. Women with endometriosis often feel worse with high-intensity exercise, so gentler movement is often more effective.
Best types of exercise:
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Walking, pilates, and strength training
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Yoga and stretching for pelvic relaxation
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Rebounding or sauna use for lymphatic drainage
2. Stress Reduction & Nervous System Support
Stress is one of the biggest overlooked factors in endometriosis. Chronic stress disrupts the immune system, increases inflammation, and worsens pain sensitivity.
Effective stress management:
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Breathwork, meditation, and vagus nerve activation
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Acupuncture and bodywork for pelvic tension relief
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Prioritising sleep and circadian rhythm regulation
3. Reducing Xenoestrogen Exposure
As covered in Part 2, xenoestrogens from plastics, pesticides, and personal care products can disrupt hormonal balance and increase the body's oestrogen load.
Simple swaps:
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Use glass or stainless steel for food storage
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Switch to organic tampons, pads, or menstrual cups
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Choose natural skincare and home cleaning products
Personalised Endometriosis Support
Every woman with endometriosis has unique needs, which is why a one-size-fits-all approach rarely works. In clinic, I create individualised plans that address inflammation, hormone balance, gut health, and detoxification pathways.
If you are struggling with pain, fatigue, hormonal imbalances, or gut issues, working with a practitioner can help:
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Identify hormone metabolism issues with DUTCH testing
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Assess microbiome and gut health
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Develop a targeted supplement and nutrition plan
If you’re waiting for an appointment, you can start today by:
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Eating an anti-inflammatory diet rich in omega-3s, cruciferous veg, and fibre
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Reducing inflammatory foods like dairy, gluten, and processed sugar
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Prioritising movement and stress management
If you're ready for a tailored endometriosis plan, book a consultation at Her Earth Medicine and start addressing the root causes of your symptoms.