I was so excited to sit down with my close friend, naturopath & nutritionist - Stephanie Carey. Steph specialises in female reproductive conditions and has navigated her own journey with endometriosis. She is a wizard with her knowledge and also happens to be one of the kindest souls on the planet.

What spurred your interest in specialising in female reproductive health?

I’ve always been interested in Female reproductive health – hormones can seem so complex but absolutely fascinating at the same time. I had always struggled with heavy periods and excruciating pain, from the age of 11 years (Yep, I got my period when I was 11 years old – the start of year 6). Fast forward to the age of 21 and I had developed all of the “textbook symptoms” – heavy, painful periods, pain in my lower back and thighs, mid cycle bleeding, thrush, digestive issues, acne. It was awful! I was referred to a gynecologist who straight away suggested endometriosis, however the only way to diagnose it – was through a surgical procedure called a Laparoscopy. In for surgery I went, the verdict: Stage 1 Endometriosis with adhesions to my right ovary. I was completely devastated! At the time of my diagnosis I was fortunate enough to be studying Naturopathy at University - so my journey began, discovering the wonderful alternatives natural medicine had to offer for the management of Endometriosis.

Can you clarify what endometriosis is?

Endometriosis or endo is a common disease that involves the growth of endometrial tissue in abnormal places, other than the uterus – where it is supposed to belong! The tissue can grow in places such as your ovaries, fallopian tubes, your bladder and in some rare cases on your elbow or face. Weird right!

The medical approach to endo involves anti-inflammatory drugs for pain management, hormone modulating drugs and the doctor’s most favourite commonly prescribed drug: the good old oral contraceptive pill! While the Pill does have a strong place in the management of endo, recent studies have found that long-term use can cause deficiencies of B vitamins, folate and zinc. Not exactly what you want when you’re already feeling pretty lousy. Therefore supplementation of these nutrients is something you should strongly consider if you’re taking the Pill.

Many women with endometriosis are told to go on the oral contraceptive pill or conceive. Is this good advice?

It’s absurd that doctors believe that advising patients to have children to simply relieve the pain (which has minimal supporting evidence) is a form of treatment. My doctor actually suggested this form of 'treatment' to me when I came out of surgery. I was a 21 year old poor uni student, living in Sydney working 3 jobs and had only been dating my partner at the time for 1 year – would that REALLY be a good idea?

Many women who have been diagnosed with endo are strongly advised by gynecologists to use a form of contraception called the Mirena. I’m not completely against the hormonal contraceptive options – of course they have tremendous merit as a reliable form of contraception. However, there are other more natural contraceptive options out there that won’t play havoc with your hormones, make you feel crazy, put on weight nor feel depressed.

What would be your top dietary and lifestyle tips for managing endometriosis?

Avoid Gluten – the protein Gliadin can be inflammatory and cause digestive issues, which can further exacerbate endometriosis when patients are already experiencing bloating, pain and other digestive issues. Studies have shown that women who follow a gluten free diet have found a decrease in menstrual pain. That’s a win!
Avoid Dairy - dairy can often cause or exacerbate inflammatory conditions such as endo. Whilst there are no strong studies to support this yet, a dairy free diet can dramatically help improve the IBS related symptoms, which commonly exist within the whole endo picture.
Avoid Soy – excessive consumption of soy can aggravate oestrogen receptor sites.
Lots of Fibre in the diet – to help remove oestrogen excess through the bowels.
Organic Meat and Poultry – to reduce the exposure of hormones and pesticides. Endometriosis is an oestrogen dominant condition – you don’t want more hormones from your meat circulating in your body when your already having issues with hormones.
Start using organic Tampons and pads – Most sanitary products are bleached to make them look beautiful and white! Trust me – you don’t want to be absorbing bleach into your lady bits! Organic sanitary products are free from bleach, chlorine, insecticides, pesticides, fragrances and dyes – much nicer for your insides and completely toxin free!
Avoid sex during menstruation – one suggested theory for development of endo is retrograde blood flow during menstruation. This means when blood is washed back into the Endometrium – this stagnant blood can potentially give rise to adhesions this way.

Stress management techniques are also really important for preventing exacerbations of Endo symptoms as well as improving your overall health and wellbeing (Hello Adaptogen herbs!)

Are there any supplements or herbs that can help support endometriosis?

My top favorite supplements for the management of Endometriosis are:

Fish Oil (Omega 3 fatty acids) – Studies have shown that fish oil supplementation is a beneficial treatment for endo. Particularly for period pain – with its primary action as an anti-inflammatory, it can help decrease pain and inflammation.
Turmeric - Turmeric is best known for its potent anti-inflammatory qualities, which also helps in decreasing menstrual pain. It also assists in preventing the growth of endometrial tissue and improving the microflora in your gut.
Zinc – A potent antioxidant that helps prevent oxidative stress and inflammation. Zinc helps regulate a healthy immune system. Endo is actually viewed as an autoimmune disease from a Naturopathic perspective – so strengthening the immune system is a must to help prevent disease progression.
B Vitamin Complex – As mentioned earlier, the pill can deplete the body of B vitamins, so this is an absolute must if you have been on the pill. B Vitamins also help with the production of energy and support liver detoxification of oestrogen.
Magnesium – Studies have shown Magnesium can assist in reducing menstrual cramps and pain – both huge symptoms that present with Endo.

[NOTE: Please ALWAYS consult with your naturopath or doctor before taking these herbs and supplements.]

What would be one misconception about Endometriosis you'd like to clear up?

The oral contraceptive pill or the Mirena is not the only option for managing endometriosis. Naturopathy can offer a holistic natural approach to manage endometriosis. So hold it right there before you think about popping out a few kids just to stop the pain - trust me, there are so many other options to explore.

Last but not least, as frustrating as female hormones can be, remember to give your body some love and appreciation – the female body is amazing and capable of so many wonderful things!

If you or someone you know is silently suffering from Endometriosis, book in to see myself or Steph. We can personally tailor a management plan from a holistic perspective, using dietary lifestyle and herbal interventions to take control and get your health back on track.

Managing Endometriosis: An Interview with Stephanie Carey