The Missing Pieces of Endometriosis Care

If you’re living with endometriosis, you have probably done everything you were told to do. You tried birth control. You took the pain meds. Maybe you had excision surgery once or even a few times. You tried to cut foods out of your diet. Exercise and drink more water. You rested when you could. You pushed through when you thought you couldn’t.

And somehow the brutal periods, bloat, fatigue, and pelvic pain keep coming back. Maybe you get an endo flare up out of nowhere. Maybe the pelvic pain shows up mid cycle, not just on your period. Maybe your gut is a mess no matter how perfectly you eat.

It is easy to wonder if this is just how it is going to be.

You are not imagining it. This is what happens when the care model you are given only covers a tiny part of what your body actually needs with endometriosis. And even if you are about to have endometriosis excision surgery, you’ll want to read this blog because I’m walking you through things your doc never told you.

But if you are about to have surgery and you want to know how to support your body PRE and POST surgery, snag my free Pre and Post-Op Endo Surgery Checklist. 

Why the current endometriosis care model is incomplete

Most women with endometriosis are given a hormone / remove tissue only treatment plan for a whole body disease. Yes, excision surgery can remove lesions and greatly reduce the chances of regrowth. Hormone suppressive medications like hormonal birth control or lupron can make period pain easier. Pain meds can get you through the worst moments. These can all help, but they are not designed to address the underlying systems that drive pain, bloat and inflammation with endo in the first place.

If you want to understand why you still have pain on birth control or lupron, read this blog here.

Almost no one explains what could be going on with your gut, immune system, nervous system, detox pathways, hormones or minerals. You are rarely told why you are bloated all the time or why fatigue hits like a wall. Except for “it could be the endo or SIBO”. And most people walk out of surgery with zero guidance on how to support their body during recovery or what to do if surgery is not available or not enough to get relief of all your symptoms.

It is not your fault that you’re struggling to get major relief. Our traditional medical model is not set up to address chronic diseases, and you see how behind the times we are on women’s health.

Endometriosis is an inflammatory and systemic disease

Endo is not an estrogen problem. Estrogen can influence symptoms endometriosis lesions can make more estrogen, but it does not cause the disease. Endo is driven by inflammation and immune dysfunction. It affects your digestion, your pelvic floor muscles, detoxification, your nervous system, and quality of life.

This is why you can have symptoms all month long. This is why it seems like your body is reacting to a million different foods (some of which can increase histamine, a part of our immune system) This is why stress makes your pain worse. Your whole body is involved, not just your reproductive organs. So your care plan has to reflect that.

Why pelvic floor physical therapy is a missing pillar of care

When you live with constant pelvic inflammation and pain, your body adapts by tightening everything in the area. This is especially true for women with endo. This leads to muscle guarding, tension, and restricted movement in the pelvic floor. And that tension can create its own list of symptoms.

Painful sex. Period pain that feels sharp or deep. Trouble emptying your bladder. Constipation. Urgency. Back pain. Leg pain. Pulling sensations. A heavy feeling in your pelvis. 

You can try every supplement and make all the diet changes, but if your pelvic floor is constantly tight, it keeps your nervous system on high alert and can keep you struggling with pain.

Pelvic floor PT helps retrain and relaxes those muscles. It improves mobility. It supports digestion. It calms down the pain signals your brain is getting. Many women, including myself, say pelvic floor PT, was a huge game changer for them. It should be part of the plan, not an afterthought.

But while pelvic floor PT is awesome, most endo babes still need deeper support. Your muscles aren’t the only thing causing pain…

Why functional medicine and nutrition fill the rest of the gaps

This is the part almost everyone with endo has to learn on their own. Your gut health, detox capacity, blood sugar stability, nervous system, and minerals all influence the symptoms + severity of them that you experience with endo. If these are not supported, symptoms may not improve the way you’re wanting them too.

Now, I’ll be diving into the pillars of how I support my clients from a functional nutrition standpoint that helps them see the greatest amount of improvement with their symptoms.

Gut Health

The gut and endo have a clear connection. Research shows higher rates of gut dysbiosis in people with endo. Many women with it also struggle with low stomach acid, low digestive enzymes, IBS misdiagnoses, constipation, diarrhea, and nutrient malabsorption.

Gut infections, imbalances, and inflammation can ramp up immune dysfunction and systemic inflammation.  They can also make your pain worse and make your body more reactive to foods. When your gut is inflamed, your brain and body will be too.

One of my favorite tests to run for gut health is the GI map stool test. It allows us to look at absorption, immune function, your good gut bacteria, rule out infections like candida, h. Pylori, bacterial overgrowths, etc to help you finally get relief.

Detoxification

Your liver and gut work together to metabolize and clear hormones. If detox pathways are sluggish, inflammation increases. This can happen due to nutrient deficiencies or imbalances, chronic stress, a heavy medication or alcohol load, or constipation that slows estrogen elimination from the bowels.

Supporting detoxification is not about juice cleanses. It is about giving your body the nutrients, protein, minerals, and fiber it needs to do its job. We have to start with the foundations first.

Blood Sugar Stability Unstable blood sugar increases cortisol levels. High cortisol feeds inflammation, disrupts gut motility, worsens fatigue, and throws off estrogen and progesterone balance which just feeds endometriosis.. Balancing your blood sugar is one of the easiest + important pillars to implement with endometriosis.

Nervous System Regulation

Most women with endo are living in a constant fight or flight state. It is not your fault. Chronic pain, medical trauma, invalidation, and years of pushing through take a toll. On top of normal life things. Your nervous system affects pain perception, digestion, pelvic floor tension, hormone output, and your immune system’s behavior.

Shifting from survival mode into a more regulated state is not a luxury. It is a crucial part of symptom management (and even supporting your pelvic floor muscles).

Minerals + Nutrients

Mineral and vitamin deficiencies are common in endo. Low Magnesium, zinc, vitamin D, sodium and potassium, B vitamins + a copper imbalance all impact inflammation, energy, hormones, digestion, and pain. These patterns usually do not show up in standard labs, which is why women are often told everything looks normal even when they feel terrible. 

That’s why I run HTMA (hair tissue mineral analysis testing on all my clients because it allows us to understand how your minerals are driving period pain, PMS or PMDD, poor detox, low energy, etc, all of which impact your endo symptoms.

The tests that actually help guide endo care

Most standard labs are not designed to uncover chronic inflammation patterns or gut dysfunction. Functional tests can fill the gaps. Read this blog here to dive deeper into the functional labs that improve endometriosis symptoms.

The GI Map looks at infections, overgrowths, parasites, immune markers, inflammation, and digestion. HTMA testing maps out mineral patterns, adrenal stress, heavy metals, and how your body is adapting to chronic inflammation. DUTCH testing shows cortisol patterns, neurotransmitters and how you are metabolizing hormones. These tests do not diagnose endo, but they help guide your nutrition and lifestyle plan.

These tests give us the information that explains why your symptoms haven’t budged even when you are doing everything right.

Why surgery and medication still have a place

This is not about choosing one side. Excision surgery can be life changing. Hormone suppressive medications can give people their life back. Pain meds and birth control can be helpful tools. If you are in a place where you want to weigh out the pros and cons of all treatment options, read this blog.

The issue is that they do not fix digestion, detox pathways, gut health, minerals, blood sugar, pelvic floor tension, or the nervous system. That is why symptoms often return. When we combine medical care with foundational body support, results last longer.

What a full body care plan looks like

A complete endometriosis care plan usually includes an integrative health team.

Pelvic floor PT supports the structure and movement of your pelvis. Functional nutrition lowers inflammation, improves digestion, stabilizes blood sugar, supports detoxification, and helps balance minerals. Testing gives you a personalized roadmap so you can stop guessing. Surgery removes the diseased tissue, scar tissue and adhesions. Medication are tools that can make the process easier or more effective. And habits like sleep, stress support, hydration, and nutrient rich meals keep everything running well over time.

No single tool heals endo. You need a plan that supports every part of your body and all the systems that can affect endometriosis symptoms.

Next steps

If you have felt overwhelmed, dismissed, or confused by your symptoms, you are not alone. Many women spend years trying to piece this together by themselves because the system does not give them the full picture. You deserve care that treats your whole body and acknowledges your lived experience. You deserve relief that lasts.

If you want support creating a full body plan, I can help. My 1:1 coaching includes a deeper look at gut health, minerals, detox capacity, blood sugar patterns, nervous system stress, and more to give you a well rounded functional health plan. We also use testing like the GI Map, HTMA, (and DUTCH when needed) to uncover what’s driving your symptoms. You do not have to figure this out alone. DM me on IG to learn more!

Another great way to stay connected if you’re not ready for all that is by tuning into the Radiate with Rita Podcast + my weekly Radiate + Thrive newsletter where I drop tips about managing endo + chronic illness, how I navigate my own journey, recipes + all the things to make your journey a little easier! Subscribe to Radiate + Thrive here!