Endometriosis; Effects + Management and more with Kimberly Kushner

In support of Endometriosis Awareness Month, and offering support to the members of our community who suffer with it daily, or believe they may have it but are not yet diagnosed, we felt it is only necessary to offer some education and information surrounding this condition. 
We had the privilege to spend time with Kimberly Kushner aka 'The Bali Naturopath' and take a deep dive into the specifics of endometriosis, its effects, supportive management of the symptoms and how to navigate life and fertility following the diagnosis. 
Kimberly is an incredible naturopath and clinical nutritionist and she has been navigating menstruation, pregnancy and motherhood with endometriosis; making her expertise and knowledge invaluable. 
Kimberly is passionate about the education of women surrounding endometriosis and the overall reproductive health of women. 
What is endometriosis?
Endometriosis is an inflammatory condition whereby tissue which resembles the inner lining of the uterus (endometrium) is deposited as lesions on organs around the body. Lesions are often found on the pelvic organs and the bowel wall, but growths have been found on all organs in the body.
How is it diagnosed?
The gold standard to get endometriosis diagnosed is via a laparoscopy. A camera is inserted into the abdominal cavity to look for endometriosis lesions. Growths are then biopsied and the diagnosis is confirmed via pathology.
What are the health implications?
There are many health implications of endometriosis. Because endometriosis grows on organs, there can be a multitude of symptoms depending on the organs that the growths are on. For example, growths are often found on the bowel wall. Digestive symptoms such as cramping, bloating, diarrhea and constipation are very common in women with endometriosis. If endometriosis is on the bladder, it is not uncommon to experience bladder pain and inflammation (eg: interstitial cystitis). Many women with endometriosis also experience pelvic floor dysfunction, and pain with intercourse. Endometriosis is so much more than a hormonal disease, it is an immune driven, inflammatory disease. Women with endometriosis will have high levels of inflammation systemically. Additionally, endometriosis can also affect fertility.
Does nutrition improve or impede symptoms?
Good nutrition can certainly support endometriosis and a myriad of its symptoms. Although high oestrogen levels are not the cause of endometriosis, high oestrogen levels can drive the growth and symptoms of endometriosis (eg: pain). Nutritionally, supporting oestrogen detoxification through eating plenty of cruciferous vegetables, and encouraging liver function with bitter foods (dandelion root tea, rocket, apple cider vinegar) can be helpful. Additionally, B vitamins, zinc, and magnesium can be helpful to encourage good oestrogen to progesterone balance. As endometriosis is highly inflammatory,  it is important eat a high antioxidant diet to combat inflammation and oxidative stress
High anti-inflammatory foods, herbs and spices include:
Colourful fruits & vegetables
Green leafy vegetables (kale, spinach, rocket, Asian greens) 
Matcha green tea
Coriander, parsley, basil
Raw nuts and seeds
Oily fish
How seriously does endometriosis affect fertility?  
Endometrial growths, chocolate cysts (endometriomas) and adhesions are all common presentations that can cause tissue changes within the pelvic organs.
Changes to the tissues of pelvic organs can cause blockages to the fallopian tubes. This can prevent sperm from reaching the egg, hindering fertilisation.Endometriosis can also cause changes to the fallopian tube and prevent it from picking up the egg which has been released from the ovary.

Endometriomas, more commonly known as chocolate cysts, can  cause changes to ovarian tissue, to the point of preventing ovulation altogether. It can do this by preventing the ovulated egg from leaving the ovary.

Adhesions are common among sufferers of endometriosis, and they can cause pelvic organs to be less mobile. Adhesions can even cause organs to stick together.

Endometriosis is a highly inflammatory condition, we know that there is significant inflammation within the pelvic cavity. There are a whole range of chemicals that drive inflammation present in large amounts, and these inflammatory mediators can cause issues with the growth and development of follicles.

There can even be an autoimmune component to the disease which affects fertility, whereby anti-endometrial antibodies. These auto-antibodies will generally cause implantation issues, and cause implantation failure.

Endometriosis can cause issues specifically in the second half of your menstrual cycle, this is the time between ovulation and your period. This part of your menstrual cycle is predominantly governed by the hormone progesterone. Progesterone can often be lacking or dominated by high levels of oestrogen.

Women with advanced endometriosis can also have a lower ovarian reserve, low egg and embryo quality and poorer implantation outcomes.
These scenarios are more commonly seen in more severe cases. However, we also know that even in mild endometriosis, fertility can be affected.
 What is your main piece of advice to anyone seeking a diagnosis?
If you are experiencing pain, don’t put up with dismissal. Severe period pain, and pain during the rest of the month is not normal. If your doctor is instructing you to take painkillers without seeking the root cause of your pain, this is a red flag. Make sure you get a referral to an endometriosis specialist who can perform a proper laparoscopy (with excision) for you and then begin naturopathic treatment right away to prevent regrowth. 
If you want further information on anything discussed above, potential symptoms you may have, or any other health related questions Kimberly offers FREE naturopathic assessments. Click the link below to book your discovery call: www.kimberlykushner.com