Endometriosis and Gut Issues: Understanding the Link

If you’re living with endometriosis and constantly battling bloating, constipation, diarrhea, or nausea, you’re not imagining it. Gut issues are incredibly common among women with endometriosis — so common, in fact, that many doctors chalk it up as “just part of the condition.”

But here’s the truth: Just because gut issues are COMMON with endometriosis doesn’t mean they’re NORMAL — and it certainly doesn’t mean you have to live with them forever.

There’s a deeper story going on under the surface, and once we start to look through the lens of functional nutrition, we can uncover the true root causes — and finally begin to support healing.

Inflammation Is a Major Player 🔥 

Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside of the uterus. This inflammation doesn’t stay isolated to the reproductive system — it creates a ripple effect throughout the entire body.

One major area it affects? The GUT.

Chronic inflammation can weaken the gut lining, disrupt the microbiome, and impair digestion.

This can lead to:

• Bloating

• Constipation or diarrhea

• Food sensitivities

• Gas and cramping

• Leaky gut (intestinal permeability)

Over time, this can make nutrient absorption more difficult and create a feedback loop of more inflammation — worsening both digestive and endometriosis symptoms.

Estrogen Imbalance Makes It Worse 🌸

Hormonal imbalance, especially excess estrogen or poor estrogen detoxification, is closely linked to both endometriosis and gut dysfunction.

Estrogen stimulates the growth of endometrial tissue. If your body can’t properly break down and eliminate excess estrogen, that hormone can circulate longer than it should — feeding more inflammation and more abnormal tissue growth.

What does this have to do with the gut?

Your gut microbiome plays a key role in clearing estrogen. A specific group of gut bacteria known as the estrobolome helps metabolize and excrete used-up estrogen. But if your microbiome is off — due to antibiotics, stress, poor diet, or inflammation — this process gets disrupted.

Result? Estrogen gets reabsorbed into the bloodstream instead of being eliminated, and the vicious cycle continues.

The Gut-Liver-Hormone Connection 🧠 

This is where the gut-liver axis comes in. Your liver is responsible for packaging up excess estrogen and toxins so they can leave your body through your stool.

But here’s the thing — if your liver is overburdened (common in women with hormone imbalance) and your gut isn’t working properly (constipation, dysbiosis, or sluggish digestion), that estrogen doesn’t leave.

It recirculates.

That means gut dysfunction isn’t just a side effect — it’s often driving the hormone imbalances that worsen endometriosis symptoms.

The Immune System Is Overactive 🛡️ 

Both endometriosis and gut dysfunction are tied to immune dysregulation. In endometriosis, the immune system doesn’t respond properly to misplaced tissue. In the gut, immune dysfunction can lead to increased food sensitivities, mast cell activation, and even autoimmune symptoms.

Many women with endometriosis develop histamine intolerance, migraines, or skin reactions after eating certain foods — all signs that the immune system and gut barrier are under stress.

What This Means for You 🚨 

If you’ve been told that it’s normal to:

• Feel bloated all the time

• Be gassy or constipated every cycle

• Struggle with random food sensitivities

• Alternate between IBS-C and IBS-D symptoms

• Live on Miralax or antacids

  
  

…it’s time to look deeper.

These symptoms are clues — your body’s way of asking for help.

Instead of chasing symptoms with medications or trying to “push through,” we want to get to the root cause and address the full-body imbalances contributing to your pain and discomfort.

How Functional Nutrition Can Help 🛠 

A targeted approach can help address both hormone and gut imbalances at the same time. This might include:

• Reducing inflammatory foods and identifying personal food triggers

• Rebalancing the gut microbiome (sometimes with herbal antimicrobials, prebiotics, and probiotics) and testing

• Supporting estrogen clearance through liver and gut detox support

• Restoring the gut lining so it can heal and seal

• Balancing hormones with targeted nutrition, lifestyle changes, and (in some cases) hormonal support

  
  

When we treat your body as a whole — not as separate systems — healing becomes possible.

Final Thoughts 💬 

You are not “crazy” or “too sensitive.” And you definitely don’t have to settle for a life of painful periods, bloating, and unexplained digestive distress.

If you’ve been struggling with endometriosis and gut issues, know that it’s not all in your head — and it’s not your fault. It’s a signal from your body that deeper support is needed.

With the right tools and a root-cause approach, real relief is possible.