Endometriose er en av de vanligste gynekologiske tilstandene som rammer kvinner i reproduktiv alder, men dens innvirkning på fruktbarheten blir ofte misforstått. Selv om mange kvinner med endometriose senere blir gravide, er tilstanden nært knyttet til vanskeligheter med å bli gravid, og mekanismene bak denne sammenhengen er mer sammensatte enn de fleste er klar over.
Denne artikkelen går gjennom hvordan endometriose og fruktbarhet henger sammen, med utgangspunkt i forklaringen i vår tilhørende video. Den tar for seg hva endometriose egentlig er, hvor vanlig tilstanden er, og de direkte og indirekte måtene tilstanden kan påvirke sjansene dine for å bli gravid – alt fra blokkerte eggleder og redusert blodtilførsel til eggstokkene til kronisk betennelse, hormonubalanse og endringer i tarm- og vaginamikrobiomet.
Kort svar: Endometriose påvirker fruktbarheten gjennom flere mekanismer. Noen er direkte, blant annet blokkerte eggledere, forvrengt reproduktiv anatomi og redusert blodtilførsel til eggstokkene som svekker eggmognad. Andre er indirekte, for eksempel kronisk betennelse, forstyrret immunforsvar, hormonubalanse der østrogen dominerer over progesteron, og dysbiose i mikrobiomet. Samlet sett forklarer disse faktorene hvorfor endometriose er så vanlig hos kvinner som sliter med infertilitet.
Livsstilen har betydning for fertiliteten. En studie i BMC Public Health viste at kvinner med 4–5 sunne vaner hadde 59 % lavere risiko for infertilitet.
Fyll ut spørreskjemaet og få et personlig, helhetlig og kunnskapsbasert program tilpasset deg.
tar 3 minutter å fylle utEndometriose oppstår når celler som ligner livmorslimhinnen vokser på steder der de ikke burde, typisk rundt eggstokkene og inne i bukhulen. Hver måned reagerer disse feilplasserte cellene på menstruasjonssyklusen og blør, akkurat som livmorslimhinnen gjør. Problemet er at blodet ikke har noen vei ut. Over tid fører denne innestengte blødningen til betennelse, smerter og arrvev som kan lime bekkenorganene sammen.
Reproduksjonsspesialister beskriver endometriose som den nest vanligste gynekologiske lidelsen hos kvinner. Omtrent 1 av 10 kvinner i fruktbar alder har tilstanden. Blant kvinner som sliter med infertilitet, stiger tallet til omtrent 50 %. Globalt anslås det at 176 millioner kvinner lever med tilstanden, hvorav rundt 1,5 millioner bare i Storbritannia. Disse tallene gjør endometriose til en av de viktigste tilstandene å forstå for alle som utforsker endometriose og infertilitet, eller som tenker på hvordan de kan optimalisere sin reproduktive helse.
For en mer utfyllende innføring i selve tilstanden, inkludert symptomer, diagnose og hvordan den vanligvis utvikler seg, er vår grundige artikkel om alt du trenger å vite om endometriose et nyttig utgangspunkt.
De mest åpenbare måtene endometriose påvirker fruktbarheten på, innebærer fysiske og anatomiske endringer inne i bekkenet. Det er tre direkte mekanismer det er verdt å forstå.
Den første er blokkering av egglederne. Egglederne er ekstremt smale, omtrent like brede som et hårstrå, og endometriose-lesjoner eller arrvev kan blokkere dem fullstendig. Hvis et egg ikke kan møte sædcellen, kan det ikke skje befruktning.
Den andre er anatomisk forvridning forårsaket av endometriomer, ofte kalt «sjokoladecyster». Når disse cystene dannes på eggstokkene, kan de forvride de fine utvekstene på enden av egglederne som har til oppgave å fange opp det frigjorte egget. Selv om eggløsningen skjer som normalt, kan det hende at egget aldri når inn i egglederen.
Den tredje årsaken er redusert blodtilførsel til eggstokkene. En sunn modning av eggene avhenger av en sterk, oksygenrik blodtilførsel. Når endometriose svekker denne tilførselen, påvirkes eggkvaliteten og modningen negativt.
Innholdet er kun til opplysningsformål. Det er gjennomgått for vitenskapelig nøyaktighet, men utgjør ikke medisinsk rådgivning, diagnose eller behandling. Rådfør deg alltid med kvalifisert helsepersonell ved medisinske spørsmål eller beslutninger om fertilitetsbehandling.
Gjennomgått for vitenskapelig nøyaktighet av: Dr. Mona Bungum
Sist gjennomgått: mai 2026
Livsstilen har betydning for fertiliteten. En studie i BMC Public Health viste at kvinner med 4–5 sunne vaner hadde 59 % lavere risiko for infertilitet.
Fyll ut spørreskjemaet og få et personlig, helhetlig og kunnskapsbasert program tilpasset deg.
tar 3 minutter å fylle utEggkvaliteten er en av de viktigste faktorene for befruktning, og endometriose kan påvirke den på flere måter. I tillegg til virkningen av redusert blodgjennomstrømning spiller det toksiske kjemiske miljøet som skapes av endometriose en betydelig rolle. Lesjonene utskiller inflammatoriske cytokiner, forhøyede prostaglandiner og overskudd av østrogen, som alle kan påvirke den utviklende eggcellen som er under utvikling.
Det er også verdt å forstå den kirurgiske behandlingen av endometriose i denne sammenhengen. Fjerning av endometriosevev kan forbedre kvaliteten på de enkelte eggcellene, men gjentatte operasjoner på eggstokkene kan ha en negativ innvirkning på den samlede eggstokkreserven. Dette er en av grunnene til at behandlingsbeslutninger må tas nøye og i samarbeid med en spesialist som er kjent med både tilstanden og dine individuelle fertilitetsmål.
I tillegg til de direkte, anatomiske virkningene påvirker endometriose fruktbarheten gjennom en rekke systemiske forandringer som er vanskeligere å se, men ikke mindre viktige.
Den første er en forstyrret immunregulering. Ved endometriose klarer ikke immunforsvaret å gjenkjenne de feilplasserte endometrielle lesjonene som fremmed vev som må fjernes. Denne svikten i immunsignaleringen gjør at tilstanden kan utvikle seg og skaper et ugunstig miljø for befruktning.
Den andre er økt betennelse i bukhinnenvæsken som omgir kjønnsorganene. Kronisk betennelse i denne væsken kan forstyrre alle stadier av befruktningen, fra eggløsning og befruktning til tidlig embryoutvikling. Dette er en av grunnene til at antiinflammatoriske strategier for endometriose ofte utgjør en sentral del av egenbehandlingen.
Den tredje er hormonubalanse. Endometriose har en tendens til å fremme østrogendominans fremfor progesteron, og denne ubalansen har ringvirkninger på menstruasjonssyklusen, eggløsningens kvalitet og livmorslimhinnens mottakelighet. Metoder som støtter hormonbalanse, slik som «seed cycling», blir ofte diskutert i denne sammenhengen.
Det fjerde er forhøyede prostaglandiner som frigjøres utenfor synkronisering med den naturlige syklusen. Prostaglandiner er hormonlignende forbindelser som er involvert i betennelse og livmorsammentrekninger. Når nivåene og tidspunktet for frigjøring er ute av balanse, kan de forstyrre implantasjonen og bidra til smertene som så ofte er forbundet med endometriose. For kvinner som lever med betydelige menstruasjonssmerter, kan skånsom egenomsorg ved menstruasjonssmerter være en del av en bredere behandlingsstrategi.
Den femte indirekte mekanismen er dysbiose i mikrobiomet, en ubalanse i bakteriesamfunnene som lever i tarmen og reproduksjonskanalen. Dette er en av de mindre godt forståtte mekanismene, men den får stadig mer oppmerksomhet.
Innenfor tarmmikrobiomet finnes det en undergruppe av bakterier kalt estrobolomet, som hjelper kroppen med å metabolisere østrogen. Når estrobolomet er ute av balanse, påvirkes østrogenmetabolismen, noe som igjen kan påvirke utviklingen av endometriose og den generelle fruktbarheten. Å skaffe seg en bedre forståelse av tarmhelse og fruktbarhet er et nyttig utgangspunkt for alle som ønsker å utforske denne sammenhengen.
Vaginalt mikrobiom spiller også en rolle. I mer avanserte tilfeller av endometriose har mangfoldet i det vaginale mikrobiomet en tendens til å øke på måter som ikke er beskyttende, en forskyvning bort fra dominansen av gunstige bakterier. Å lære mer om vaginal helse og den bredere rollen mikrober spiller for å bli gravid kan hjelpe kvinner med endometriose å tenke på dette aspektet av sin reproduktive helse.
Det finnes ingen enkelt løsning på endometriose, men det er flere behandlingsmetoder som kan kombineres. Grovt sett kan disse deles inn i fire områder:
Livsstilen er ofte det området hvor kvinner har størst innflytelse i hverdagen. Å senke tempoet i hverdagen, prioritere hvile og sikre god søvn kan alle bidra til en sunn menstruasjonssyklus. Det er en grunn til at «hvile er gratis» dukker opp så ofte i samtaler om endometriose. Å forstå hvordan søvn påvirker fruktbarheten er et godt sted å starte. Målrettet ernæring ved endometriose kan lindre betennelse og støtte hormonmetabolismen, og for par som ønsker en strukturert plan, gir en rask start på optimal fruktbarhet ved endometriose en oversikt over det viktigste.
For de som har en mer avansert form for endometriose, eller som har prøvd å bli gravide i en stund, er assistert reproduksjonsteknologi ofte en del av samtalen. Å kjenne til det grunnleggende før man starter med IVF bidrar til at dette skrittet føles mindre overveldende.
Det viktigste er å bygge opp et kompetent team rundt deg. Gynekologer, fertilitetsspesialister, ernæringsfysiologer og andre som forstår både endometriose og din generelle fertilitetssituasjon, kan bidra til å utforme en virkelig personlig tilpasset plan.
Ja. Mange kvinner med endometriose blir gravide på naturlig vis. Tilstanden øker sannsynligheten for at du vil møte vanskeligheter, men den utelukker ikke en naturlig graviditet.
Nei. Omtrent 1 av 10 kvinner har endometriose, og mange av dem får barn uten fertilitetsbehandling. Tilstanden øker risikoen for infertilitet, men er ikke en garanti for det.
Omtrent 50 % av kvinnene som sliter med infertilitet, har endometriose. Tilstanden påvirker fruktbarheten gjennom flere mekanismer, blant annet blokkerte eggleder, anatomiske forandringer, redusert blodtilførsel til eggstokkene, betennelse, hormonubalanse og forstyrrelser i immunforsvaret, og det er derfor den dukker opp så ofte i fruktbarhetsundersøkelser.
Endometriose kan påvirke eggkvaliteten på to hovedmåter. Redusert blodtilførsel til eggstokkene svekker eggmognad, og det betente miljøet rundt endometriose-lesjonene – fullt av cytokiner, prostaglandiner og overskudd av østrogen – utsettes det utviklende egget for skadelige kjemikalier.
Sjokoladecyster er endometriomer som dannes på eggstokkene fra endometriotisk vev. I tillegg til å skade eggstokkvevet, kan de forvrenge de fine utvekstene på egglederne som har til oppgave å fange opp det frigjorte egget, noe som kan hindre egget i å komme seg inn i egglederen selv når eggløsningen er normal.
Kirurgi for å fjerne endometriosevev kan forbedre kvaliteten på de enkelte eggene og lindre symptomene, men gjentatte operasjoner på eggstokkene kan påvirke eggstokkreserven negativt. Denne avveiningen må diskuteres med en spesialist før man tar en beslutning.
Ja. Estrobolomet, en undergruppe av tarmbakterier som metaboliserer østrogen, påvirker hvordan kroppen behandler hormoner. Når tarmmikrobiomet er i ubalanse, påvirkes østrogenmetabolismen, noe som kan bidra til utviklingen av endometriose og dens innvirkning på fruktbarheten.
I mer avanserte tilfeller av endometriose viser det vaginale mikrobiomet ofte økt mangfold på måter som ikke er beskyttende – en forskyvning bort fra dominansen av gunstige bakterier som normalt støtter reproduktiv helse.
Å prioritere hvile og søvn, spise på en måte som støtter hormonbalansen og redusere betennelse gjennom ernæring er de livsstilsfaktorene som oftest anbefales. Ingen av disse er hurtigløsninger, men sammen skaper de forutsetninger der kroppen kan reagere bedre på andre behandlinger.
Dette er en beslutning som må tas sammen med en fertilitetsspesialist. Assistert reproduksjonsteknologi vurderes ofte når naturlig befruktning ikke har skjedd etter en rimelig periode med forsøk, eller når endometriosen er så langt fremskreden at naturlig befruktning er usannsynlig.
Endometriose påvirker fruktbarheten på flere måter enn det de fleste kvinner får vite. Noen mekanismer er fysiske og synlige på en ultralydundersøkelse, mens andre er systemiske, hormonelle og knyttet til mikrobiomet. Det er viktig å ha et helhetlig bilde, fordi det endrer hvordan du tilnærmer deg behandlingen og hvor trygt du kan fremme dine egne interesser overfor en spesialist.
Hvis du lever med endometriose og tenker på å bli gravid, er det mest nyttige neste trinnet å bygge opp et team rundt deg og lage en plan som tar for seg både de direkte og de indirekte mekanismene som spiller inn. Kunnskap gir styrke, og med riktig støtte klarer mange kvinner med endometriose å få den familien de ønsker seg.
00:00:00 All too often, we aren't able to or we don't take the time out to give ourselves rest and true rest from, you know, the fast paced world that we really live in. And actually, I think COVID has really shown how fast paced our world was before it happened and that there are some benefits because it's actually shown us just, you know, how actually nice it is just to slow down that pace sometimes. now the break by having that breakaway it had a massive effect on my cycle um afterwards which now the break by having that breakaway it had a massive effect on my cycle um afterwards which was really interesting and it was just real testament to me that to me and also those you know my clients that i teach that the huge importance of rest especially when so many of you suffer from chronic stress now remember rest is free um and it is literally the most powerful healer but it's the thing that actually um i find my clients find is one of the things that we
00:00:54 actually struggle with the most because it's the thing that when you're short of time you steal time from sleep but you know it's it's what we shouldn't do sleep really is is the power to heal time from sleep but you know it's it's what we shouldn't do sleep really is is the power to heal when we're sleeping um i really am starting to feel the benefits of my energy level starting to go up. My cycle and period have dramatically improved since I had that break and I've really been focusing on my sleep, which is a key sign that my body's getting stronger, my chi's getting stronger. I'm going to first start with a little bit of general information about endometriosis stronger. I'm going to first start with a little bit of general information about endometriosis
00:01:30 and then discuss the ways in which endometriosis can directly and indirectly affect your fertility. I don't have enough time to go into the really detailed actions you can take to optimize your fertility in this episode though I will mention one or two where appropriate but I will be covering that in episode two next week as there are plenty of things that you can do. Now believe it or not endometriosis is common and often debilitating condition for women during their reproductive years and I don't need to really tell you that. Now according to Diane Stefferson-Mills years and I don't need to really tell you that. Now according to Diane Stefferson-Mills reproductive gynecologists recognize it as the second most common gynecological complaint in
00:02:09 women which is crazy. Now here are some more crazy statistics I'm sure you might be aware of and if you're not then it's really important to know them. It's understood that one in every 10 women have endometriosis that's somewhere between 6 and 10 percent of the general female population but up to 50 percent in sub or infertile women. Now this equates to about one and a half million but up to 50 percent in sub or infertile women. Now this equates to about one and a half million in the UK and over 176 million worldwide based on 2017 figures. Now what I find really hard to take is on average it takes seven and a half years for women to get a diagnosis and for many it's far longer than that. I mean for me it took almost 25 years to get to the bottom of it. Now those
00:02:54 statistics are immense and frankly shocking and it's why we need to be talking about this more statistics are immense and frankly shocking and it's why we need to be talking about this more so that women know about this before they're trying to get pregnant. It can affect anyone, regardless of where you live in the world, your body type, race, colour, social status, etc. Now, I could spend the whole podcast talking about this, but I'm not going to. Now, the word endometriosis means that some of our body's cells are basically growing in the wrong place.
00:03:25 They are similar cells to those that grow inside the womb lining, but instead they're outside the womb and can grow anywhere though more commonly around the ovaries but instead they're outside the womb and can grow anywhere though more commonly around the ovaries and in the peritoneal cavity which is commonly known as the abdomen. The problem occurs when these cells act in the same way that they do in the womb in that they're nutrient-rich tissues that build up blood and then break down and bleed in conjunction with a woman's menstrual cycle. Now this is where one of the key problems lie because there's nowhere for this blood to go like there is with a period exiting from the womb. Instead it can cause inflammation, pain
00:03:55 like there is with a period exiting from the womb. Instead it can cause inflammation, pain and scar tissue. So scar tissue or fibrous connective tissue is formed as the body tries to isolate the endometrial growths by putting a plaster type growth over the top of them. Now this tissue then thickens and goes hard over it as you can see when you have scar tissue on your skin after a cut. Now this kind of makes sense doesn't it? But the problem is that this scar tissue can then stick or glue tissues together nearby whilst it's still soft and scar tissue can then stick or glue tissues together nearby whilst it's still soft and this is where real problems occur as organs can get stuck to the wrong places and cause distortion,
00:04:40 further pain and functional problems such as poor gut motility, cerebral infertility. Right I want to go straight into how endometriosis can affect fertility rather than go into more detail about how endometriosis affects the body overall. Our fertility can be affected in a number of ways, some directly and some indirectly. Here are the key seven I've found in my research, some directly and some indirectly. Here are the key seven I've found in my research, though it should be noted that the precise mechanism is still unknown. Three direct inways include number one, fallopian tube blockages. Now the fallopian tubes are the width of a hair which is really tiny and when ovulation occurs they swell in response to an estrogen surge.
00:05:28 Now fertilization takes place in the upper third so sperm have a really long way to swim Now fertilization takes place in the upper third so sperm have a really long way to swim and a woman's orgasm can actually really help this because it helps propel the sperm up further into the fallopian tube. Now unfortunately the fallopian tubes can be easily blocked by endometriosis lesions and scar tissue along or over these tubes which can then either either prevent the sperm from reaching the egg or the fertilized egg from reaching the womb. Another way is that chocolate cysts, which are fluid-filled ovarian cysts that occur Another way is that chocolate cysts, which are fluid-filled ovarian cysts that occur
00:06:01 deep within the ovary, can actually result in distorting the fallopian tubes so that these finger-like projections cannot reach the ovary, meaning the egg cannot then pass into the fallopian tubes. One thing that can really help with blockages, depending on the extent and why it is blocked is abdominal massage and therapy. Now there is a really really good podcast episode by Lisa Hendricks and Jack on the Fertility Friday podcast with Larry and Belinda Worm. Lisa Hendricks and Jack on the Fertility Friday podcast with Larry and Belinda Worm. I'll pop it in the show notes but I absolutely loved it and as a massage therapist it really connected with me and the positive results that these two have actually found with abdominal
00:06:44 therapy. Now it's especially uplifting for any of you that have blocked tubes and if you want to know how to do self abdominal massage I have a video tutorial available which I'll also pop into the show notes. Two is poor egg quality and count. Now cysts or ovarian endometriomas as they're the show notes. Two is poor egg quality and count. Now cysts or ovarian endometriomas as they're known occur in about 17 to 44 percent of women with endometriosis and are often associated with more severe forms of the disease. Now when cysts, lesions or scar tissues grow on, over or in the ovaries it can result in fewer eggs and poor maturation of eggs resulting in sub-optimal quality and its ability to be fertilized. Now this would explain why studies have found women
00:07:26 quality and its ability to be fertilized. Now this would explain why studies have found women with endometriosis experiencing a higher rate of early miscarriage i.e. in the first six weeks and often you may not even be aware that you might have actually got pregnant. Now there are several reasons why poor egg quality can happen. The first is due to chemical secretions that come from the endometriotic tissues. Now these secretions not only contain blood but many things including cytokines which are inflammatory immune cells that are toxic to eggs and pre-implantation embryos. cytokines which are inflammatory immune cells that are toxic to eggs and pre-implantation embryos. Now research has shown that over an egg quality improves after cysts are removed
00:08:10 though there is still research needed on this. Second reason is other chemicals such as prostaglandins and excess estrogen which I'll come on to in a minute whether that's natural or external can be damaging to conception. And then the third reason, repeated surgery involving work external can be damaging to conception. And then the third reason, repeated surgery involving work on the ovaries has unfortunately been shown to have a negative effect on ovarian reserve despite it improving the quality of the eggs themselves. This is why it's really important to consider your options if you have cysts as to whether you want surgery
00:08:46 if you want a family. Or it might not be that you want surgery whether you actually just want them to leave the eggs alone whilst you have surgery and elsewhere within your abdomen. Now there are pros and cons and this is a huge subject and I cannot cover it here and I cannot cover it here but you do need to do your research before your surgery
00:09:03 and advise your skilled excision surgeon of your desire to have a family and discuss it with them in detail. Now, the third direct way that endometriosis can affect your fertility is that it can reduce blood flow. Now, ovaries require blood with fresh oxygen and nutrients to mature healthy eggs. Scar tissue can compromise blood getting to and within the ovaries, meaning less oxygen and Scar tissue can compromise blood getting to and within the ovaries, meaning less oxygen and nutrients and more toxins or less toxins that can be taken away. Now lower oxygen levels may mean the eggs do not mature as well making them less likely to be able to be fertilized or implant
00:09:45 very well. Now one study found that surgery to remove scar tissue and surgery improved uterine blood flow to the ovaries. Now this is another reason why abdominal massage or therapy is really good because it can really help break down scar tissue and increase blood flow to the pelvic area. good because it can really help break down scar tissue and increase blood flow to the pelvic area. There are five indirect ways yet all interrelated in some way that I've found that endometriosis affects fertility. I hope I've explained them clearly as it can be difficult without diagrams and pictures. Now number one is a dysregulated immune system. Endometriosis is associated with a dysregulated or as I call it a discombobulated immune system. Our immune system is there to
00:10:25 a dysregulated or as I call it a discombobulated immune system. Our immune system is there to protect us from foreign or abnormal cells in our body. Now you may have heard of autoimmune diseases this is when our body mistakenly attacks the body's own healthy tissues. In contrast with endometriosis the body fails to recognize the endometrial lesions that are growing in the wrong place as being foreign and this results in a poorly coordinated immune response which is why some consider endometriosis an immune disease that is still not fully understood. Unfortunately some consider endometriosis an immune disease that is still not fully understood. Unfortunately there is lowered natural killer activity natural killer cell activity and yet increased inflammation
00:11:06 and this is a phenomenon referred to as counter inflammation. Now counter inflammation means inflammation that contributes to less coordination in the immune response to control growth of irregular cells. Now in relation to fertility the rise in progesterone during the luteal phase or in other words the second half of your cycle it acts to down regulate the immune system so that in other words the second half of your cycle it acts to down regulate the immune system so that our bodies do not reject sperm and the egg or even the developing embryo. Therefore if you have low progesterone as a result of hormonal imbalances and increased inappropriately placed inflammation it can result in the rejection of all three. Now there are many steps you can take to improve your
00:11:51 immune system but one key thing is improving your gut health where 70% of your immunity occurs. So the second indirect way is through inflammation. As I just mentioned the immune system is more So the second indirect way is through inflammation. As I just mentioned the immune system is more often than not dysregulated and results in inflammation in the peritoneal cavity that's in the abdomen and the peritoneal fluid containing an increased number of immune cells including macrophages, mast, natural killer and T cells as well as elevated growth factors, chemokines and inflammatory cytokines. So that's a lot of things and you're probably thinking my god I've no idea what you're talking about there and I'm not going to go into the individual sort
00:12:28 god I've no idea what you're talking about there and I'm not going to go into the individual sort of chemistry of all of those things but just be aware that as a result the peritoneal fluid that coats the outside of the womb and the pelvic area becomes toxic effectively and it can then affect the ovarian reserve, egg and embryo quality and even make it difficult for the embryo to implant into the uterine lining. This is why reducing inflammation is a really important step in improving your overall health and improving your fertility. Number three is hormone imbalance. Now improving your overall health and improving your fertility. Number three is hormone imbalance. Now endometriosis increases your oestrogen and this then causes an imbalance with progesterone.
00:13:10 The endocrine system is a finely tuned machine and any part that is out of balance will have a knock-on effect as other endocrine glands step in to help and pick up the imbalances which cause further imbalance. This is why for some women an imbalance in their estrogen and progesterone especially combined with an elevated stress can have a knock-on effect on the thyroid progesterone especially combined with an elevated stress can have a knock-on effect on the thyroid function which then affects egg health and ovulation. Now number four is elevated prostaglandins. So prostaglandins are hormones that are involved in many functions around the body but are strongest associated with our reproductive health. Specifically they're involved in ovulation,
00:13:51 the breakdown of the corpus luteum which occurs if you do not get pregnant and signals the end of the cycle and therefore the start of your period. Immune interactions, the motility of of the cycle and therefore the start of your period. Immune interactions, the motility of sperm and contractions. They are secreted by normal endometrial tissues in the uterus as well as endometrial growth outside the uterus in women with endometriosis. Now if they're elevated at the wrong time in the wrong place due to endometriosis they can interfere with the fertilization of the embryo and many other elements of reproduction. Now prostaglandins released by growth outside the uterus have been shown to do it out of sync with the release inside
00:14:26 released by growth outside the uterus have been shown to do it out of sync with the release inside the uterus which then sends the wrong messages and can have dire consequences. Now interestingly fats from dairy and meat can raise certain prostaglandins and PGE2 specifically so excessive consumption can actually cause an issue. So this is one of the reasons why people say you know not to have an excessive consumption of both dairy and meat and also to be careful of the sources which you get them from. Now finally number five is something that's far less understood it's the which you get them from. Now finally number five is something that's far less understood it's the micro is microbiome dysbiosis. Now it's not that it's not less understood it's just that the link
00:15:12 with fertility is less understood. So our body is host to trillions of bacteria and they are continually being discovered in unique communities present in their own microbiome such as the gut, reproductive system, skin, nasal, mouth. I mean every pocket within your body has its own reproductive system, skin, nasal, mouth. I mean every pocket within your body has its own microbiome that's slightly different from the next one. So essentially we are bacteria and we wouldn't be here if we didn't have bacteria living on and within us. What's been discovered is that there is a link between our gut bacteria and endometriosis and even some mention of our reproductive bacteria and endometriosis. Though which way round they affect each other is yet to
00:15:52 be discovered as this really is an evolving science. Now the status of our gut microbiome is so so important as it's involved in so many incredible things from nutrient absorption, is so so important as it's involved in so many incredible things from nutrient absorption, maintaining the integrity of our gut lining and thus the systemic overall inflammation within our body, gut brain signaling, gut liver detoxification interactions, sleep, stress and so many other things. Now, the clearest connection between gut and fertility is the regulation of sex hormones, specifically estrogen. The gut microbiome has its own estrobilone. I love that word, estrobilone, which is a subset of the gut microbiome associated with estrogen metabolism.
00:16:36 And this is where, if it's out of kilter, it can cause endometriosis progression, which then is you know going to affect and impact our fertility as I've just mentioned. Now studies are still going on for this but they have been done as well in relation to vaginal and cervical microbiomes and endometriosis and though it's still in its infancy and has shown vaginal and cervical microbiomes and endometriosis and though it's still in its infancy and has shown it has shown that there are differences in the microbiomes between someone who is healthy and say someone's got stage three or four endometriosis in the fact that those with endo have far more diversity which is not desired in fact for your vaginal microbiome
00:17:18 we want as least diversity as possible dominated by a lactobacillus species and this diversity is known to affect fertility it's still a very new area of research and something I'll be discussing is known to affect fertility it's still a very new area of research and something I'll be discussing in more detail in future podcasts. I actually have an interview with an amazing lady all about the astrobalone for example and this is why looking after your gut health is actually really really key and one thing I've not mentioned actually is there is a link between your gut health and your vaginal microbiome so the gut and the vaginal microbiome are also really linked so by looking after your gut you have a knock-on effect on your vaginal microbiome also. So that was all rather
00:17:55 after your gut you have a knock-on effect on your vaginal microbiome also. So that was all rather complicated as complex as the miracle that is reproductive process in humans this is why it's important to enhance immune and reproductive systems and get the right hormonal messages working and going to the right places so it means that the body is then less tolerant of endometriosis it's really important to note that you may have other things that are related to your endometriosis that affect other important things that are required for you to be in optimal fertility that affect other important things that are required for you to be in optimal fertility function. Now one really common thing for example and I've already mentioned about gut health is
00:18:37 well-functioning digestive system because it has a big impact on your optimal nutrient stores. If you're depleted in certain areas it's going to have a knock-on effect in what you need to both grow a baby but also for certain systems to function whether it's your liver whether it's your thyroid so that's what is really really important and I will always harp on about our digestive health. What I do want to finish off with is that not all women with endos suffer digestive health. What I do want to finish off with is that not all women with endos suffer with infertility. For some it just may take longer than the average so it's really good to be aware of this. Also that there is a lot you can do to manage your endometriosis and optimize your
00:19:16 fertility using a variety of modalities including surgical intervention, natural lifestyle and nutritional changes and assisted reproductive technology. Now if I were to share one thing with you today it would be that knowledge is power as if you understand more about your with you today it would be that knowledge is power as if you understand more about your endometriosis you're more likely to ask questions and take action so you can empower yourself and understand how you can personally improve your health in conjunction with a well-qualified team of specialists around you whether this is surgeons pelvic floor therapists acupuncturists nutritionists and fertility specialists don't be embarrassed to speak out and tell your story now i do understand
00:19:56 And if you don't want to talk about your fertility, this can be a really sensitive area. So you don't have to. So you don't have to. But just share your story about your endo, whether it's how long it took you to get diagnosed, whether, you know, it's how you feel. It's, you know, how it makes you feel in your private life, how it affects your work. You know, you may find that close friends and family are actually suffering in silence and they've not mentioned it and you've never realized. So it can make, you know, you can end up making some real connections there. So thank you for listening.
00:20:24 I hope you found this informative and not too overwhelming I find that knowledge is power and I hope you do too and it's better to know what you're dealing with so that you can then make I hope you do too and it's better to know what you're dealing with so that you can then make informed choices to help grow your family so that you so deeply desire so have a great week I look forward to chatting to you next week all about the things that you can do to help improve your health and optimize your fertility
