If you’re on this site, you’re probably looking for more natural and alternative treatments for endometriosis. I hear ya! I did the same thing for a long time. I could never afford a professional excision surgery, and finding the right integrative tools for my own endo put me in remission. I am … lucky. But this doesn’t mean everyone is.

Here’s the thing: endometriosis is complex. And you may really need a surgery to feel better.

How do we know when to consider surgery? In researching my book Heal Endo, I spoke to endometriosis researchers who generally agreed that diet, lifestyle, western medicine, and holistic healing could be beneficial and prevent the need for surgery in some. But But if you do not see the gains you need in 6-12 months, then consider seeking out a surgical consultation. Let’s chat about some of the biggest questions around endometriosis and surgery.

1) Does surgery cure endometriosis?

No, but it removes lesions and can also help remove scar tissue and adhesions causing trouble (such as an ovary being adhered to your bowel, ouch!). While endometriosis is a full-body disease and more than lesions, the lesions themselves are the major players of pain, damage, and infertility. It’s why removing this diseased tissue can change lives in many endo journies.

2) If an endometriosis diet and lifestyle can support remission, can I avoid surgery?

colors, ANTIOXIDANTS, minerals, fat soluble vitamins, omega-3s? YES please. Replacement for surgery? well, that depends on your body, your disease level, and so much more. — Colors, ANTIOXIDANTS, minerals, fat-soluble vitamins, omega-3’s? Yes, please. Replacement for surgery? Not if you need one.

Totally depends! There are so many levels of endometriosis, from very minimal amounts of lesions to an entirely frozen pelvis. So while some evidence shows some bodies able to find remission through targeted lifestyle approaches, there’s still the issue of scar tissue, adhesions, and sometimes enormous or painful cysts which aren’t so easy to dissolve.

Truthfully, some women I work with have been able to reclaim their lives through diet and lifestyle alone. Other women I’ve worked with felt specific symptoms decrease, but still had pain or an issue to resolve. In these cases, I always recommend surgical consultation as the next step.

3) Endometriosis Treatment: We’re all Unique!

It’s so important to remember your journey is going to be TOTALLY different than all your endo-sisters, and to get to a point of full or partial remission your journey is going to be your own. You may need a surgery, or two.

That’s because endo affects women differently, and there is such a thing as more aggressive endo and less aggressive endo. You also may have inherited genetic characteristics from your parents that may make your body more susceptible to certain health issues, meaning you may have associated autoimmune disease, mental health issues, or physical barriers on top of your endo.

That being said, it’s soooo important to know that you’re not a failure if you need surgery or other medical help while Susie just needed to stop eating gluten to feel totally fine.

4) Endometriosis symptoms may continue after surgery if you don’t address the whole picture

Important message: a well-done surgery may throw you into full remission, or it may not. There’s been a huge push these past few years of well-meaning folk repeating “One Surgery One Time”, meaning one expertly done surgery to remove all the endo and give you a state of full remission - and yet this isn’t totally true for every woman.

In my clientele, I’ve had a handful of women so far who had an advanced, expertly done endo surgery and still needed my services for alllllll the associated issues they thought the surgery would fix. They can’t digest properly, they’re fatigued out of this world (spoonies), they may still oddly have pelvic pain. These are associated issues of endo, and ones that surgery can’t just pick out of your body and toss in the trash.

There’s also the social justice issue of “One Surgery One Time”, since many women will not be able to afford such a surgery, nor even qualify for a loan to afford the surgery. Since there are only a certain amount of expert surgeons in the world most of us will find ourselves forking over personal funds for these experts. Even if you have insurance, a skilled surgeon may still leave a hefty co-pay in your mail, something not every woman can fathom when just making rent (with a chronic disease) is hard enough. I know when I was looking into specialty surgery years ago, I threw in the towel as $40k was beyond my comprehension at the time.

5) What’s a girl to do in the face of all of this?

Learn!!! Learn about endometriosis in its totality (Like, READ THIS PAGE), then learn about how it’s affecting your own body. First, follow your symptoms and unique diagnosis, get opinions and second opinions, and get surgery if you need one.

It sounds corny, but get a self-titled PHD in endo. Read pubmed, listen to stories, understand your symptoms and ask “is this endo, or is this digestive distress” or “is this stress related”. etc

In the meantime, do everything you can to heal your body and associated symptoms. Remember that endometriosis is affected in severity by:

Immune dysfunction - work to recalibrate your immune system so it functions normally.

Under-nutrition - aim to reverse chronic disease by doubling your nutrient intake rather than worrying about whipping your thighs into shape.

Gut-Issues - we now know that bad bacteria in the gut shed something called LPS, it leaks out of the gut, and falls into your pelvis, stimulating more inflammation and more growths of endo. This means you need to absolutely heal and seal your gut to help your endo severity. Each woman may have her own unique set of gut issues and infections, but 2 places to consider starting are with a lowFODMAP diet (if you have IBS) or a PaleoAIP diet if you don’t have IBS. Both should be considered short-term, therapeutic diets, not long-term lifestyles.

Movement - sometimes I wonder if the recurrence rate of endo in super healthy people has to do with incorrect movement and breathing patterns, or stagnant flow of blood to the pelvis. Indeed we need to eat nutrients and then GET THEM TO THE PELVIS, which only happens with correctly blood flow. A recently published study “suggested that pelvic floor spasm may be a major contributor to endometriosis-associated pelvic pain”, so take your core + pelvic floor function seriously ladies.

Surgical Takeaway

No matter now much you want to avoid it, surgery may be a huge part of your endo solution. One that demands respect. One that is never a failure when needed. One that even a woman currently in remission and doing everything under the sun to heal may need in the future, because endo is one-heck-of-a-disease. But also one that may not be the perfect solution depending on your disease severity and symptoms, and one that should be approached with caution to avoid the risks and costs that inherently come with surgery. Do your research, talk to other women, find a surgeon you believe in and who believes in you. Healing from endo is holistic, meaning using all the tools in your kit, and sometimes your holistic road will also need some professional surgical help. That being said, surgery is also no replacement for dietary and lifestyle shifts :) This is why healing must be balanced. So is life.