By Lindsay Kluge

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March 26, 2021

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Explaining PCOS and Endometriosis with Dr. Ferreira

Vanessa Ferreira, ND is a naturopathic doctor with specializations in anti-aging, lifestyle & stress management, dermatology, women’s health, men’s health, homeopathy, and hormone optimization. Today, she explains PCOS and Endometriosis and her approach to each from a naturopathic medicine perspective.

What are PCOS and endometriosis, and what are the key differences?

PCOS (polycystic ovarian syndrome) is a condition that commonly presents with increased androgens and insulin resistance which can show as symptoms of acne, irregular menses, hair loss, hirsutism (facial hair growth), weight gain, and infertility. Methods of diagnosis may involve pelvic ultrasound, lab work to assess hormone function, and medical history.

Endometriosis is commonly an estrogen-dominant condition that presents with uterine lining tissue located on other organs outside of the uterus and has symptoms of heavy, painful menses and infertility. Diagnosis may include ultrasound and a minor surgical procedure called laparoscopy. These conditions have the ability to coexist in one person. Many patients have had success in working with a Naturopathic Doctor to provide support in overcoming PCOS with the naturopathic approach to PCOS.

Is there a genetic component to PCOS or endometriosis?

Endometriosis can have a hereditary component making it more likely to occur if a family member on either side has had it. In PCOS, it is possible to see it occur in multiple members of a family leading to a possibility of a hereditary component. Both conditions are still being studied for the genetic factors that could be involved in the predisposition for a female to be diagnosed with these conditions, though we know there are also lifestyle and environmental factors involved as well.

At what age are women likely to experience symptoms of PCOS or endometriosis?

PCOS and endometriosis symptoms can start to occur at puberty due to the hormonal changes and onset of menstruation which can start to show as irregular or painful and heavy. Many young females have different and possibly irregular cycles at menarche (first period), so it will commonly take a few cycles to understand and observe true abnormalities to the menstrual cycle. Some women will deal with the period abnormalities for years and only when they are trying to conceive will they notice if fertility is an issue and that is when many diagnoses are made.

Read More: Beyond Balancing Hormones: What Factors Play Into Dysregulation?

How can conventional birth control influence the presentation or symptoms?

Birth control is often used to help regulate hormonal imbalances and can sometimes help to lessen the presentation of symptoms in both PCOS and endometriosis, but oftentimes they can negatively affect other aspects such as PMS, increased headaches, poor digestion, weight gain, increase menstrual pain, etc. Since female hormones live in ratios to one another which has an effect on how symptoms appear, sometimes a good hormonal combination is found for a person and they feel well-managed, but more often there is an underlying issue that is not addressed by the birth control, which is why women who feel well-managed on birth control may still have fertility issues in the future.

Read More: Signs You May Need To Assess Your Hormones

How can PCOS and endometriosis affect fertility?

Since both of these conditions, as mentioned earlier, affect the hormonal balance within a woman’s body, this in itself can affect the ability to ovulate regularly or even maintain a healthy pregnancy. In PCOS we look into issues of improper ovulation and cycling as well as blood sugar dysregulation to help put the body into a fertile state. With endometriosis, there are issues with hormonal imbalance, but also the potential for that uterine tissue to be found over the reproductive sexual organs preventing them from functioning properly and possibly leading to infertility.

As a naturopathic doctor, what is your approach to women and girls with PCOS and endometriosis?

As a naturopathic doctor, I look into the root of the concerns and not just the symptoms as they happen to present themselves.

PCOS has a few moving parts to it and therefore needs to be approached in multiple ways. Some key goals when managing PCOS are to support liver detoxification, regulate blood sugar and insulin resistance, and balance hormones.

I like to start with the basics of establishing a diet that promotes appropriate blood sugar control and insulin sensitivity. Starting by addressing diet and lifestyle can help to establish a strong framework on which we can stack improvements. This step isn’t always the same for everyone as we all have different fuel needs, but the common goal is to reawaken your body’s response to food in order to support a more balanced hormonal picture.

The liver is one of the main organs that process hormones and with age and overloading on the liver (with medications, caffeine, alcohol, etc.), we have a more difficult time metabolizing hormones- especially when they are in excess within our bodies. This can lead to a worsening of symptoms including irregular cycles, hair loss, and acne. We can support liver pathways, commonly with supplements and herbs, to promote good hormonal metabolism.

Since we understand that hormones are unbalanced in PCOS, normalizing them will be crucial. As we know, everyone experiences this condition differently, so this is commonly when labs and assessments come into play to understand the hormone pathways that might be most affected in each individual case. This information leads to recommendations varying from dietary considerations to supplements that can have an effect on the imbalanced hormone levels to help improve menstrual cycle irregularities, infertility, skin, weight, etc.

In endometriosis, we have some similar goals to PCOS, but with slightly different moving parts. The main goals in endometriosis are to reduce inflammation, promote liver detox pathways, and decrease overall estrogen load.

A good starting point for reducing inflammation is, again, through diet and lifestyle because if our gut is inflamed and unhappy, it will start to show in other aspects of our health. There are many foods that can cause or worsen inflammation such as processed foods, trans fats, sugar, etc., and since symptoms of endometriosis tend to worsen with inflammation, it is important to eliminate those culprits to allow for healing of the gut and lessen symptoms such as pain, weight gain, or heavy periods.

Improving the detox pathways of the liver is important in helping to process high estrogen levels. A part of this is, of course, decreasing overall estrogenic activity, but also supporting the pathways through which estrogen is metabolized out of the body. Unfortunately, we are constantly surrounded by exogenous estrogens in our environment, food, and products, and making little lifestyle changes to avoid these pathways as best as we can help to support lowering your body’s overall estrogen load.

Both endometriosis and PCOS can present with symptoms in common such as weight gain, irregular cycles, and lower abdominal pain (different severities and locations). While working on the other aspects of lifestyle to help improve your health, don’t forget to include mood-boosting and stress management habits as well. Adding inappropriate types of exercise can help to manage pain, weight, mood, and hormone balance especially by supporting lymphatic movement and detoxification through sweating, and regulating hormone and insulin sensitivity. Stress management can be as simple as supporting yourself through breathing techniques or even incorporating meditation or self-care into your routine. These conditions need to be addressed from multiple aspects, because humans are multi-faceted, and working one aspect of health and not the others can lead to incomplete healing. Though the journey requires patience, there are multiple options for improvement.

If you are struggling with a diagnosis of PCOS, endometriosis, or need support with hormone balance and women’s health, consider consulting with Dr. Vanessa Ferreria for a personalized approach to finding balance.

Vanessa Ferreira, ND is a naturopathic doctor with a specialization in anti-aging, lifestyle and stress management, dermatology, women’s health, mean’s health, homeopathy, and hormone optimization.

Dr. Ferreira received her B.S. degree in Exercise Physiology, with a double minor in Biology and Disability Studies, from the University of Delaware. She then received her naturopathic medical doctorate degree from Southwest College of Naturopathic Medicine. In 2016, she completed a residency in general medicine at the Southwest College of Naturopathic Medical Center.