Endometriosis: What's Happening in Your Body — and What You Can Do

Every month again: pain that feels like a knife in your stomach. Days when you can barely get out of bed. And doctors who tell you it's "normal during your period." If you know this, you should know: It's not normal. And you're not alone.

Endometriosis affects an estimated one in ten women in Germany —

and is, on average, only correctly diagnosed after seven to ten years. A disease so widespread and overlooked for so long finally deserves a clear look. Here you'll get it.

Normally, the uterine lining — the endometrium — only grows inside the uterus. With endometriosis, it doesn't. Endometriosis-like tissue settles outside the uterus: on the ovaries, fallopian tubes, intestines, bladder, sometimes even the lungs or diaphragm.

The problem: This tissue behaves like the "real" lining — it builds up over the course of the cycle and sheds with menstruation. Except that the blood has nowhere to go. It remains in the body, causing inflammation, adhesions, and scar tissue. This can worsen with each cycle.

The result: chronic pain, systemic inflammation, and often significant limitations in daily life.

The symptoms are so diverse that endometriosis remains under the radar for years — or is dismissed as "normal period pain":

• Severe menstrual pain that hardly responds to painkillers

• Pain during sex, especially during deep penetration

• Pain during bowel movements or urination, especially around the period

• Chronic pelvic pain, even outside of menstruation

• Heavy or irregular bleeding

• Profound exhaustion and fatigue, far beyond simply "being tired"

• Unfulfilled desire to have children

Endometriosis is one of the most common causes of female infertility, along with PCOS, thyroid dysfunction, and anovulatory cycles. Not every woman experiences all symptoms. Some only learn about their condition when they want to conceive. Others are unable to work every month. The disease is as individual as you are.

Among other things, zinc regulates the release of FSH — the hormone that stimulates egg maturation and ensures a regular cycle. Since the body cannot store zinc for long, a regular, daily intake can make a difference. In addition, it has an antioxidant effect — particularly relevant in endometriosis, which is strongly associated with oxidative stress. Important for eating: Phytates in whole grain products inhibit zinc absorption — soaking legumes and grains helps.

Vitamin D is much more than a bone vitamin. Its influence on the regulation of the female cycle and fertility has long been researched - but is still underestimated. It supports the immune system and can inhibit inflammatory processes. Since most people in Germany have a deficiency, targeted supplementation can be useful - ideally combined with vitamin K2, which ensures optimal utilization and incorporation into tissues. The individually required dose varies greatly and should be determined via a blood test.

Coenzyme Q10 (ubiquinone) is a powerful antioxidant that protects mitochondria and shields cells from oxidative stress. In chronic inflammatory diseases such as endometriosis, oxidative stress is a constant companion.

Vitamin C acts as a free radical scavenger with antioxidant effects, strengthens the immune system, and improves iron absorption from the intestine — relevant as many women with heavy bleeding suffer from iron deficiency. It unfolds its full effect especially in combination with other antioxidants.

Your gut is much more than a digestive organ. It hosts around 1.5 to 2 kilograms of microorganisms — bacteria, viruses, fungi, and single-celled organisms — which together form a highly complex system. This microbiome influences many processes in the body, including hormone metabolism.

A part of the gut flora — the so-called estrobolome — is connected to how estrogen is processed and excreted in the body. If the gut flora is out of balance, this process can be impaired. Especially during phases of hormonal changes, it is therefore worthwhile to pay special attention to gut health.

Probiotics and Prebiotics — what's behind them?

Probiotics are microorganisms such as lactic acid bacteria that naturally occur in the gut and contribute to a healthy gut flora. Prebiotics, on the other hand, are food components that support these gut bacteria in growing and thriving. Both need each other — and both can be supplied through diet and specifically through dietary supplements.

What the gut flora needs to thrive

Fiber-rich foods are the best nourishment for beneficial gut bacteria: vegetables, legumes, whole grains, and fermented foods like sauerkraut or kefir. Psyllium husks are particularly practical - they swell in the intestine, support healthy intestinal transit, and simultaneously act as a natural prebiotic. Important: always drink enough water. Those who want to supplement with a probiotic benefit most from a preparation that contains many different strains, and from regular, daily intake.

1. Have your vitamin D levels checked. This can be done with any blood count — and is one of the quickest ways to close a real supply gap. A deficiency is the rule in Germany, not the exception.

2. Balance your Omega-3. More EPA and DHA — from fatty fish or algae oil — and less Omega-6 from sunflower oil and convenience foods. This will long-term change the inflammatory climate in your body.

3. Look at your gut. Bloating, irregular bowel movements, feeling full — often indications of an unbalanced microbiome. Fermented foods daily, psyllium husks as a prebiotic and a probiotic with relevant strains can make a real difference here.

4. Think in systemsMagnesium, B vitamins, zinc, vitamin D, antioxidants, probiotics — these nutrients work together and reinforce each other. A robust, holistic nutrient supply is the basis on which any further therapy can build. 

Endometriosis is complex — and it deserves more than a "there's nothing you can do." There are many levers you can pull. Not as a substitute for medical treatment, but as an active addition to it.

The better you understand what is happening inside you, the more targeted you can act. And precisely this — this knowledge, this self-competence — is the first step out of the feeling of helplessness.