How to get rid of Endo Belly?

You are struggling with Endometriosis and as if it isn’t bad enough your belly feels bloated, distended and sticks out like you are pregnant. This is affectionately known as ‘Endo Belly’. Endo being short for Endometriosis.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


I have been missing in action because behind the scenes. I have recently shifted my focus of my clinical practice, social media accounts & YouTube channel to focus on periods, hormones & menstrual cycles. So, I won’t be talking specifically about fertility in relation to getting pregnant on my social media accounts or YouTube channel from this point forward. Of course, you are still welcome to follow me for content around periods, hormones & menstrual cycles which is still an important aspect of being fertile.


I am extremely passionate about educating women about having easy, pain free periods & healthy menstrual cycles.




What is it?


Endometriosis is when tissue similar to that of the uterine lining grows in an area where it shouldn’t be (outside the uterus). It causes a lot of inflammation and can also arise in adhesions & scar tissue formation.


Most commonly it can occur either on or around the reproductive organs or in the pelvic region:


  • Ovaries

  • Fallopian tubes

  • Lining of pelvic cavity

  • Ligaments around uterus (uterosacral ligaments)

  • On the outside surface of the uterus


Other areas where it can grow:


  • Space between uterus and rectum or bladder

  • On your bowels (small or large intestine)

  • Cervix

  • Bladder

  • Rectum

  • Stomach (abdomen)

  • Vagina or vulva


Signs & Symptoms of Endometriosis


  • Painful periods

  • Heavy periods

  • Period bleed is dark red in colour

  • Large clots in period blood

  • Painful sex (dyspareunia)

  • Fatigue

  • Diarrhoea or constipation

  • Pain when doing a poo or wee particularly during the period


 Endo Belly?

What is it?

When you have Endometriosis you can experience ‘Endo belly’ or ‘Endo Bloat” and your belly or abdomen swells. The duration varies, it can be a few hours, days, or even weeks. You feel so bloated & it can look like you are a pregnant & it can be difficult to even button up your jeans.


What causes Endometriosis bloating?


There can be a few reasons why abdominal bloating takes place with Endometriosis:


  • The build-up of endometrial-like tissue

These Endometrial lesions (the tissue that resembles that of the uterine lining growing outside the uterus) still responds to your hormones the same way the uterus does so it will build up and then it will shed and bleed each month. But instead of your uterine lining that is shed along with blood and released out through the vagina known as your period.


There is nowhere for it to go, so this results in inflammation, pain, irritation & the development of scar tissue & adhesions which can bind organs together. This build-up of lesions, arises in inflammation in the abdomen which will cause swelling, bloating, and water retention.


  • Endometrial Ovarian Cysts

This imposter of endometrial like tissue can implant in the ovaries arising in cysts filled with blood. And this can arise in, you guessed it, bloating due to the inflammation & swelling.


  • Increased risk of SIBO

A high percentage of women that have Endometriosis actually also have SIBO (Small Intestinal Bowel Overgrowth). This is when there is an overgrowth of bacteria in the small intestine. Normally there is only a small amount of bacteria there. The exact mechanism of why there is an increased risk of SIBO is not fully understood. One thought is that if there is Endometrial lesions on the bowels this can impact the normal function of the bowel.


However, if Endometrial lesions are present this will slow motility of the bowel and if this is slowed down it leads to a build up of not so desirable bacteria and bacteria that is not so commonly found in the small intestine arising in SIBO. The symptoms can include bloating, constipation, diarrhoea etc.


But not all women with Endometriosis have lesions on the bowel, but still experience bloating and have SIBO. So, in that case, it is thought that perhaps this is due to inflammation, pain receptors & mast cells that are activated > leaky gut (inflammation & damage to the gut lining) > gut dysbiosis (imbalance between good and bad bacteria).


  • Increased risk of IBS

There can be an increased incidence of Irritable Bowel Syndrome in women with Endometriosis. Again, this may be due to Endometrial lesions on the bowels which impact the normal functioning of the bowels or the inflammation arising in dysbiosis & leaky gut as mentioned above. Symptoms can include bloating, constipation, diarrhoea, gas, pain & cramping etc.


There can be an overlap in symptoms of Endometriosis and IBS too, which can unfortunately extend the time of diagnosis of Endometriosis if you were initially diagnosed with IBS. However, they can definitely coexist as well.  



How do you get rid of Endometriosis bloating?


Treatment of this, is all dependent upon why you have Endo belly out of the common reasons mentioned before. In my experience, you simply can’t ignore the digestive system and the contributing role that it has to play with driving Endometriosis & the awful symptoms that accompany it.


If you just focus on treating the reproductive symptoms of Endometriosis – heavy bleeding, painful periods, clots, hormone imbalance etc you won’t get too far. Similarly, if your ONLY treatment is a laparoscopy or multiple laparoscopies with surgical removal of the adhesions that also won’t get you far either. The aspects contributing to Endo are multifactorial and all the different causative factors need to be addressed.


Every patient that I have seen with Endometriosis, has some degree of gut dysbiosis or issues there contributing to their Endometriosis. Whether it be, SIBO, IBS or bacterial imbalance in the large or small intestine of some shape or form.



How would I know if my gut is contributing to Endo belly?


Testing gut function is so important to assess this. In my clinical practice, I refer for gut health investigations. One of the tests is a methane / hydrogen breath test for SIBO which measures the amount of these gases in the gut and if they are over a certain level it indicates SIBO is present. This is an assessment of the small intestine.


The other test that I do looks at the microbiome (so good and bad bacteria in the gut) present in your large bowel. This assessing your poo sample.


These tests are functional tests that a Naturopath can refer you for. My suggestion would be to see a Naturopath that specialises in Periods & Hormones like myself; to assess your digestive function, and whether that is contributing to your Endometriosis. The difference of quality of life you can make for that individual is truly amazing.


You absolutely need a Naturopath on your team of health professionals. You may already have a GP and perhaps even a Gynaecologist. In addition to that a Naturopath is essential as part of your health health care plan so that the root cause of your Endometriosis is addressed and treated. 


I use a combination of herbal medicine, nutritional medicine, NER (Naturopathic Emotional Release) to look at underlying emotional contributors, diet & lifestyle advice to treat each individual based on the clues gained from the gut testing and other tests done.


If you are experiencing endo bloat or endo belly and you need help managing your Endometriosis, I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

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