Your Endometriosis Health Team

endometriosis health team, toronto naturopathic doctor, naturopath toronto

If you are living with endometriosis, you’re likely aware that it’s a complex condition that can benefit from a health team (#endometriosisdreamteam). Because I believe in integrative medicine and the value of different wisdom and experiences, I wanted to share a few of health practitioners (aside from your Ob/Gyn) that can help you alleviate pain and improve your quality of life!


Who should be on your team

Pelvic Floor Physiotherapist

Pelvic floor physiotherapy is more than just kegels! Within the pelvic region, endometriosis can cause inflammation, scar tissue, adhesions, pain and muscle tightness. Muscle tightness may occur when women are curled up in fetal position or because of anticipation of painful sex. Pelvic floor physiotherapists are able to assess the pelvic floor muscles and release any trigger points as well as help release scar tissue. 

Moreover, the alignment of pelvic organs and ligaments may be distorted due to pain or other factors, and pelvic floor physios are able to help bring back a healthy alignment to the pelvic region. 

When the body has a pelvic floor dysfuntion, it may lead to the following symptoms:

  • Pain in the back, hips, and sacroiliac joint
  • difficulty urinating, increases urination, burning or pain with urination
  • constipation or diarrhea
  • painful bowel movements and faecal incontinence
  • painful sex
  • inability to tolerate a speculum during a gynaecological exam
  • pain with wearing tampons and menstrual cups

Massage Therapist

Massage therapy is one of those gentle, yet effective treatments that can have big results. Abdominal massage is designed to stimulate and increase the flow of blood, lymph and qi to everything in the pelvic region (such as organs, ligaments and tissues). Moreover, some treatments can gently shift the uterus and other organs into a healthier alignment – which may lead to the reduction of uterine spasms and adhesions. 

Sex Therapist 

Sexual therapy can aid people who are experiencing sexual difficulties, with the goal of promoting physical intimacy. Many women with endometriosis suffer from sexual dysfunction, specifically when it comes to deep penetrative sex (likely due to the area inhabited by endometrial lesions). Down the line, this may lead to negative effects on relationships, mental and emotional well-being, a decrease in quality of life. 

Because fear and anticipation of pain can inhibit the sexual response (and affect desire and lubrication), a sex therapist may suggest and facilitate communication between partners, help with alternative sexual practices, and provide relaxation techniques.  

Naturopathic Doctor

I might be biased, but Naturopathic Doctors bring a lot to the table! When I work with my endometriosis clients, I like taking a look at the modifiable causes when it comes to guiding treatments. Specifically I take a look at inflammation and estrogen and work on those to help decrease pain within the body. 

Therefore treatments include acupuncture (yes, NDs can perform acupuncture!), nutritional support, lifestyle changes, and smart supplementation. For instance, turmeric can be quite helpful for pain experienced with endometriosis. But before you make yourself a golden milk latte, it’s important to remember dose and duration of treatment is necessary to elicit the desired effects. Lastly additional testing to assess stress and cortisol levels, as well as estrogen detoxification, can be quite useful in helping to guide treatment plans.  

Final Thoughts

It’s obvious that each member of this endometriosis dream team provides something unique in the treatment of this condition. And to be honest, you don’t need to have endometriosis to have a well-rounded group of health practitioners. Most of us have a GP, Optometrist, Dentist – which help us take care of physical components of our body. But don’t underestimate the value of taking care of your emotional and mental states as well!

Understanding Period Pain

February 12, 2018
period pain, menstrual cramps, period pain relief, toronto naturopathic doctor, menstrual pain

Talking about period pain isn’t easy – especially when most women believe that it’s a normal part of the experience. I remember when I first learned about periods, I was told that experiencing menstrual cramps were to be expected. Luckily, there are things that provide period pain relief!

What is period pain?

Dysmenorrhea is a fancy word for painful periods. In fact, painful periods are the most common gynecological symptom affecting almost 45-95% of women! While many women think that pain is a normal part of their menstrual cycle, it can have negative effects on their daily activities (forcing them to stay home from school and/or work). 

When you’re on your period, the lining releases prostaglandins which causes the uterine muscles to contract. Too many prostaglandins will ultimately cause period pain – like menstrual cramps and feelings of pressure. 

Types of dysmenorrhea

Primary Dysmenorrhea

Primary dysmenorrhea is pain without a pathology (ie. a structural cause), and can be due to prostaglandin production, nutritional deficiencies, and diet and lifestyle factors. This usually happens after a woman first experiences her period that has ovulatory cycles. It may be present right at the beginning of her period and will improve over time. 

Secondary Dysmenorrhea

Secondary dysmenorrhea is pain due to an underlying condition which increases during menses. Causes can include: endometriosis, adenomyosis, fibroids and cysts, infection, and even IUDs. This usually occurs in a woman’s 20s to 40s, and worsens over time. Not to mention, she might be experiencing her pain before, during, and after her period. 

For the purposes of this post, I’ll be focusing on primary dysmenorrhea

Is PMS the same thing as period pain?

Dysmenorrhea isn’t quite the same as PMS. Dysmenorrhea occurs during your period (typically on your heaviest days). Symptoms can include abdominal and lower back pain, diarrhea, nausea and vomiting, and dizziness and headaches.

Whereas, PMS (premenstrual syndrome) occurs a few days before your period and may continue a few days in. It’s an mix of psychological and physical symptoms that may encompass dysmenorrhea including: depression, anxiety, irritability, bloating and painful breasts. In order to ‘diagnose’ PMS we should be recording our symptoms for at least 2 cycles using a symptom chart.

Period Pain and TCM

You know I love bringing in Traditional Chinese Medicine into the mix of things. Here are some causes of menstrual cramps from a TCM perspective:


When the body is cold, it can cause the blood to stagnate. Think of it this way, when you’re freezing you want to curl up with a wool blanket and not move. You may find that warmth relieves period pain and gravitate towards warm foods and drinks. 


Similarly, when women are experiencing heat signs like early, bright or dark red periods, a yellow-coated tongue, and constipation, they usually find relief with cold foods and drinks. 

Period Pain Remedies

Remedies are wide ranging, and would best be tried after exploring the root cause of why the cramps are happening. Nevertheless, we may want to begin by reducing prostaglandins. 


Cow dairy may cause inflammation within the body that leads to feelings of pain. While it is recommended to avoid cow dairy – have no fear, goat, buffalo and sheep dairy is just as delicious!


Too much histamine in the body may result in an increase in estrogen (resulting in a deficiency of progesterone) as well as inflammation. Increased inflammation in the body can translate into pain. Reducing histamine would be indicated, which means limiting histamine producing foods (dairy and alcohol) as well as histamine containing foods (bone broth, cheese, fermented foods like kimchi and red wine).  


Magnesium is one of the body’s most essential nutrients. It reduces prostaglandins and relaxes the smooth muscle of the uterus. There are many forms of magnesium, but my favourite is magnesium bisglycinate. It doesn’t cause loose stools, and it’s absorbed by the body to help promote muscle relaxation. 


Whenever I’m having trouble with my period (thanks to stress!), I immediately book an acupuncture appointment. Acupuncture helps get the qi and blood flowing smoothy throughout the body and is a calming treatment which focuses on the mind and spirit.  


Ginger can be used in a variety of ways – supplements, teas, tinctures, etc. By nature it’s a very warming herb and can help with blood circulation and inflammation. Most of all, if you experience nausea with period pain – this is the herb for you! With menstrual cramps, ginger is primarily used a few days before the menstrual cycle and a a couple of days into it. This is because it targets the prostaglandin production, and acts as an anti-inflammatory. 


This is the one herb that I always have diffusing in my home. A study showed that women who inhaled lavender essential oil experienced significantly fewer symptoms of dysmenorrhea.  


Sometimes you just need to stretch it out. Because menstruation is part of the ‘yin’ phase of the cycle, it’s recommended that you take it easy. Going for a walk, or even doing a couple of yoga poses can help promote pelvic circulation and decrease pain!

Final Thoughts

Yes, this post was jam-packed with info! But, I hope it gave you an idea of the difference between period pain and PMS, as well as gave you some options to help manage your period pain. Like always, I would recommend working with a Naturopathic Doctor, so they can help you figure out why your period pain is happening and the most appropriate treatments for you. 

Lastly, if you found this information helpful, please sign up for my monthly newsletter called The Flow for more informative content like this!

A Guide to the Endometriosis Diet

February 5, 2018
endometriosis diet, endometriosis treatment, IBS diet, toronto naturopathic doctor, endometriosis naturopath

Women who live with endometriosis often report symptoms of abdominal bloating, diarrhea, constipation and of course pain. It’s been suggested that IBS (irritable bowel syndrome) may happen in about 90% (!!!) of women with endometriosis. Since almost all women are affected, it seems obvious that diet can play a huge role in pain and overall health, highlighting the need for an endometriosis diet. 

The above symptoms may happen because of the location of endometriosis (ie. near the sigmoid colon or rectovaginal space). Moreover, endo may affect nervous system function and lead to changes in sensitivity and movement in the GI space.

How is IBS Diagnosed?

IBS is often a diagnosis of exclusion –  aka. many conditions need to be ruled out before IBS can be ruled in. Nevertheless, IBS is diagnosed by the the Rome IV criteria. 

You may have IBS if you have recurrent abdominal pain on average at least one day/week in the last three months, associated with two or more of the following criteria:

  • related to defecation

  • associated with a change in frequency of stool

  • associated with a change in form (appearance) of stool

The Endometriosis Diet

Because IBS is so common in women with endometriosis, focusing on nutrition and diet makes total sense. Ultimately, we want to see if certain foods are causing pain and bloating, and changes in stool formation. 

The FODMAP diet has a lot of research with respect to improving symptoms of IBS. Therefore, it should be considered for women with endometriosis as it may provide therapeutic benefit. 

FODMAP Diet for IBS and Endometriosis

If you’ve never heard of a FODMAP – that’s okay! It’s an acronym that refers to carbohydrates (ie. sugars) commonly found in food. Here’s what the letters mean:

  • Fermentable

  • Oligosaccharides

  • Disaccharides

  • Monosaccharides

  • And

  • Polyphenols

The Pathway of Food and Gut Bacteria

When we eat, food travels from our mouth down the esophagus, and enters the stomach where the carbs, protein and fats are digested. As it moves through the small intestine, the food will continue to break down into smaller nutrients which will end up being absorbed into the bloodstream. The leftovers will pass through the large intestine, which will remove fluid through absorption. The bacteria in the large intestine will digest any leftover bits of carbs and proteins.

If someone has IBS, then the above carbs (O, D and M) will NOT be properly digested and will move into the large intestine, where the gut bacteria will begin to ferment them. This may cause painful gas, bloating, diarrhea, and other undesirable symptoms.

Therefore when someone chooses to follow a FODMAP diet, they’re choosing foods that are low in fodmaps – PREVENTING fermentation by the bacteria. 

Understanding FODMAPs

Let’s talk about the FODMAPs acronym again – oligo, mono and di are saccharides (which is another name for sugar).

  • Oligo means a FEW sugars linked together – like cellulose and starch

  • Di means TWO sugars linked together – like lactose which is made up of glucose and galactose sugars (monosaccharides)

  • Mono which means ONE sugar like fructose/glucose/galactose

A note about fructose: fructose is only an issue if there’s NOT enough glucose to help with absorption. Which means that anything with high fructose corn syrup or foods that have excess fructose (ie. apples) should be AVOIDED if you’re on a FODMAPs diet.

Lastly, polyols are sugar alcohols – basically any sugar that has –ol at the endo of it, such as xylitol, mannitol, etc.

How does the diet work?

This diet is similar to an elimination diet, with 3 phases: 

Phase 1: Low FODMAP

Eating a low-FODMAP diet. You would accomplish this by going through the FODMAP list and designing your meals around foods that you can eat, and foods you should avoid. For instance, if you’re used to eating an apple at 11am (to obviously keep the doctor away), you’ll want to switch it up for an orange. 

To make sure you get all the FODMAPs out of your system, you’ll want to follow this for about 2-6 weeks.  

Phase 2: Challenge

This is where you introduce FODMAP rich foods back into your diet (although not all at once!) to determine which foods trigger symptoms. If you do experience symptoms once you re-introduce a particular food into your diet, it’s best to avoid introducing another for a few days to let your gut get back to baseline. 

Based on how many foods you’re introducing and which symptoms keep popping up, this may take about 6-8 weeks. It’s best to go through this phase with a Naturopathic Doctor’s help.  

Phase 3: Adaptation

Now that you’ve gone through re-introducing all the foods that may cause unwelcome symptoms, you’ll know which foods you can safely eat and which you should avoid. In the adaptation phase, you can also re-challenge foods that previously cause you pain to again determine if they’re safe or should be avoided – this is because tolerance may change as time progresses. 

Final Thoughts of the Endometriosis Diet & Additional Resources

Monash University has an easy to use app highlighting FODMAP foods, as well as a great blog that provides additional information and FODMAP-friendly recipes. One particular article that I like is eating out on a FODMAP diet – because it’s always a huge limitation for everyone 

If you found this information helpful, I would encourage you to download my FREE EndoDiet meal guide and plan. It goes through everything we discussed: foods that are safe and that should be avoided, and a 7 day meal plan and preparation guide!