Turmeric & Black Pepper

Untitled-4 copy

So, back in the day when I first received my diagnosis and went nuts researching how to best rid my body of inflammation, I started making a tea that contained ginger, honey, and lemon.  I later added turmeric.  And when I could, I used fresh ingredients.

Now I’m lazy and just sip on a mug of tea steeped from a tea bag.  I’ve tried several different ginger teas (some with turmeric, some without).  But my favorite right now is Trader Joe’s Organic Ginger Turmeric Herbal Tea.  I’ve also started putting a turmeric powder in my shakes in the morning.  It’s made by Gaia Herbs and it’s their Turmeric Boost Restore formula.  I blend it with a banana, some almond milk, and a pea protein powder mix.

But somewhere between making my homemade tea and finding TJ’s tea, someone told me that in order to allow my body to really soak in the benefits of turmeric I needed to incorporate black pepper. What?  Hence the hunt for the alleged uber anti-inflammatory tea (and other products) with ginger, turmeric, and black pepper.

I was tellin’ my Mum about it recently and she poked me to research and write about it.  Why ARE they supposed to be consumed together?  Why not? So, here I am…drinking my TJ’s tea and hitting the internet for answers!!  AND using goodsearch.com drops a one-cent donation to the Endometriosis Foundation of America each time I search a term! A double whammy!

I’m no nutritionist and don’t understand the chemical breakdowns of these types of things, so here’s my laymen understanding …

From what I can tell, an ingredient found in turmeric (called curcumin) is processed too quickly in our bodies and we don’t have a chance to absorb it well.  An ingredient found in black pepper (called piperine) slows down that process and allows the curcumin-y goodness to enter our bloodstream and work its magic.  There’s a 1998 study out there that compares the levels of curcumin in the bloodstream with and without black pepper.; showing a 2000% increase when consumed with black pepper (don’t ask me the ratios).  Do be careful, though: there are suggestions and concerns of piperine and certain drug interactions. So, as usual: talk to your doctor first.

BUT…please…feel free to read the articles in the Resources section below and form your own opinion!  I know nothing!!  But I do know I’ll continue my turmeric & black pepper combo routine.


Healthcloud – (Article, Feb. 18, 2015) Do I Need to Take Pepper with Turmeric?

Healthy and Natural World – (Article) How to Optimize Turmeric Absorption for Super Boosted Benefits

Lucy Bee Blog – (Article, Sept. 22, 2016) Why We Should Be Eating Turmeric with Black Pepper

Just Vitamins – (Article, Sept. 25, 2017) Why Turmeric and Black Pepper Need to Be Taken Together

Pharmacy Times – (Article, July 28, 2017) Piperine Drug Interactions

Planta Medica – (Study, 1998) Influence of Piperine on the Pharmacokinetics of Curcumin in Animals and Human Volunteers

Turmeric for Health – (Article) 6 Amazing Health Benefits of Black Pepper and Turmeric

~ Again, I am a layman. I do not hold any college degrees, nor mastery of knowledge. Please take what I say with a grain of salt. If curious, do your own research 😉 Validate my writings. Or challenge them. And ALWAYS feel free to consult with your physician. Always. Yours ~ Lisa

Tomatoes & Endometriosis


During our September support group meeting, I was munching on some cherry tomatoes when one of our girls stated, “I thought tomatoes were bad for our Endo…” Damn it. Now I have to research…AND during a camping/survival skills trip in early October, I learned that the ENTIRE tomato plant (except for the tomatoes) is poisonous!  What?  How amazing is that?!?

Anyway, I digress…back to research.

My first page I found digging into tomatoes and Endometriosis introduced me to a word, “lycopene.”  What IS lycopene? It’s a carotenoid – a plant pigment – and specifically, lycopene is responsible for making fruits and veggies red…like TOMATOES.

In 2008, Dr. Tarek Dbouk announced at the American Society of Reproductive Medicine Conference that a study found lycopene could prevent or reduce the production of a protein that promoted adhesion growth. Numerous studies claim that an increase of tomatoes and tomato products in the diet reduces chances of various cancers and cardiovascular disease (although the FDA was found very little evidence to substantiate the claims).  It has been suggested that women with Endometriosis may be able to reduce their symptoms by increasing their lycopene consumption.  Although studies have suggested the lycopene may act as a powerful antioxidant and anti-inflammatory and help reduce adhesion formation, further studies are needed.

So after reading all of that, you wanna cram your fridge full of tomatoes and other red fruits and veggies right? Well…not so fast (there is always a flip side).

Tomatoes belong to a family of plants known as nightshades.  Some studies have suggested that nightshades may increase inflammation or worsen symptoms of autoimmune diseases.  Healthline published an extensive article on nightshades and various findings and theories on the effects of conditions or sensitivities.  The author also suggests (if you suspect you may have issues with nightshades) to cut ALL nightshades out of your diet for four weeks, then reintroduce them and see how you feel: the ol’ Elimination Diet.  Sounds easy?  Well, here are some fruits & veggies that are nightshades:

  • eggplants
  • goji berries
  • peppers (sweet, bell, chili, etc.)
  • potatoes (except sweet potatoes and yams)
  • tobacco
  • tomatillos
  • tomatoes

This also means that spices derived from those are included in the list of “avoid nightshades”: cayenne pepper, crushed red pepper, chili powder, and paprika.  Um…think we’re done? Nope…think again – ketchup, marinara sauce, hot sauce, and salsa all are made from nightshade components. Not an easy task avoiding nightshades.

But are tomatoes the only source of lycopene? Nope – plenty of other fruits and veggies contain lycopene:

  • apricots
  • asparagus (that’s not red!)
  • basil (again…not red!)
  • gac fruit (what is that?!?)
  • goji berry (aka wolfberries; careful…it’s a nightshade)
  • papaya
  • parsley (it’s green!)
  • pink grapefruit
  • pink guava
  • red cabbage
  • red bell peppers
  • red carrots
  • rosehips
  • sea-buckthorn
  • watermelon

A 2015 study tested 10 fruits and veggies in raw and processed forms to discover which had the highest lycopene content.  A breakdown of the tested fruits and veggies (lowest to highest lycopene quantities) in their raw forms: watermelon, asparagus, carrot, grapefruit, gac, red cabbage, sweet peppers, papaya, tomato, and pink guava.  In processed food form, the following order was determined (lowest to highest): mango juice, canned carrot juice, cherry tomato paste, watermelon juice, dried apricots, marinara sauce, sundried tomatoes, canned tomato juice, canned tomato puree, and canned tomato paste.  That being said, they concluded the study by stating, ” The appropriate dose and duration of lycopene supplementation remains to be determined.”  It’s been said that just 8 ounces of tomato juice a day can help increase the levels of lycopene in your system. But, but, but…TOMATOES…nightshades…Endometriosis…!!

Last night, Merritt Jones of Natural Harmony Reproductive Health taught a class on nutrition and Endometriosis and discussed nightshades and why they may be harmful to Endometriosis-sufferers and should be limited or avoided altogether.  But, she also stressed finding what works best for your body, your digestion, and your symptoms.

But wait! There’s more…a flipside of the flipside!  Healthline also wrote an article about nightshades and inflammation in regards to arthritis pain.  Some people with arthritis who avoided nightshades did not experience any symptom relief after eliminating nightshades, so they were encouraged to continue to eat them due to the health benefits that they provide.  The pros outweighed the cons for those individuals.  AND, Ms. Jones informed us at last night’s class that if cutting out anti-inflammatory foods does not help reduce symptoms, you may be suffering from a bit of bad gut health, possibly even leaky gut syndrome.  Always talk to your healthcare provider if things aren’t working – something else may be going on.

So now what?  Tomatoes are good for you. Tomatoes are bad for you.  “Tomayto, tomahto” – do your own research, try the elimination diet, see how you feel, and follow your gut (but do make sure your gut is healthy!).  BUT if you do want to increase your lycopene intake, there are plenty of other options (food and supplement-wise) besides tomatoes.  And, as always, please talk to your healthcare providers before starting any new supplements.

What am I gonna do?  Man, I love me some tomatoes.  I have a little carton of them on my desk right now – delicious, cherub tomatoes.  I really don’t know what I’m going to do.  So, that means I’ll likely do my best to cut them out (and other nightshades) to see if I notice a difference in how I feel – and decide after I reintroduce them back into my diet.

But what about you? What are you going to do? Or what have you already done – and did it make a difference? I’d love to hear about it…drop me a comment below.

(Updated March 27, 2019)


Annual Review of Food Science and Technology (Manuscript; 2010) – An Update on the Health Effects of Tomato Lycopene

Canadian Medical Association Journal (Article; Sept. 2000) Tomato Lycopene and Its Role in Human Health and Chronic Diseases

Daily MailEating Tomatoes Could Help Fight a Painful Womb Condition that Affects 2 Million Women in UK

Dr. WeilTomatoes for Endometriosis?

Healthline (Article; June 2017) – Are Nightshades Bad for You?

Healthline (Article; March 2017) – Nightshade Vegetables and Inflammation: Can They Help with Arthritis Symptoms?

Journal of Basic Sciences – (Article, 2015) – Evaluation of Lycopene Contents from Various Fruits and Processed Food

Journal of the Natural Cancer Institute – (Article; July 2007) – The U.S. Food and Drug Administration’s Evidence-Based Review for Qualified Health Claims: Tomatoes, Lycopene, and Cancer

Journal of the Society of Laparoendoscopic Surgeons – (Article; Apr-Jun 2007) Patients with Chronic Pelvic Pain: Endometriosis or Interstitial Cystitis/Painful Bladder Syndrome?

LiveScience– (Article, Oct. 2015) – What are Carotenoids?

Livestrong – (Article; Oct. 2017) – List of Nightshade Vegetables & Fruits

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

Endometriosis & Salt/Sodium


I enjoy salt.  Love it, actually.  And one night my Jim asked if I thought salt altered my Endometriosis at all.  We’ve all heard too much salt is a bad thing for blood pressure, watch your sodium-intake, blah blah blah…but I didn’t care – I love my salt.  Well, his question stuck with me over the months and it’s finally time to look into it.

I’d always thought salt and sodium were the same thing…nope.  Table salt is a blend of ingredients, including sodium.  Sodium is a natural mineral.   Sodium helps our bodies balance electrolytes and fluids and is mainly stored in our kidneys. We pee out any excess sodium our body doesn’t use.

How does high sodium effect us?  If your kidneys can’t process the sodium well or fast enough, it gets to your blood.  Sodium retains water, which makes your blood vessels swell, which means your heart has to beat more to pump it around, which leads to high blood pressure…which can lead to a whole slew of problems.

Endometriosis and inflammation are bosom buddies. Recent studies are finding that high salt intake may very well effect the immune system and promote inflammation, as well.  It can also cause a lot of discomfort and pressure around your joints, due to the swollen veins.  People with Rheumatoid Arthritis may feel these effects even more, as some medications may cause the body to retain more sodium.

But, as usual, science goes back and forth.  There are studies that say it increases inflammation, and studies that say it has no effect on inflammation.

How much sodium is too much sodium?  The FDA recommends no more than 2,300mg of sodium per day for adults under 50 years old…or 1,500mg of sodium per day for adults over 50, or people suffering with high blood pressure, diabetes, or kidney disease.  One teaspoon of table salt contains slightly over 2,300mg of sodium.  One teaspoon of sea salt contains about the same amount.  So, one teaspoon of salt is the daily allotment for most people.  One.  Teaspoon.  Some people salt their food while cooking, others salt for seasoning once it’s hit the plate, and others (um…me) do both.  Whoops.

Salt is often used as a preservative, which means most processed foods may contain a lot of sodium.  Mmmmmmm bacon.  Sodium is also found naturally in food and may be higher in seafood, dairy, vegetables, and meat.  Read the labels.  Do your homework.  Make a grumpy face.  For a chart on examples of different sodium levels (in mgs) in different foods, click here.

An example (let’s pretend this is my food & drink for one day…which it isn’t):


THIS is what I ate yesterday…


PaleoLeap wrote an interesting piece dissecting studies of sodium intake and they opine that high salt intake doesn’t lead to inflammation – but the intake of junk foods (which are often sodium-laden) do.  The Paleo Diet also anaylzes a lot of recent studies of sodium intake and inflammation and suggest that it does increase inflammation.

Back and forth.  Back…and…forth.

I’m gonna read my labels and try to make an effort to at least keep my sodium intake within the daily recommendations.  I’ve done it with sugar (well, a whole hell of a lot better than I used to…). I tracked my sugar intake for a week and got a good sense of what had how much – it will be fun with sodium, too!


But, what are you going to do?



American Heart AssociationNew Sodium Targets Could Help Put Food Choices Back in Your Hands

American Heart AssociationSea Salt vs. Table Salt

Arthritis FoundationHow to Eat Less Salt

European Journal of Clinical Nutrition – (Abstract; 2012) Dietary Salt Intake is Related to Inflammation and Albuminuria in Primary Hypertensive Patients

JagWireScientists Explore Whether a Little Less Sodium in the Diet Translates to Less Inflammation, Oxidative Stress in the Body

Journal of Nephrology – (Abstract; 2010) Impact of Adopting Low Sodium Diet on Biomarkers of Inflammation and Coagulation: A Randomized Controlled Trial

LivestrongSalt, Sodium, & Inflammation

Paleo LeapIs Salt Really Inflammatory?

The American Journal of Clinical Nutrition – (Abstract; 2009) Is Higher Sodium Intake Associated with Elevated Systematic Inflammation?  A Populatrion-Based Study.

The Paleo DietNew Studies on Salt: Adverse Influence Upon Immunity, Inflammatoin, and Autoimmunity

US Food & Drug AdministrationLowering Salt in Your Diet

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 🙂 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

Inflammation & Endo


The Oxford Dictionary defines inflammation as, “a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury and infection.”

An article which is slated to be published in June 2016’s Frontiers in Bioscience reviews previous studies and literature which discuss how inflammation may cause Endometriosis to develop.  It states, “…inflammation is crucial in the pathogenesis of endometriosis…” Pathogenesis is the development of a disease; the cellular events and mechanisms that lead to a disease.

It also discusses how estrogen can affect inflammation which, in turn, affects Endometriosis.  It points out that anti-inflammatory medication and GnRH analog drugs (such as the highly-controversial Lupron Depot which depletes our estrogen production) have been found to reduce inflammation in Endometriosis patients.

Remember our blog about stress and Endometriosis?  This June 2016 study identifies that stress hormones may also play a role in creating inflammation and aggravating Endometriosis.

The authors theorize that inflammation may not only play a role in the development of Endometriosis, but that Endometriosis may contribute to pelvic inflammatory disease.  Imagine if you will a snowball effect : stress = inflammation + estrogen = Endometriosis + more inflammation = pelvic inflammatory disease or other illnesses.

A study published in Fertility & Sterility (Oct. 2017) also showed that inflammation may play a role in the development of Endometriosis, especially peritoneal cavity inflammation.  It concludes “therapeutic strategies focused on reducing peritoneal inflammation may be effective in limiting the development, progression or recurrence of endometriosis.”

I may not have understood a lot of the science mumbo-jumbo of the article, but I did certainly walk away with one thing : inflammation is noooo bueno and I will do anything I can do to naturally reduce my body’s inflammation.

Diet plays a huge role in reducing inflammation.  You have to decide what aids and hinders your body…not just do what “works for everyone else.”  You may have heard this all before, but :

  • Omega-3 fatty acids, like those found in salmon or tuna, are great at reducing inflammation.  Don’t like fish but take fish oil caplets?  Be careful; Omega-6 fatty acids, which may be found in fish oil supplements, may spurn inflammation rather than quell it.
  • Nuts are also a great sort of antioxidants and Omega-3s.  Try walnuts or almonds.
  • Whole grains contain a lot of fiber, which may decrease inflammation.
  • Eat your fruits & veggies.  Leafy greens, broccoli, tomatoes, beets, garlic, onions, berries, and cherries (the tart ones) all have amazing properties that combat inflammation.
  • Ginger and turmeric, two very ugly roots which are common spices, also have properties which are well-known to fight inflammation.  Cinnamon has also been found to be anti-inflammatory.
  • Don’t forget about herbs!  Rosemary, thyme, sage, and oregano are among the top 10 herbs and spices for fighting inflammation.
  • Extra virgin olive oil has been found to have similar anti-inflammatory properties to NSAIDs (i.e, Ibuprofen, Naproxen Sodium).

Dr. Andrew Weil has created a fun graphic known as the Anti-Inflammatory Food Pyramid.  If you like visual aids, click here.

There’s also a list of foods that promote inflammation, which you may want to avoid (if you’re able to).  These include dairy, soy, red meat, and foods that are high in saturated fat and sugar. Some people are affected by a gluten sensitivity or intolerance, which flare up their inflammation and symptoms.

Also, try to reduce your stress levels.  In any way : stretching, meditation, yoga, medication, rest, a different job, removing toxic people from your life, etc.

I repeat : do what feels good and works well for you.  Pay no mind to someone else if they say “this works,” but you’ve tried it and it doesn’t make you feel any better…or if it makes you feel worse.  You, and only you, really know your body.

*Updated September 12, 2017*


Body Ecology10 Top Foods that Prevent Inflammation in Your Body

Center for Disease Control and Prevention – Pelvic Inflammatory Disease

Fertility & Sterility (Article; Oct. 2017) – Effect of Inflammatory Environment on Development of Endometriosis in Murine Model

Health.com14 Foods that Fight Inflammation

Mercola Top Anti-Inflammatory Food, Herbs, and Spices

U.S. National Library of Medicine (Abstract; June 2016) – Inflammation and Endometriosis; the full article is available for purchase from Frontiers in Bioscience

Women to WomenReducing Inflammation – The Natural Approach

A biiiig thank you to Gary for his help in securing the entire article for me to read.  I truly appreciate you.

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa


Evaporated Cane Juice Crystals

Today we’ll be talking more about the “Endo Diet,” particularly why we’ve been told to cut out as much processed sugars as possible.  I’ve read that sugar may cause or aggravate inflammation, but it’s time to dig deeper and find the scientific backing to these claims.

What is Inflammation?

Inflammation, when needed, fights bacteria and infections, repairs damaged tissue, and helps our bodies heal faster from injury or illness.    Cells and proteins whiz to the injury or infection site and begin to surround, protect, and heal.  However, like the old saying goes: all things in moderation.  Too much or excess inflammation can actually damage our bodies.  Chronic inflammation may overwhelm or body rendering it unable to maintain a healthy balance and may lead to clogged arteries, stroke, heart disease, asthma, lupus, or a multitude of chronic illnesses.

Sugar in particular has been found to create an immune system response (inflammation) as the body tries to break down the proteins found in sugar.  Sugar also increases insulin levels, which (when there’s too much) may cause certain Omega fatty acids to increase prostaglandin levels, which may increase inflammation.  Not to mention heightened blood sugar levels may increase chances of becoming Diabetic.  And many people also believe that sugar intake, and increased chronic inflammation, may increase the risk of cancer.

Many people believe by making an active effort to reduce their sugar intake, they are taking steps to help reduce their body’s chronic immune response, thus helping reduce their inflammation and pain.


At the 1999 55th Annual Meeting of the American Society for Reproductive Medicine, it was presented that certain pro-inflammatory proteins and cytokines (cytokines are increased by sugar consumption) may influence and increase the inflammation of Endometriosis implants.

A study published in 2006 focused on diet and the metabolic syndrome.  What’s “metabolic syndrome?”  Well, it’s a combo of different conditions all leading to an increased risk of heart disease: high blood sugar level, excess body fat, and abnormal cholesterol levels.  Although not dealing with Endometriosis, I found the study equally fascinating.  This study found that a diet high in refined starches, sugar, saturated and trans-fatty acids and low in fruits, veggies, whole grains, and Omega-3 fats may cause issues with the immune system, likely due to an increase of inflammatory agents and a reduction of anti-inflammatory goodness.

“The whole diet approach seems particularly promising to reduce the inflammation associated with the metabolic syndrome. The choice of healthy sources of carbohydrate, fat, and protein, associated with regular physical activity and avoidance of smoking, is critical to fighting the war against chronic disease. Western dietary patterns warm up inflammation, while prudent dietary patterns cool it down.”

A study published in 2008 discussed several lifestyle changes which may help prevent or regulate the pain of Endometriosis, as well as fibroids and breast cancer.  Maintaining healthy blood-sugar levels by following a low-glycemic-index diet is referenced as potentially preventing or fighting inflammation.

A study published in 2011 found that “sugar-sweetened beverages” promoted inflammation in healthy young men.  Twenty-nine men consumed low to moderate sugar-sweetened beverages.  I’d love to see the same study conducted on much higher-level beverages, such as Monster or Rockstar!

A study published in 2015 conducted on mice suggests there may be estrogen and inflammation suppression techniques that may help prevent or treat Endometriosis.  Ongoing research is needed.  “Inflammation suppression” simply drives my determination to try and reduce/limit my body’s excess inflammation…unfortunately, I do not have access to the entire article, only the abstract, but still : “inflammation suppression.”

Sweetener Alternatives

Still want to eat sweet but lessen your processed sugar intake?  Try these alternatives:  artichoke syrup, blackstrap molasses, coconut palm sugar, lucuma powder, raw honey, or stevia.  These are all “less evil” than sugar, but again: all things in moderation.  Some people suggest pure maple syrup or agave nectar; others dissuade against them as a sugar alternative.  And, please, avoid those artificial sweeteners like Sweet’N Low, Splenda, Equal, etc.  They may contain chemicals that pose an increased risk of developing cancer.

What Will I Do?

Sugar is found in nearly EVERYTHING you put in your mouth.  Fruit, vegetables, meat, processed foods, sugar cane, maple syrup, honey, agave, etc.  The list just goes on and on.  Sugars are also labeled many different ways…for more information on how to find added sugars on your food labels, click here.

And since I still want to eat and drink, I choose to eat and drink differently for my Endometriosis.  I find it interesting that the foods I’ve already either reduced or fully-eliminated from my diet also coincide with the whole sugar-thing: soda, coffee (with copious amounts of added sugar), bread, red meat (some red meats have been linked with high sugar levels), baked goodies (cakes, cookies, brownies), desserts (creme brulee, ice cream), and alcohol.  I drink herbal tea in the morning and a homemade tea at night, using organic honey to sweeten both.  I enjoy my fruits and vegetables, my fish, my poultry.  And I drink a lot of water (I really don’t drink anything else anymore, except my glass of wine at night with dinner).  I like to think I’m reducing my chances of increasing my inflammation and pain.

But the question is: what will you do?


American Journal of Clinical Nutrition

Arizona Center for Advanced Medicine

Carolyn Chambers Clark

Endometriosis Symptoms



Harvard Health Publications

Hungry for Change

Integrative Medicine : A Clinician’s Journal – 2008 (full text) – An Integrative Approach to Fibroids, Endometriosis, and Breast Cancer Prevention

Julie Daniluk

Lawrence Wilson, M.D.

Mayo Clinic

Mayo Clinic Health Letter

National Cancer Institute

National Institute of Allergy and Infectious Disease

News Medical

Nutritionist Resource

Science Direct – 1999 (abstract) : 55th Annual Meeting of the American Society for Reproductive Medicine

Science Direct – 2006 (full text) :  The Effects of Diet on Inflammation: Emphasis on the Metabolic Syndrome

Science Translational Medicine– 2015 (abstract) : Dual suppression of estrogenic and inflammatory activities for targeting of endometriosis

U.S. National Library of Medicine – 2006 (abstract) : The Effects of Diet on Inflammation: Emphasis on the Metabolic Syndrome

University of Maryland Medical Center

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

A sit down with my Gyno


So today was my last Liquid Crazy injection (yay!!!) and I also had a chance to sit down with my gynecologist/Endo surgeon to discuss future treatment and ask my giant list of questions.

I wanted to share the answers with you.  Please now that these are answers for me from my physician.  If you have similar questions, I encourage you to talk to your doctor. Your situation may be different than mine. Your doctor’s opinions may vary from mine.

But I do feel a lot better.  And since some of you helped me develop my list of questions, I wanted to share the answers with you guys!

  • How long until the Lupron Depot is out of my system? I know the medication is supposed to last one month, but when will the side effects go away?
    • It should be out of my system in 1 – 1.5 months. Maybe 2.
  • I have about 35 Northindrone pills left (5 in current prescription; 30 for next month).  Shall I continue to take them each day until gone?
    • As soon as I start taking birth control pills, stop taking the Norethindrone.
  • Will menopause be as bad as it was on Lupron Depot? Or was that magnified due to the chemical inducement?
    • Every woman is different, but natural menopause should not be as bad as it was on Lupron Depot.  This was a chemically-induced state. Natural menopause should be a little bit easier.  I let him know my Mum didn’t even know she was in menopause, her symptoms were so light. Hoping I get the same gift. Ha!
  • When do I start birth control?
    • As soon as I pick up the prescription.
  • How long will I have to be on continuous birth control?
    • I can stop taking birth control if my significant other and I decide to have a baby and can start trying to conceive.  Although raising a child is something I’d wanted for a very long time, I do not feel it is right for us now. So likely will not be trying.  However, I can continue to take birth control until I am 48-49 years old, about the time when menopause will begin to kick in.
  • I know that women over the age of 35 should not take B.C., or be monitored while taking it. What sort of regular monitoring will we need to do?
    • Being that I do not smoke and do not have any negative history of blood clots, I’ll be just fine.  If I’m concerned, I can bring it up during my annual exams.
  • I’ve heard B.C. can cause cysts and/or even cancer.  Is that true?
    • No.
  • I understand I will have breakthrough bleeding or spotting while on continuous B.C.  How bad will it be? Predictable?
    • It shouldn’t be too bad, but isn’t predictable.  I can expect to start my period after stopping the Norethindrone, and I can also expect to have my period every 3-4 months while on  birth control (this will be a continuous birth control, so less periods…yay!)
  • Will Lybrel/Amethyst be bad for me because of my Gilbert’s Syndrome? What about the Endo on my liver?
    • My gyno hadn’t heard of Lybrel or Amethyst and will do some research prior to writing the prescription.  He wants to make sure it will meet my Endo needs.  If not, he will prescribe his favorite low-estrogen continuous B.C. I let him know I didn’t want any of the birth controls like Yaz or Yasmin that have been involved in serious mass torts and class actions.  He agreed.  Per my gyno’s advice, I’ve posed the Gilbert’s Syndrome question to my Primary Care physician.  I expect the use of birth control will be just fine (I was on OrthoTri-Cyclen in my 20s) and should have an answer by the end of this week.
  • If I don’t like Lybrel/Amethyst, when can we try something else?
    • I didn’t ask this, especially since I’m not sure if he’ll prescribe it. Figured I’d cross that bridge if I came to it.
  • If I can’t stand B.C. at all, what’s another option?
    • I didn’t ask this. Figured I’d cross that bridge if I came to it.
  • If I do need a hysterectomy, would it be partial, total, or radical? Remind him of my history of abnormal Paps.
    • If the Lupron Depot and continuous birth control do not help my Endometriosis pain, we may want to consider a hysterectomy to help reduce my massive menstrual cramps.  IF we did choose this method, he would only remove my uterus first.  If symptom continued after, we would then remove my ovaries.  Both of us agreed that this is a last ditch effort and it’s not something I want at all. I understand that hysterectomies are not a cure for Endometriosis.
  • If I do need a hysterectomy, can we do it without transvaginal mesh?  TVM has ongoing mass torts…
    • He doesn’t use transvaginal mesh for hysterectomies.
  • If I do need a hysterectomy, will I have to go on Hormone Replacement Therapy?  If so, will the estrogen make the Endo grow back quickly?
    • I also didn’t ask this question.  Figured I’d ask it if we ever have the Hysterectomy sit-down Q&A.  Interestingly enough, in our conversation he brought up how some women use soy to help with their menopausal symptoms : it has been known to mimic estrogen and help relieve symptoms.
  • Assuming my next appointment will just be for my annual pap? Or will we schedule an ultrasound?
    • My next appointment is in April for my annual pap.  We can decide then if I need another ultrasound.
  • When will I know if we need a second excision surgery?
    • When my pain returns, we can talk about this.  Hoping it will be several years.
  • I’ve changed my diet hoping to help keep symptoms tame.  I’ve also started taking supplements (Omega-3s, Folic Acid, Calcium+Vitamin D, Milk Thistle Seed Extract).  Anything else I can do naturally to help?
    • My doctor has heard that people have altered their diets to reduce any hormonally-enhanced foods such as red meat and dairy.  To avoid that as much as possible may be way to avoid any additional estrogen-increasing contact which may further aggravate Endometriosis.  Also, he said to avoid soy products, as it has been known to mimic estrogen.

I absolutely appreciate and cherish my doctor for taking the time today to listen to all of my concerns, answer my questions, and to do research regarding my choice of birth control.  I also appreciate his staff for making this process less of a terrifying ordeal.  My nurse has been amazing and a joy to see each month for my injection, and the receptionist has always made me laugh.

Finding the right physician’s office is critical to maintaining a healthy attitude during scary moments of questions and ongoing treatments.  If any of my readers are in the San Diego area and are looking for a good Endo specialist/surgeon, I highly recommend Dr. Mel Kurtulus and his staff.

Yours, Lisa

EndoInvasion : Stages

A stage with the Bloomin' Uterus logo centered on it in a spotlight
Our Uterus : center stage!

So there are four “Stages” of Endometriosis.  It’s the doctors way of categorizing the depth of the EndoInvasion in our bodies.  It was developed by the American Society of Reproductive Medicine.   Diagrams of the various stages can be in an article published in Fertility & Sterility back in 1997.

I didn’t know my Stage level and had to ask my doctor.  My Endometriosis was Stage 4, the most severe it can get. Probably because it was brewing inside me undetected for nearly 2 decades. Ugly disease. (Update: As of June 6, 2019, I’ve now had a total of four excision surgeries; each one classified my illness as Stage 4).

The interesting things about Stages: the Stage Level doesn’t necessarily dictate our symptom or pain levels.  Someone with Stage 1 can have severe pain, while someone with Stage 4 may not even realize it.  Just one more mystery o’Endo.

So what are these Stages?  Here ya go:


Stage 1 Endo (Minimal) : subtle growths and implants that may be present.  These are considered superficial implants.  No adhesions (spiderweb-like scarring) are present yet. Evidence of inflammation may be found.


Stage 2 Endo (Mild) : Spots (implants/leions) are beginning to take shape and form over your body’s organs and tissue.  There are more than Stage 1, and are deeper in the body. Adhesions may have begun to form. The lesion colors can range from clear to black.


Stage 3 Endo (Moderate) : Same as above, but implants and cysts are present, usually on the ovaries. The lesions may be deeper.  Adhesions may be in greater number.


Stage 4 Endo (Severe) : Same as above, but many more solid masses of Endometriosis, as well as deep implants.  One or both ovaries have entrometriomas (a blood-filled chocolate cyst), and extensive adhesions are binding organs or tissue together.  The bowels, bladder, and other organs may also be involved.

Regardless of what Stage of Endo we are (or were at the times of our excision surgeries), all EndoSisters share this invisible illness.  And we all share the desire for better treatments and a cure to be found.  We are all in this together.  We all suffer together.  And we’ll get through this…together.

(Updated June 6, 2019)

Resources and More Info:

Endometriosis Foundation of America

Fertility & Sterility – (Article; 1997) – Revised American Society for Reproductive Medicine classification of endometriosis: 1996

Johns Hopkins Medicine


Merck Manual 


I can’t eat WHAT?!?

pyramidSince my June 30, 2014, surgery and diagnosis of Endometriosis, I went on a radical journey to find out how I can help my body fight this disease, especially while I was waiting for the insurance to approve my treatment regimen.  Several books and webpages pointed out the same facts of what foods to avoid, and which to devour!  So, overnight I made a decision : to do a 180 degree flip on what I did, and did not, eat.

Some say the choice and change was too rapid.  I should have eased into it, rather than cold turkey’d it.  I agree now, but hindsight and all of that jazz.  Regardless, I feel SO much better.  I don’t know if it’s the dietary change, or the Lupron Depot injections, or both, but I do feel a lot better.

I no longer eat the following foods, with a short (aka layman) explanation of why (keep in mind, these are pretty much ALL I ate prior to my diagnosis):

Wheat : contains gluten and phytic acid, which can aggravate symptoms of Endometriosis

Red Meat : causes increased inflammation and hurts digestion (also may contain crazy amounts of hormones)

Refined sugars (including juices and sodas) : causes inflammation and further aggravates symptoms of Endometriosis (I can’t cut this out ’cause it’s everywhere, but I do make a conscious effort to cut back…)

Caffeine : causes abdominal cramps and increases estrogen levels

Chocolate : contains sugars and caffeine

Dairy : causes inflammation (also may contain crazy amounts of hormones)

Alcohol : muddies up the liver (I haven’t cut this out, but I have drastically reduced.  I no longer drink beer and only enjoy 1 glass of white wine when I do drink)

So what do I eat?!?  Well, I severely miss my cheese and cupcakes and ice cream and frozen yogurt.  But have quickly gotten used to life without red meat and caffeine!  Surprisingly quickly!  I do eat a lot of turkey, chicken, fish, leafy greens, beans, fresh veggies (there’s a whole new realm of cooking out there!!!), and enjoy a wide variety of gluten-free pastas and baked goods.  I’ve also substituted coconut milk for regular milk, and enjoy cooking with coconut oil rather than butter.  About the only drink I have now is water.  I do enjoy 1 glass of white wine at night, and also 1 cup of an herbal (non-caffeinated) tea in the morning. I’ve had to budget in some extra money for the grocery budget every month, but it has been totally worth it.  And Farmers Markets and supermarket sales have been a god-send.

I also enjoy a nightly tea made of lemon juice, sliced ginger, honey, and water.  It not only helps with indigestion and inflammation, but is incredibly soothing and is the perfect “relaxy” drink right before bed.  Recipe and more info.

I also take daily vitamins and supplements, which include Omega-3 Fish Oil, Milk Thistle Seed Extract, Folic Acid, Calcium + Vitamin D3, “Hair Skin & Nails Support,” and Norethindrone (an add-back hormone for my Lupron Depot treatments).

I’ve lost 10 pounds since my surgery, and have kept it off.  I rarely have any headaches or back pain EVER.  And my cramps and discomfort of Endometriosis are gone (again, this could be due to the Lupron Depot).  I am looking forward to continuing this diet once my Lupron regimen is over (late January 2015) to monitor my symptoms and progress.

I have fallen in love with a resource for dietary information: http://www.endo-resolved.com/diet.html.

What have YOU found that works well for you?  What foods to you love to devour? What foods did you cut out? Comment and share below!

And if you made it all of the way to the bottom on this blog, Thank You!