Hormonal Harmony & Endometriosis

Understanding how your hormones shape your cycle — and what goes off track in endometriosis

The Normal Menstrual Cycle: A Monthly Conversation

A healthy menstrual cycle follows a steady rhythm, usually lasting about 28 days. It is driven by two main hormones: estrogen and progesterone. These hormones work together to grow, prepare, and shed the uterine lining each month.

Here’s how the cycle usually unfolds:

Menstrual Phase (Days 1–5):

This is the period phase. Estrogen and progesterone are low, and the uterus sheds its lining. This marks the start of a new cycle.

Follicular Phase (Days 6–13):

Estrogen begins to rise. It rebuilds the uterine lining and prepares the body for ovulation. This is often when energy and clarity increase.

Ovulation (Around Day 14):

Estrogen reaches a peak, triggering another hormone (LH) to release an egg. This is the body’s fertile window.

Luteal Phase (Days 15–28):

Progesterone becomes the lead hormone. It matures the endometrial lining and helps maintain balance by calming estrogen’s growth signals. If no pregnancy occurs, hormone levels drop, and the cycle starts again.

In a balanced cycle, estrogen builds the structure, and progesterone fine-tunes and stabilizes it.

What Happens Differently in Endometriosis?

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus—on organs like the ovaries, pelvic walls, or bladder. Though in the wrong place, this tissue still responds to hormones, but in abnormal ways.

A. Estrogen Becomes Overactive

• The lesions can make their own estrogen using an enzyme called aromatase.

• This extra estrogen promotes continued tissue growth, inflammation, and pain.

• A receptor called ERβ becomes overly active, encouraging survival and inflammation in these abnormal cells.

B. Progesterone’s Calming Role Is Lost

• In a typical cycle, progesterone slows tissue growth and helps with repair.

• In endometriosis, the tissues often resist progesterone — a condition known as progesterone resistance.

• The cells have fewer progesterone receptors, especially the type (PR-B) needed for calming and anti-inflammatory effects.

• Without this pathway, the body can’t regulate estrogen’s effects properly.

A Cycle That Feels Out of Sync

When estrogen is dominant and progesterone can’t do its job, the body ends up stuck in a state of overgrowth and inflammation.

• Estrogen remains elevated and fuels the growth of lesions.

• Inflammation doesn’t resolve and becomes chronic.

• Symptoms like pain, fatigue, and cycle irregularities often intensify.

• The normal signals that guide ovulation, healing, and renewal may be disrupted.

This creates a cycle that doesn’t just repeat—it escalates.

What Studies Show Us

In lab studies on endometriosis cells:

• Estrogen makes the tissue more aggressive. It reduces the barriers between cells, making them more likely to invade nearby tissue.

• Progesterone (or supportive approaches that mimic it) can help repair these barriers and reduce inflammation—but only if the cells are still able to respond to it.

This explains why endometriosis behaves differently even if hormone levels in the bloodstream appear “normal.”

Supporting Your Cycle Holistically

You don’t have to push through your cycle blindly. Understanding your unique rhythm can help you care for your body in a deeper way.

Here are supportive approaches that can help manage estrogen dominance and support hormonal balance:

• Track your cycle. Not just your period, but energy, mood, pain, and sleep throughout the month.

• Support liver and gut health — both play a role in clearing excess estrogen.

• Focus on fiber, leafy greens, and anti-inflammatory foods to assist natural hormone balance.

• Reduce exposure to environmental estrogens (like some plastics or body care products).

• Avoid blood sugar spikes, as they can throw off hormone signaling.

• Explore stress reduction techniques such as breathwork, mindfulness, or gentle movement - this one keeps coming up every time, right? Calm nervous system = Harmony!

• Talk to your endometriosis specialist to check hormones.

The goal is not perfection — it’s connection. When you begin to understand the language of your body, you can respond with clarity, not fear.

Normal vs. Endometriosis Cycle – A Comparison

Conclusion

A healthy menstrual cycle is like a thoughtful conversation between estrogen and progesterone. One builds, the other refines. One expands, the other restores.

In endometriosis, that conversation is disrupted. Estrogen takes the lead — loudly and often — while progesterone’s role is ignored or silenced. The result is a cycle that becomes louder, more painful, and harder to manage.

But understanding this gives you power. By observing your cycle, supporting your body naturally, and working with professionals when needed, you can begin to bring back harmony — on your terms.