Let’s be honest—having endometriosis is hard enough without the added bonus of digestive issues. But did you know that people with endometriosis are three times more likely to also have Irritable Bowel Syndrome (IBS)?

As a naturopath with a focus on women’s health, I see this overlap frequently in clinic. Many of my patients come in with a diagnosis of IBS, only to later discover that endometriosis was at the root of their symptoms all along—or that they’re managing both conditions simultaneously.

Understanding the connection between endometriosis and IBS can be a game changer for your health, your pain levels, and even your fertility. Let’s explore the link, the possible causes, and what you can do from a holistic, naturopathic approach to support your body.

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Why Endometriosis and IBS Are So Often Misdiagnosed

It can take many years to get a proper diagnosis of endometriosis. Why? One big reason is that the symptoms—think bloating, abdominal pain, and altered bowel movements—look a lot like IBS.

In some cases, the issue might not be IBS at all, but rather digestive symptoms triggered by endo. In others, both conditions coexist because they often share similar root causes.

Some of these underlying issues include:

• Chronic low-grade inflammation
• Histamine intolerance and mast cell activation
• An overly sensitive gut-brain axis (aka heightened nerve sensitivity between your gut and brain)
• Leaky gut and gut dysbiosis (an imbalance in your gut microbiome)

These factors can drive both endometriosis and IBS, which is why so many people are affected by both.

Deep Infiltrating Endometriosis and Digestive Symptoms

For those with the subtype called deep infiltrating endometriosis, digestive symptoms can be even more severe. This is because scar tissue (from endometriosis lesions or from surgeries to remove them) can cause organs like the bowel to stick together or become restricted.

These adhesions can slow down digestion, contributing to constipation and conditions like SIBO (Small Intestinal Bacterial Overgrowth). On top of that, they can cause significant pain, especially during bowel movements or certain times in your cycle.

Interestingly, research shows that IBS symptoms can occur in people with endometriosis whether or not lesions are affecting the intestines directly. This means it’s not just a mechanical issue—it’s often linked to systemic inflammation and gut health imbalances.

Could Your “IBS” Actually Be Endometriosis?

Here’s something important: Endometriosis is believed to start before your first period, and IBS-like symptoms can be one of the first signs.

In adolescents, endo can show up a bit differently—more nausea, generalised pain, and non-cyclic discomfort. These symptoms often get labelled as IBS, which unfortunately delays an endometriosis diagnosis.

Delays can lead to progression of the disease, including:

• Scarring and adhesions
• Increased oxidative stress in the ovaries
• Central sensitisation, where your nervous system becomes hypersensitive to pain

This can affect everything from fertility to quality of life. Early recognition is key.

The Holistic Connection: Supporting IBS and Endo Together

The good news? There’s significant crossover in how we manage IBS and endometriosis holistically, and naturopathic treatment shines here.

Since we know that gut health issues—like leaky gut, dysbiosis, and bacterial endotoxins—can worsen inflammation, supporting digestive function is a cornerstone of managing both conditions.

A naturopathic approach often includes:

• Reducing histamine excess and supporting mast cell stability
• Restoring gut microbiome balance
• Improving gut motility
• Supporting the gut-brain axis to reduce pain sensitivity
• Addressing inflammation to calm both the gut and pelvic pain

These strategies not only ease digestive symptoms but can also support hormonal balance, fertility, and reduce the progression of endometriosis.

Want to Know What Your Hormones Are Doing?

Wondering if your hormones are in balance? Take my free hormone quiz to get insights into how your hormones might be affecting your gut, mood, energy, and more. It only takes a few minutes!

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