# Endometriosis

Category: Conditions

Endometriosis is fundamentally a condition driven by unopposed estrogen acting on tissues that have shifted into a primitive, inflammatory metabolic state. Ray Peat argued that the disease is not merely a matter of excess circulating estrogen, but of local estrogen production…

10 passages · 2 authors · 2013–2023 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/endometriosis

## Synthesis

**Endometriosis** is fundamentally a condition driven by **unopposed estrogen** acting on tissues that have shifted into a primitive, inflammatory metabolic state. [Source 1, 5] Ray Peat argued that the disease is not merely a matter of excess circulating estrogen, but of local estrogen production within the lesions themselves. The abnormal endometrial cells express the enzyme **aromatase**, which manufactures estrogen, creating a self-perpetuating cycle where the estrogen then activates *cyclooxygenase* to turn polyunsaturated fatty acids into inflammatory prostaglandins, which in turn stimulate more aromatase activity. [Source 1] This vicious cycle is normally prevented by the surge of progesterone after ovulation, which should cause the cells to stop producing estrogen, but in endometriosis this protective interruption fails. [Source 1, 5]

The metabolic underpinning of this process is a shift away from oxidative metabolism toward a *reductive, glycolytic state* characterized by the production of lactic acid. [Source 2] Peat cited research showing that unopposed estrogen causes lactate to appear in the uterine lining, and that this dedifferentiated, stem-like cellular environment, stabilized by a reducing redox balance, is essential for the abnormal cell division and inflammation seen in the disease. [Source 2] The structural proteins that form the mitotic apparatus are stabilized by this reducing environment, and the activated cells transmit their regressed metabolic state to neighboring cells via lactate secretion. [Source 2] This connects the local hormonal disruption directly to a failure of cellular respiration, where pyruvic acid is reduced to lactic acid instead of being oxidized by oxygen. [Source 2]

Peat identified **hypothyroidism** as the basic systemic problem enabling this process, describing a vicious circle where low thyroid function permits estrogen to rise, and the elevated estrogen then further blocks thyroid action, particularly by interfering with the liver's conversion of T4 to the active T3 hormone. [Source 3, 8, 10] He reported that correcting hypothyroidism with proper thyroid supplementation could turn off endometriosis symptoms immediately, sometimes within two to three days. [Source 1, 3] The liver's role is also compromised, as the estrogen-thyroid disruption and constant growth hormone stimulation effectively *feminize the liver*, impairing its ability to detoxify estrogen. [Source 1, 4] Peat noted that simply reducing estrogen exposure can alleviate symptoms, and that a diet providing adequate protein, sugar, trace minerals, and vitamins supports the physiological resolution of the cycle. [Source 1]

Therapeutic intervention, in Peat's framework, centers on breaking the estrogen-prostaglandin-aromatase loop. He recommended **aspirin** or other prostaglandin blockers to reduce the formation of estrogen and inflammation, noting that aspirin alone can greatly reduce symptoms. [Source 1] Because **polyunsaturated fats** are the essential substrate for the cyclooxygenase enzyme that produces inflammatory prostaglandins, eliminating them from the diet is central to treatment; even stored polyunsaturated fats released from tissues under stress can feed the cycle. [Source 1, 7] Peat advised that sugar and **niacinamide** can limit the release of these fatty acids into the bloodstream, backing up the function of aspirin. [Source 7] Georgi Dinkov has extended this understanding by noting that a compromised gut barrier and translocating bacteria, leading to **endotoxin**-driven chronic inflammation, may be an additional contributing factor, as the body forms fibrotic tissue to encapsulate the bacteria, a pattern also observed in rheumatoid arthritis and lupus. [Source 6, 9]

## People also ask

### How does local estrogen production sustain endometriosis?

Peat argued that abnormal endometrial cells contain the enzyme aromatase, which produces estrogen locally. This estrogen then stimulates the production of inflammatory prostaglandins from polyunsaturated fats, which in turn further activates aromatase, creating a self-perpetuating cycle.

### What role does thyroid function play in the condition?

Peat identified hypothyroidism as a basic systemic problem, describing a vicious circle where low thyroid function allows estrogen to rise, and elevated estrogen further blocks thyroid action by interfering with the liver's conversion of T4 to active T3.

### Why is aspirin recommended as a therapeutic intervention?

Peat recommended aspirin because it blocks prostaglandin synthesis, which helps reduce both inflammation and the local estrogen production driven by the aromatase cycle, and he noted that aspirin alone can greatly reduce symptoms.

## Related concepts

- [Cori Cycle](https://bioenergeticoracle.com/md/concepts/cori-cycle/index.md)
- [Body temperature and pulse](https://bioenergeticoracle.com/md/concepts/body-temperature-and-pulse/index.md)
- [Cancer](https://bioenergeticoracle.com/md/concepts/cancer/index.md)
- [Cancer metabolism](https://bioenergeticoracle.com/md/concepts/cancer-metabolism/index.md)
- [Estriol](https://bioenergeticoracle.com/md/concepts/estriol/index.md)
- [Estrogen dominance](https://bioenergeticoracle.com/md/concepts/estrogen-dominance/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — EastWest Healing: Energy and Metabolism

Ray Peat · Interview · Jul 17, 2013 · https://www.youtube.com/watch?v=VaF26fTAkWw

> ## Endometriosis and Inflammation
>
> **Ray Peat:** It involves the liver and the pituitary, but estrogen is very central to the actual lesion or abnormal tissue of endometriosis. Simply by reducing estrogen exposure, you can alleviate the symptoms. The cells begin producing estrogen; they express the enzyme aromatase, which manufactures estrogen. They used to think aromatase existed only in the ovary, but it turned out to exist in fat cells, breast cells, skin cells, bone, and muscle. Everywhere that is under stress will begin to produce estrogen molecules. In endometrial tissue, it should be exposed to estrogen for only about 12 hours each month. Then progesterone should surge up to 50 or 100 times higher concentration and cause the cells to give up their production of estrogen. But instead, the aromatase keeps churning out estrogen. The estrogen excites the tissue and turns on the cyclooxygenase enzyme, which turns polyunsaturated fatty acids into prostaglandins, creating inflammation that causes the pain and contractions. The inflammation from the prostaglandin in turn creates more aromatase. So it gets a vicious cycle going. The simplest, most physiological way to stop it is to eat a diet with adequate protein, sugar, trace minerals, and vitamins, and to make sure your thyroid is functioning. I've seen people who had been suffering painful endometriosis for years who, in two or three days, completely stopped the symptoms permanently just with quick-acting thyroid, a good diet, and aspirin. Aspirin or other blockers of prostaglandin production all by themselves can greatly reduce the formation of estrogen and break the cycle.

### Source 2 — Lactate, metabolic regression, & political-medical implications

Ray Peat · Newsletter · 2020

> When a woman isn’t pregnant, unopposed estrogen can cause lactate to appear in the lining of the uterus, leading to endometriosis (Horne, et al., 2019). Starting with the structure of the ovum, there are metabolic gradients, differences in the degree of oxidation and reduction, at all stages of development, and these differences in electron affinity can be detected as electrical fields and currents.
>
> The importance of these gradients and fields in the development of the organism, and in healing and regeneration, has been known since early in the last century, but beginning in the 1950s research in these areas was defunded, in favor of the genetic determinist idea that there is a blueprint of the organism “in the genes,” and that this blueprint explains everything in growth, health, and sickness, and that medicine must concentrate on correcting errors in the blueprint.
>
> When the organism is understood as an organized on-going process of development, sustained by appropriate metabolic energy, rather than as a pre-determined machine, the parallels between the generative process in the embryo and the healing processes in later life offer a guide to protective and therapeutic practice.
>
> The angiogenesis inhibitors produced huge profits for the drug industry, without a noticeable change in cancer mortality—they forgot to consider that normal tissues need to keep producing new blood vessels.
>
> Dedifferentiated, stem-like cells, are created in areas of injury or chronic stress, where lactic acid is being formed. In the 1950s and ‘60s, L.V. Polezhaev showed that even mature neurons in the brain are stimulated to divide by the presence of injured, degenerating nerve cells. Daniel Mazia, Katsuma Dan, and others during the same period were showing that the proteins responsible for cell division become highly reduced, showing a high concentration of -SH groups, in preparation for the cell cleavage leading to embryonic development, and others showed that glycolysis is needed for this process. The structural proteins, microtubules, that form the “mitotic apparatus” that Dan and Mazia studied, are essential parts of the glycolytic system, working closely with the enzymes that produce lactate, and a reducing environment stabilizes them and supports their function.

### Source 3 — Butter Living Podcast: Fertility, Pregnancy, and Development

Ray Peat · Interview · Feb 19, 2020 · https://www.youtube.com/watch?v=aPM5XVKEUFk

> **Ray Peat:** It's the same effect in a cancer cell. A cancer under the influence of estrogen becomes more likely to metastasize and progesterone makes it tend to stay put. All of the women that I've known who had very serious endometriosis, I cured it immediately when they corrected their hypothyroidism. Just an immediate turning off of all of the symptoms. Awesome.

### Source 4 — EastWest Healing: Energy and Metabolism

Ray Peat · Interview · Jul 17, 2013 · https://www.youtube.com/watch?v=VaF26fTAkWw

> ## Endometriosis and Inflammation
>
> **Josh Rubin:** Regarding endometriosis and body temperature, you've talked about the work of Desjardins and how estrogen's interactions with unsaturated fats cause damage to brain cells. Is that a major factor in endometriosis?
>
> **Ray Peat:** Desjardins and his group were interested in many of the side effects of estrogen on the brain, pituitary, endorphins, iron accumulation, and fatty acids. Because of the estrogen-thyroid effects and the constant pushing up of growth hormone from the pituitary, the liver is feminized from an early age. This shows up in studies of liver transplants. They found that because of this process of stress hormones and growth hormone feminizing women's livers, they make poor candidates relative to the livers of men for transplant.
>
> **Josh Rubin:** So you're saying endometriosis is more of the inability to detoxify this excess estrogen versus a low progesterone?

### Source 5 — Ask the Herb Doctor: California Proposition 65

Ray Peat · Interview · Sep 15, 2017 · https://www.youtube.com/watch?v=CvJXEoled6E

> ## Endometriosis and IUDs
>
> **Andrew Murray:** We had a question about endometriosis and IUDs. Is there a relation?
>
> **Ray Peat:** Yes, it's well established that endometriosis comes from prolonged, excessive exposure to estrogen without interruption from progesterone. The mechanism of a plastic or copper IUD is to send a signal to the ovary that the uterus isn't ready for pregnancy because there is a foreign object in it. The uterus perceives this injury, and the signal travels up the fallopian tube telling the ovary *not* to make progesterone. It is a specific interruption of your hormone ratio, similar to the birth control pill.

### Source 6 — Hormones Hiding in Your Tissues w/Georgi Dinkov

Georgi Dinkov · Interview · Jun 23, 2023

> **Kitty Martone:** Yeah. I'm not very optimistic.
>
> **Kitty Martone:** There's a new documentary coming out. I was trying to look for it on PBS that is about endometriosis. But the executive producer is Hillary Clinton.
>
> **Georgi Dinkov:** I'm sorry. No, by the way. Hillary Clinton, despite what she may tell you on TV, she has a very different health regimen. I don't know if you've seen it. There's some bits and pieces leaked to the media. Every once in a while in interviews, she says she's taking thyroid. She's taking aspirin. She's taking vitamin E. She's taking gelatin. So all of these things are basically. Yes. Yes. So, well, maybe there's
>
> **Kitty Martone:** hope for that documentary, but I'm sure that I think I predict the overall message is going to be estrogen protects the uterus is what I think.
>
> **Georgi Dinkov:** There's no hope for that documentary. The message, what she's doing, she's saying, do as I said, not as I do. I don't. I don't think she's ever told people, hey, it's a good idea to take thyroid. It's a good idea to take vitamin E. And she very rarely discusses her personal regimen. So the message that she puts out there, which is pure propaganda, like most politicians, I don't want to pick on Hillary alone. Plenty of politicians are like that. Basically is probably whatever her pharma buddies have sponsored her to say.

### Source 7 — EastWest Healing: Energy and Metabolism

Ray Peat · Interview · Jul 17, 2013 · https://www.youtube.com/watch?v=VaF26fTAkWw

> ## Endometriosis and Inflammation
>
> **Josh Rubin:** So eliminating unsaturated fats will help reduce estrogen production?
>
> **Ray Peat:** Yes, they are central to endometriosis.
>
> **Josh Rubin:** Can you elaborate on aspirin therapy?
>
> **Ray Peat:** In cancers, the cells that are stressed begin to produce estrogen. As long as there is polyunsaturated fat available, the estrogen is going to activate the cyclooxygenase enzyme that makes prostaglandins, which keep the aromatase active, producing more estrogen. Even if you aren't eating it currently, the polyunsaturated fat that was incorporated into your tissues is going to break down under stress, flow into the bloodstream, and feed the production of estrogen. Sugar is one of the things that can reduce the flow of polyunsaturated fats out of your tissues into your bloodstream. Niacinamide is another thing that limits the release of these fatty acids. So both sugar and niacinamide back up the function of aspirin.
>
> **Josh Rubin:** So for endometriosis: get the right amount of carbs, regulate thyroid, use niacinamide, and possibly aspirin therapy.
>
> **Ray Peat:** Yeah.
>
> **Josh Rubin:** How does estrogen relate to body temperature and pulse?

### Source 8 — Ray Peat KMUD: 7-19-13 BPA, Estrogen, HRT, Testosterone, Cancer, Tumors, Eyes Full Interview

Ray Peat · Interview · Jan 29, 2017 · https://www.youtube.com/watch?v=6Z21WRIKs_c

> **Andrew Murray:** Okay, excellent. And there's another reason why the excess estrogen found in postmenopausal women or even menstruating women works against them, works against their thyroid.
>
> **Ray Peat:** I didn't hear that.
>
> **Andrew Murray:** Okay. I just said that that's the main reason why menstruating or postmenopausal women are at more risk in terms of low thyroid function.
>
> **Ray Peat:** Yeah. And some of the typically female problems such as endometriosis are just amazingly responsive to the proper thyroid supplementation. Yeah. Because... Once the thyroid goes down, then estrogen goes up. Right. And since the estrogen blocks thyroid action, it becomes a vicious circle.
>
> **Andrew Murray:** Yeah, got it. Okay, well, there is another caller on the air, so let's see if...
>
> **Sound Engineer:** Well, no, it's the caller who didn't want to go on the air, but they wanted to know what the effects of cannabinoids are on cancer.
>
> **Andrew Murray:** Dr. Peat.
>
> **Ray Peat:** Oh, on cancer, I think people are still exploring that. There are some... suspicions that it might actually slow cancer growth. Others worry that it might make it worse. But mostly it's used to prevent the stress symptoms. And for that it's effective.

### Source 9 — Hormones Hiding in Your Tissues w/Georgi Dinkov

Georgi Dinkov · Interview · Jun 23, 2023

> **Kitty Martone:** So what do you think about this new study that came out about endometriosis being driven by a bacterial infection? Did you see that? It's possible.
>
> **Georgi Dinkov:** It's possible because just like rheumatoid arthritis, when they look at the joints, the swollen joints of people, and they took some biopsy samples, they found antibodies to several bacteria. And even they found components of some of the gram negative bacteria, which is usually in your colon, right? But basically this kind of says that endotoxin is involved. So basically you produce a lot of endotoxin. You destroy the gut barrier. through many different means. Apohole can do it very well. Chronic inflammation can do it very well. People with Crohn's disease. In general, inflammatory bowel disease is a very compromised intestinal barrier. And by the way, they have a higher rate of rheumatoid arthritis, of endometriosis, and all these things. So this bacteria has to have come there from somewhere, right? And usually the inside of the body is sterile. It's the gastrointestinal tract that really has most of our bacteria. So it's really a matter of time, a matter of looking at what this bacteria that was found in the endometriosis samples is and whether it's represented in the gut. My bet is it is. Because the same thing has been shown for lupus. The same thing has been shown for rheumatoid arthritis. So really, if you have translocating bacteria, yes, the body will form some kind of an immune response. There will be chronic inflammation and this bacteria cannot get destroyed. Then eventually some kind of a fibroid scar tissue will form there because the body tries to insulate it, encapsulate it and keep it sort of intact. It makes so much sense.

### Source 10 — Ask the Herb Doctor: Heart III

Ray Peat · Interview · Jul 19, 2013 · http://l-i-g-h-t.com/files/herb-doctors-heart-III.mp4

> **Ray Peat:** Yeah. And some of the typically female problems, such as endometriosis are just amazingly responsive to the proper thyroid supplementation, because once the thyroid goes down, then estrogen goes up, and since the estrogen blocks thyroid action, it becomes a vicious circle.

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