Why Endometriosis Keeps Coming Back (And How to Break the Cycle)

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Mar 30, 2026

Dr. Elizabeth Boham, functional medicine physician and Medical Director at The UltraWellness Center, focuses on root‑cause women's health. She discusses how endometriosis is driven by inflammation, immune and gut dysfunction, estrogen metabolism, and environmental xenoestrogens. Practical topics include gut repair, detox strategies, diet, supplements, and why treating the whole body prevents recurrence.

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ADVICE

Apply The 5R Approach To Repair The Gut

Use the 5R gut-repair framework: Remove inflammatory foods and pathogens, Replace digestive support, Reinoculate with pre/probiotics, Repair the gut lining, and Reset stress and mind-body healing.
Apply targeted tests (microbiome, breath for SIBO, food sensitivity) to individualize treatments.

ADVICE

Target Gut Bugs That Increase Estrogen

Target beta-glucuronidase producers with specific interventions like Saccharomyces boulardii or antibiotics when indicated.
Test and treat dysbiosis rather than relying only on hormonal suppression or repeated surgeries.

INSIGHT

Environmental Xenoestrogens Alter Estrogen Biology

Xenoestrogens (BPA, phthalates, parabens, pesticides, dioxins) bind estrogen receptors and disrupt estrogen metabolism from fetal life onward.
Reducing exposure and supporting detox pathways changes long-term risk and lesion behavior.

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Endometriosis affects 1 in 10 women yet it often takes years to diagnose, and many are told their pain is “normal” or simply treated with birth control or surgery. But endometriosis isn’t just a hormone issue—it’s a whole-body condition driven by inflammation, immune dysfunction, gut health, and environmental exposures. In this episode, we break down what’s really causing it and what you can do to address it at the root. I’m joined by my longtime colleague and friend, Dr. Elizabeth Boham, Medical Director and Functional Medicine Physician at The UltraWellness Center. Here’s what we break down: • Why endometriosis is not just a gynecologic condition and the root causes most doctors miss • The hidden role of gut health, inflammation, and the microbiome in driving symptoms • How estrogen imbalance and environmental toxins (xenoestrogens) fuel the condition • A functional medicine approach to reducing pain and preventing recurrence beyond medication or surgery If you’re struggling with endometriosis or unresolved symptoms and want a more personalized, root-cause approach, you can learn more about becoming a patient at The UltraWellness Center here: https://www.ultrawellnesscenter.com/becoming-a-patient/ Visit ⁠functionhealth.com for 160+ lab tests at just $365 a year. Have a question you’d love answered on Office Hours? Submit it here

(0:00) Introduction, statistics, and overview of endometriosis and functional medicine

(2:27) Introduction of Dr. Elizabeth Boham and explanation of endometriosis

(6:10) The immune system, gut health, and their roles in endometriosis

(10:29) The gut microbiome, estrogen metabolism, and the 5R approach

(16:55) Xenoestrogens and detoxification strategies

(22:53) Nutritional supplements and additional detox support

(25:41) Surgery and lifestyle interventions for endometriosis management

(30:20) Blood sugar, insulin resistance, and hormonal balance

(32:11) Prevention and recurrence of endometriosis

(33:40) Summary, key takeaways, and closing remarks

(38:11) Sponsor: Gratitude to sponsors