A woman with a uterus scratching her arm

Eczema and Endometriosis: What's The Connection?

Angry skin? Even angrier pelvis? You’re not alone.

Recently, I polled my Instagram audience and 80% suffered with some kind of skin condition such as eczema, acne, or rosacea. So, is this just a coincidence or is there a link to endo? Let’s dive into one of the most difficult skin conditions to live with - eczema.

What is eczema?

There are different types of eczema, but atopic eczema is the most common form. Eczema presents as dry, cracked, flaky skin that’s itchy and often painful.

Research has found that people with endometriosis have higher rates of atopic diseases1, which are essentially conditions triggered by an allergic reaction (the body makes antibodies against certain irritants, triggering a reaction in the body). These diseases include food allergies, allergic asthma, hay fever, and eczema. In fact, 61% of people with endo have been found to have allergies.2

The role of histamine intolerance

Eczema can also be triggered by histamine intolerance, a condition where the body is either overwhelmed by high histamine levels or can no longer break down histamines. Histamines are immune cells that help to protect the body from allergens (they also do other things too, such as playing a role in ovulation and menstruation3, so for example, when you get hay fever, this is triggered by a histamine reaction.

I see a lot of clients with histamine intolerance symptoms including eczema, and this isn’t surprising. Endometriosis lesions contain mast cells in high numbers (these are the immune cells which release histamines)4, and it’s been shown that these mast cells are producing histamine in excessive quantities. These histamines have also been shown to be involved within the inflammatory process of endo, further promoting its growth and development.4

What about interstitial cystitis?

Interestingly, research has also found that 80% of people with endometriosis also have interstitial cystitis, more commonly known these days as painful bladder syndrome.5 Unfortunately, mast cells and histamines are found in higher levels in patients with interstitial cystitis and histamine intolerance is now considered to be one of the causes of the bladder condition.6

Histamine production is also increased via the sex hormone estrogen. Estrogen actually triggers mast cells to release histamines7, whilst histamines in turn can further estrogen production8. Quite the vicious cycle! Histamines can also rise as estrogen rises with the menstrual cycle and estrogen also lowers the effects of DAO9, the digestive enzyme that helps to break down histamines.

This becomes more of a problem for people with endometriosis as we may already have elevated levels of estrogen in the pelvic cavity, due to the endo lesions. I also see nearly all of my endo clients suffering from estrogen excess or dominance.

Gut problems may play a role

This leads me to my final connection, the gut. Gut health problems are a common complaint of people with endo and there’s multiple reasons behind this, but one of the biggest causes is a condition called small intestine bacterial overgrowth.

SIBO has been found in 80% of endo patients in research and comorbidities of SIBO include inflammatory skin conditions like rosacea.10 Whilst I couldn’t find any direct research actually linking SIBO to eczema, lots of doctors agree that SIBO can trigger or exacerbate the condition.11

Additionally, SIBO is also a driver of histamine intolerance and leaky gut12,10, which has been strongly linked to eczema. Furthermore, SIBO and other gut health problems can change the microbiome, which can affect the way the body breaks down estrogen, leading to a rise in estrogen13 and of course, potentially worsening histamine issues if present.

So, in short, a healing plan that focuses on your gut, your immune system and inflammation is likely to help you to manage eczema with endo.

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