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

Mark Hyman

Mar 30, 2026

Episode description

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

Mindsip insights from this episode:

Stop rogue cells from fueling growth and inflammation with aromatase inhibition

Endometrial cells outside the uterus can create their own estrogen through a process called aromatase, fueling a vicious cycle of more growth and inflammation.

#estrogen

#inflammation

Balance vaginal microbiome to reduce endometriosis risk

New research shows a connection between an imbalance of microbes in the vaginal, cervical, and uterine microbiome and an increased risk of endometriosis.

#cancer

#microbiome

Utilize Saccharomyces boulardii to enhance estrogen metabolism

The probiotic Saccharomyces boulardii can specifically help lower the levels of the beta-glucuronidase enzyme in the gut, which improves estrogen metabolism.

#estrogen

#probiotics

Utilize infrared patches to alleviate pain and boost circulation

New patches that use infrared technology can be placed on the abdomen to help decrease pain and increase circulation to the area.

#infrared

#pain

Utilize sulforaphane for effective detoxification support

Sulforaphane, which is essentially broccoli sprouts in a pill, is a go-to supplement because it supports both phase one and two detoxification and helps the body produce more glutathione.

#detox

#sulforaphane

Test estrogen metabolism pathways with 24-hour urine collection

You can use a 24-hour urine collection test to see exactly how your body metabolizes estrogen down various pathways, some of which are protective and others more carcinogenic.