March is National Endometriosis Awareness Month. Endometriosis is estimated to affect over 6 million women in the United States, and while many women know about this condition, there is still a lack of helpful information. Most are left suffering and looking for answers, as it can be one of the most painful and stressful conditions and affect your overall quality of life.

Our founder Jena Covello's diagnosis with endo and adenomyosis was the beginning of her lifelong quest to heal her body and help others do the same. In fact, the silver lining of her pain was what pushed Jena to start Agent Nateur. As a result, Jena has become an advocate for endometriosis, spreading awareness and sharing her journey.

Here, Jena shares her struggles with finding answers, the critical missing information her doctors never shared, why surgery may not be for everyone, and some of the best doctors and treatments that have helped her tremendously along the way! 

What has been the biggest challenge and struggle in your journey with Endometriosis? 

Definitely the pain. Some months I’ve been bedridden for half of the month. That changed when I began physical therapy and began weight resistance with my trainer. I’m very cognizant of the shoes I wear. If shoes or sneakers are too flat, it triggers hip pain and sciatica. Band resistance exercises can help with this also. 

The second biggest challenge is the failure of western doctors who butchered my surgery, misdiagnosed me, caused adenomyosis from a botched surgery, and gave me no alternatives aside from surgeries and a hysterectomy. 

What advice would you give your younger self about Endometriosis that you wish you had known in your early diagnosis? 

I would have started working out consistently when I was in my teens if I had known then what I know now. It’s a double-edged sword. I regret the surgery because I’ve been in debilitating pain from it, but I also have my company because of the pain. Endo was the silver lining of Agent Nateur. I’m not saying all surgery is bad. But my first surgery caused adenomyosis. Endo should never be removed through laparotomy, which is a C-section cut. It should only be removed laparoscopically. Laparotomies and C-sections spread endo to the muscle of the uterus; this is known as adenomyosis and can be more painful than endo. 

What are some important things to know about Endometriosis that doctors don’t usually speak of? 

Your emotions play a pivotal role in chronic endo pain. You need myofascial release and pelvic floor therapy. Low-dose naltrexone can be miraculous. Avoid surgery if you can. Take systemic enzymes like Vitalzym XE and MSM to break up the adhesions and scar tissue. Cup yourself. Don’t drink alcohol. Stress majorly impacts the period. Work out consistently and strengthen your pelvic floor and hips. This will relieve a good portion of the pain. Figure out if cold water is more helpful than hot. Heating pads can sometimes make things worse. 

Also, look into high-quality supplements and glutathione drops. Take magnesium every night. Don’t allow yourself to get constipated because it will cause chronic pain and inflammation. Your thoughts are more important than anything you can do or eat. If your emotions and thoughts aren’t in balance, nothing else really matters. Make sure you’re taking iron. If you’re bleeding heavily, you’re most likely throwing up and nauseous due to the pain and because you’re anemic. You have to fix your digestion. Sometimes pain and exhaustion can be a sign you’re not drinking enough water and are deeply dehydrated. 

What treatments have helped you the most?

Everything I listed above :). Being happy. Truly doing whatever you can to not have negative thoughts that are fear-based. Stop worrying. Uterine artery embolization (UAE) can be great if you have adenomyosis or fibroids; plus, it will save your uterus. It’s minimally non-invasive and not many people know about it. 

Will Cole was the only person who ever fixed my hormones and got my estrogen dominance under control. He is the only person who ever told me that if you’re estrogen dominant, the body can’t distinguish between phyto and xenoestrogens. Every other doctor told me to keep eating phytoestrogens to cancel out xenos. But if your body is loaded up with estrogen, it can’t tell the difference. Once I cut phytos out, my estrogen went down. 

How has low-dose naltrexone (LDN) played a part in your journey with endometriosis?

It immediately cuts the inflammation. I combine it with a Motrin I buy from Italy called Moment Act. It’s the only one that doesn’t hurt my gut, but I still take Pure’s Leaky Gut Defense and holi (mane) to protect my gut from non-steroidal anti-inflammatory drugs (NSAIDs). The only problem with LDN is that it can cause insomnia, and in some cases, it makes you feel depressed. However, the benefits outweigh the side effects. It’s a miraculous drug that was developed for addiction. It essentially cuts off the pathways that get someone high. They found that if you microdose it, it’s anti-inflammatory, amazing for rheumatoid arthritis, and can put Hashimoto’s in remission. It’s great for autoimmune conditions. I’m not sure I would have been able to get by without it. 

Are there any books or literature you would recommend to those who want to learn more? 

I’d research the emotional causes of disease. Louise Hay and Dr. Christiane Northrup do a great job explaining. I’d follow @heal.endo and read her book. I think she’s really well-versed, and I’ve found her to be the most helpful, especially when she talks about endo’s connection to the gut. 

What are your thoughts on and experience with surgery?

To expand on what I said above, sometimes I believe it’s needed and helpful. I would find a really skilled surgeon who has high Yelp reviews and make sure they are doing laparoscopy and well versed in pelvic floor therapy and diet. 

Are there any doctors you have worked with that you recommend?

Dr. Kanayama in NYC had to redo my surgery. A lot of my pain went away afterward, but then I developed hydrosalpinx from the initial surgery. I opted for the Wern Technique, systemic enzymes, and MSM instead of removing it. Will Cole is the only doctor who helped me control estrogen dominance. And Tarek and his team from Kinetix 365 helped through myofascial release and weight training. 

My trainer Rob Parr has tremendously helped with the hip, leg, and pelvic pain. I don’t see one doctor for everything. I pick and choose what I like from each one. I love Dr. Dominique Fradin Read from Vitalife MD for certain things. She’s really advanced with the latest alternative medicine, and she was the one who put me on LDN. We tried a number of things together, but that’s the one that worked. I like that she prescribed off-label medications and experiments with you to see what your body responds well to. I also love her vitamin and glutathione drips and her NAD therapy. But I go to Will Cole for nearly all supplement recommendations and blood panels. It’s the most advanced blood panel I’ve ever had. You need a functional doctor to draw your blood because it’s so much more in-depth than a western panel. 

What is the biggest lifestyle change that has made a difference in your pain?

Wow, there were so many. I didn’t eat healthy at all in my early and mid-20s. Cutting gluten initially made a huge difference and really stopped the pain for a while. But now I’m able to have high-quality sourdough if I don’t overdo it because the yeast is fermented. 

When I’m in Europe, I eat some gluten, which doesn’t affect me. The water and soil are so much better in France, Italy, and Spain, and there’s not as much of a presence of Monsanto. Spain has taken extreme measures to mostly only grow organic food and produce organic wine. I was on a hardcore, strict autoimmune diet for three years and eliminated so much. I don’t find these extreme diets necessary other than to figure out what bothers you long term and heal leaky gut. 

We are all so different, and what affects me might not affect the next person. It really is about finding out what your triggers are. For me, I can’t eat too many nuts or too much dairy. I don’t eat any processed sugar. I don’t drink any alcohol, aside from 1 to 2 occasions a year. A glass of champagne will make me feel sick for days on end. I really hate alcohol. It suppresses the immune system and affects your skin, and you can see it in the face past your mid-30s as it ages the complexion. 

Also, I’d say working out for endo vs. vanity has been the biggest lifestyle change. I HAVE to work out so that I’m not in pain. I HAVE to be careful with the shoes I wear so the pelvic and hip, and sciatic pain is not triggered. Most importantly, I learned that being happy and in love directly impacts pain and has the ability to take it away. Right now, I’m really focusing on portion control and not stuffing myself until I’m bloated and full. Most of the time, we eat because we like the taste of food and not truly because we are hungry. We have to recognize when we have eaten enough and stop ourselves so that we don’t negatively impact our digestion. I’m also chewing slowly and making sure my food is liquid before swallowing. 

 What role do our emotions play in autoimmunity, and how have you seen this play out in your own life?

When my thoughts are positive, my nervous system is at peace, and I’m happy, most of the pain goes away. A loving relationship can really heal autoimmune pain. 

How can we stay positive during this journey? Share some of your mindset tips that have kept you strong. 

I was in chronic bedridden pain for almost 8 years. For most of those years, I threw up every single month. I constantly wrote affirmations and resolutions that my wish was to be pain-free. When I’d cry and get really upset, the pain would get worse, so I didn’t have a choice. I know that there can be a time for surgery or a hysterectomy, but sometimes the pain is still bad afterward, and that’s why you have to nurture your emotions, improve your diet, figure out what your triggers are, get on the right supplements, and consistently weight train.