Endometriosis affects an estimated 1 in 10 women. The average time from first symptom to diagnosis in the U.S. is eight to 10 years. That’s years of adhesion formation, years of pain, and years of being told to just deal with it.
But what if endometriosis isn’t strictly a gynecological disorder? What if the root cause is metabolic? And what if strength training plays a critical role in your treatment plan?
On a recent podcast episode, I had a fascinating and insightful conversation with Kimberly Cunningham—a functional medicine provider, nurse practitioner, and FastFit member who has had five endometriosis surgeries herself—about what the research is starting to reveal and what women can actually do about it.
The Connection between GLP and GIP Deficiency and Endometriosis
Endometriosis is defined by adhesions—scar-like tissue that forms in the peritoneal cavity and attaches to organs like the bowel, bladder, and ovaries. These adhesions can’t be seen on imaging. The only way to confirm them is through surgery.
What’s emerging in the research is a connection between adhesion formation and a deficiency in GLP and GIP. These are peptides produced in the small intestine that regulate blood sugar and inflammation. Studies examining peritoneal fluid in women with endometriosis suggest these peptides may be significantly diminished. If that’s the case, the disorder may begin upstream as a metabolic problem—not downstream as a reproductive one.
Microdosing GLP-1s for Symptom Relief
Kimberly uses a microdose of tirzepatide (a GLP-1/GIP agonist) to manage her own endometriosis: 0.9mg twice weekly, well below the standard starting dose. At that level, she reports near-complete symptom resolution without weight loss or side effects. A recent quality-of-life study found that 68% of women with endometriosis on GLP-1/GIP medications experienced significant reduction in at least one symptom measure, with over 30% reporting complete resolution.[1]
Why Muscle Matters
Here’s where it gets practical. Kimberly strength trains at FastFit twice a week. And in six months on her microdose protocol, she’s added four pounds of muscle. For a woman with Ehlers-Danlos syndrome who struggles to build muscle under normal circumstances, that’s significant.
Because one of the biggest risks with taking even a micro-dosed amount of a GLP-1 is muscle loss. Maintaining or adding to your muscle mass is a must while on this medication—and for keeping your body in working order while fighting the inflammatory nature of endometriosis.
For Kimberly, these are her non-negotiables for every patient, with or without endometriosis:
- Balance your hormones
- Strength train with real intensity and stimulus
- Eat protein every four hours
- Get high-quality sleep
None are optional. They work together, and effective strength training is the foundation that makes everything else work together more effectively and in harmony.
We’re not doctors. This isn’t a treatment plan. But if you’re dealing with endometriosis, you deserve a provider who looks beyond the gynecological and into the metabolic. And you need a sustainable strength training practice that supports your body through it.
Want to learn more? Watch the full episode on endometriosis here.
And if you’re ready to get started with an effective, doable strength training plan, find the study nearest you and book your free intro session.
Citations
[1] Mahsa Gholiof, Narges Kalani, Mathew Leonardi. Effects of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) on Endometriosis Symptoms Management and Quality of Life: An International Survey Study. Authorea. 24 February 2026. DOI: https://doi.org/10.22541/au.177194722.27223197/v1
