What is Endometriosis?
The endometrium is a special type of tissue that usually lines the inner walls of a woman’s uterus. Sometimes endometrium migrates and becomes implanted in other areas within the pelvis. In women with endometriosis there may be endometrial tissue on the fallopian tubes, the ovaries or anywhere else on the lining of the pelvis- these are all places endometrial tissue is not meant to be.
During a woman’s normal menstrual cycle the endometrium within the uterus becomes thickened and prepared for the possibility of conception and pregnancy. This occurs under the influence of hormones in the blood stream. If conception does not occur, the hormone levels decrease and the endometrium comes away from the wall of the uterus and is shed through the vagina – what we know as menstruation or our monthly period.
In women with endometriosis the same process occurs but the extra endometrial tissue in various sites around the pelvis reacts in the same way to hormonal changes in the bloodstream. This means the misplaced endometrium thickens and breaks down as normal but then has nowhere to exit the body and becomes trapped. This can lead to inflammation and pain in the surrounding tissue and, in the long term, can form cysts and scar tissue.
How will I know if I have Endometriosis?
Endometriosis can cause severe pain, usually in the pelvic area, and women with this condition usually feel the most pain and discomfort during their monthly period. This pain can be debilitating and is generally more severe than what other women experience as "period pain." Other symptoms of this condition are menorrhagia or excessive menstrual bleeding, bleeding in between periods and pain during sexual intercourse or bowel movements.
Endometriosis may also decrease fertility and is an important factor in women who are having difficulty getting pregnant. In some women, endometriosis may cause few or even no symptoms at all.
Endometriosis is a very common disorder and current estimates indicate that almost 1 in 10 women in their reproductive years suffer from this condition. It is most common in women who have not had children.
What Causes Endometriosis?
Modern medicine is not quite sure what causes endometriosis. However, although the cause of endometriosis has not been scientifically proven, there are a number of possible options that are being researched by conventional medicine. One theory is that a small amount of menstrual blood does not flow out of the vagina as is usual but instead travels backwards through the fallopian tubes into the pelvic cavity.
Endometrial cells contained in this blood then act as "seeds" to produce areas of endometrial tissue outside of the uterus. It is not understood why this process leads to endometriosis in some women but not others. Studies suggest that it has something to do with immune system functioning. Another theory is that the endometrial cells are transferred within the bloodstream. This theory is based on the fact that endometrial cells can be isolated from blood in the blood vessels and would explain cases of endometriosis found in obscure sites such as the lung.
Traditional Chinese and Oriental medicine has a different understanding and approach to the cause of endometriosis – but one which fits the current scientific knowledge and would fill in many of the gaps in scientists’ theories. In Traditional Chinese Medicine, endometriosis is classified as a liver disorder and associated with liver stagnation. In every woman with endometriosis the underlying cause for this liver blood stagnation may be slightly different but the outcome is similar.
Recent studies have supported this theory and implicated chronic exposure to dioxins (an environmental pollutant) to both liver health and endometriosis independently. Unfortunately, for women living a modern lifestyle, avoiding these dioxins would be very difficult as they are found in a large proportion of all fish, meat and dairy products produced for human consumption. A compromised liver would also play a part in weakening the immune system – once again a factor implicated in endometriosis.
Eating foods that are understood to be liver-weakening is also a problem of modern lifestyle and endometriosis. Refined foods, especially those containing wheat flour and sugar, deep fried foods, caffeine and ice-cold drinks, all compromise liver functioning and should be avoided by women in general, but particularly those with a predisposition to or past experience of endometriosis. Stress is also a big enemy of liver health and in Chinese medicine the liver is considered the most emotion-sensitive organ of the body.
Apart from stress and environmental toxicity, conventional drugs and medications are also largely to blame for liver weakness and stagnation. Painkillers are a huge culprit in endometriosis. Women with this condition often rely on conventional pain killers and Non-Steroidal Anti Inflammatory Drug’s (NSAIDs) to help them cope with the pain around menstruation. NSAID’s are one of the most damaging classes of drugs, especially to the liver and kidneys, and these medicines can actually contribute to the worsening of endometriosis in the long-term, even causing irreversible damage.
Because various other conditions may mimic the same symptoms as endometriosis, it is important to consult your health care provider about any troublesome menstrual symptoms or anything else that causes you to suspect this condition. Endometriosis is usually easily diagnosed by means of an internal pelvic examination. Other tests that may be necessary include blood tests, a laparoscopy or an ultra-sound.
If left untreated or if poorly managed endometriosis generally worsens over time. The most serious and often heart-breaking complication of endometriosis is infertility. Endometriosis is sometimes diagnosed for the first time when a woman seeks fertility treatment.
Scar tissue caused by endometriosis may be the culprit in preventing conception – sometimes partially or completely blocking the path of the egg to be fertilized. There are probably also other, less understood ways that endometriosis can affect fertility and although many women with endometriosis can still fall pregnant, it usually takes longer than average or requires some type of intervention.
Help for Endometriosis
Conventional treatment for endometriosis is based on prescription medications or surgery depending on the severity of the condition and whether the woman wants to get pregnant.
For women who wish to control the pain of endometriosis and menstruation in this condition, the most common treatment is with Non-Steroidal Anti-Inflammatory Drugs (NSAID’s) which vary in effectiveness depending on the severity of the condition, the strength of the drug prescribed as well as individual factors. The use of pain-killers or NSAID’s in endometriosis is only really effective at treating the symptoms, such as menstrual cramps, pelvic pain and painful intercourse and will have no positive long-term effect on the condition itself.
Hormonal medications including the contraceptive pill are used to treat the progression of endometriosis itself and are useful in reducing symptoms and shrinking the endometrial deposits. Unfortunately though, hormonal drugs are also only a temporary solution. While using these drugs the endometriosis will be suppressed and symptoms improved but long-term, the condition will return. Within 1-2 years of stopping hormonal treatment, the endometriosis will flare-up again with all of the associated symptoms. Also, large deposits of endometrial tissue in the pelvis (i.e. larger than 3 cm in diameter) do not generally respond to hormonal treatment at all.
Both NSAID’s and hormonal treatments can also cause a variety of adverse side-effects including irregular bleeding, thrombosis, menopausal symptoms such as hot flashes, reduced bone density and vaginal dryness (which may or may not be reversible). As mentioned above, use of painkillers and NSAID’s can also compromise liver functioning – thereby contributing to the continuation or even worsening of the endometriosis.
Surgery may be regarded as either conservative or radical. In conservative surgery endometrial deposits, scar tissue and cysts are removed as much as is possible with the maximum amount of healthy tissue left intact. Radical surgery is usually reserved for severe cases or women who have completed their families and usually takes the form of a complete hysterectomy.
Natural Herbal and Homeopathic Remedies
By treating the underlying cause of the endometriosis – namely a poorly functioning liver – Traditional Chinese Medicine has the potential to cure the condition and prevent future recurrence rather than just suppressing the symptoms and outcomes as is the case with conventional medicine.
The herbal ingredients used in traditional Oriental treatment of endometriosis work by fundamentally changing the functioning of the liver and female reproductive system. In order to do this, the treatment must be continued regularly for a regimen of several months and even longer if necessary in particularly stubborn cases. Medicinal herbs in general take longer than allopathic medicines to show their effectiveness but the patience and persistence required is usually worth the safer, superior and often permanent results achieved.
Herbal ingredients associated with the holistic treatment of endometriosis include Vitex agnus-castus (also known as Chasteberry), Don Quai and Milk Thistle. Both Vitex agnus-castus and Don Quai act as hormone balancers and are well know for their beneficial effects when treating female reproductive disorders, while Milk Thistle is particularly effective in the treatment of liver problems.
More Information on Endometriosis
Tips for Endometriosis
- Don’t ignore severe menstrual symptoms as normal or "part of life". The symptoms of endometriosis can be debilitating and negatively affect your whole life, even your emotional wellbeing. Left untreated endometriosis may also worsen and lead to complications.
- Take regular exercise – apart from all the other health benefits, exercise will strengthen your liver as well as keep oestrogen levels balanced.
- Avoid prescription drugs especially hormonal medications, pain killers and NSAID’s.
- Eat a healthy, balanced diet based mainly on organic, whole food with lots of fruit and vegetables. Avoid refined and processed foods as well as caffeine-containing food and drinks as these may contribute to higher levels of estrogen and thus worsening the symptoms of endometriosis.
- When buying meat or fish, try and buy from organic sources known to come from farms which follow organic farming methods, without the use of antibiotics, growth hormones and artificial pesticides. Make sure that eggs and poultry come from farms which feed whole grain to their birds and no animal derived food.
- Make sure your diet includes Omega-3 fatty acids which are found in fish, flax seed, and eggs, and in many available supplements.
- Take the time to relax and de-stress. Stress hormones tend to aggravate the pain associated with menstrual cramps and endometriosis so consider exploring some relaxing activities, meditation, yoga or deep breathing exercises.