Endometriosis

Endometriosis is a condition where endometrial cells (the cells that line the uterus and are shed during menstruation), are found outside the uterus and even outside the abdominal cavity. It is estimated that 10–15 per cent of women of menstruating age have endometriosis and around 35 per cent of infertile women are possibly affected.

Cells of a kind are designed to band together. Toe cells cuddle up next to one another at the end of each foot, nasal hair cells keep a low profile (hopefully) within their designated nostril, and endometrial cells, side by side, companionably line the wall of the uterus. Except in the case of endometriosis, where endometrial cells fancy themselves as corporeal travellers, leaving the womb to explore new lands elsewhere in the body. Usually they stay locally, within the pelvic cavity, attaching to ovaries, the bowel and fallopian tubes. However, some cells have grander plans and ex-pat endometrial cells have been found as far afield as the lungs, spleen and even in the nose. The problem you have with these wanderlust cells is that they, like their stay-at-home cousins, respond to cyclic hormonal signals. Endometrial tissue proliferates when oestrogen levels rise and sheds with progesterone withdrawal, leaving blood and endometrial debris at these sites, causing bloating and pain.

Symptoms

• Sometimes there are no symptoms.
• Painful or heavy periods.
• Pain during and after intercourse.
• Pain with bowel movements.
• Pelvic or lower back pain.
• Pain and cramping before menstruation.
• Infertility (the catch 22 is that falling pregnant is in itself a ‘cure’ for endometriosis).

What causes it?

• There is no official cause for endometriosis.
• One theory is that endometriosis is the result of a retrograde or backward flow of menstrual blood.
• It is possible that endometrial cells escape during abdominal surgery.
• There may be a hereditary link with this condition.
• Red-haired women are more likely to develop endometriosis than the rest of the population. Odd.
• Women with irritable bowel syndrome (IBS) have a higher chance of also developing endometriosis.

What to do

The naturopathic approach is two-fold. First, stimulate circulation and drainage from the pelvic region. This will reduce adhesions and scarring as well as stimulate tissue healing and speed up the removal of unwanted endometrial cells. The second is to regulate the hormones and improve liver clearance of excess oestrogen. Have patience. Treating any hormonal imbalance takes time. Hopefully within 3 menstrual cycles you will notice a marked improvement in symptoms.

Diet

• Women who eat more fish, fresh fruit and vegetables have less endometriosis.
• Include 4 servings of fish a week into your diet for the anti-inflammatory omega 3 fatty acids.
• Try avoiding gluten for 3 cycles to see whether your symptoms improve. They often do.
• Caffeine, red meat and deli meats have been found to increase the risk of endometriosis.
• Decrease deep-fried foods and sugar.
• Include cruciferous vegetables such as broccoli, Brussels sprouts, cabbage and garlic in your diet. They contain substances that help the liver get rid of excess oestrogen.
• Ginger and turmeric are anti-inflammatory, enjoy and use them in your cooking.

Remedies

• Herbs are the most effective treatment for endometeriosis. Take a tincture or tablet that contains vitex agnus castus, peonia, shatavari, dong quai, wild yam, raspberry leaf, pulsatilla and/or corydalis.
• Ginger is anti-inflammatory and antispasmodic as well as warming. It is recommended by traditional Chinese medicine, which regards endometriosis as a cold condition. Drink 1 or 2 cups of ginger tea daily or include it in your herbal preparation.
• The essential fatty acids EPO and EPA are very important. Start with 9 g of a combined supplement daily for 2 months, then take 6 g daily for another 3 months.
• Vitamin E can help reduce scarring and adhesions. Try 500 iu daily. (Wondering whether these dosages should go, as not used in many other conditions?)
• Magnesium helps relax the smooth muscle of the uterus, reducing cramps. Take 200 mg 3–4 times a day as required.
• Take a women’s multivitamin with iron, zinc and B vitamins, especially B6.

Other

• Exercise can reduce the symptoms of endometriosis.
• Lose weight if needed. Extra body fat can increase oestrogen levels and this will exacerbate endometriosis.
• Stress is a contributing factor to this condition. Learn to relax. Try meditation, tai chi or yoga.
• While tampons do not directly cause endometriosis, long-term use may make a woman more susceptible to developing the condition.
• Acupuncture has an impressive success rate in the treatment of endometriosis. Use in conjunction with herbs.
• After childbirth, breastfeeding for as long as possible will reduce the chance of endometriosis reoccurring.