What is Endometriosis?
Endometriosis is a condition where portions of the lining of the uterus have escaped their normal environment inside the uterus and have lodged somewhere within the abdominal cavity. This tissue is sensitive to hormonal changes. It grows in response to increases in estrogen levels just as the uterine lining would. This growing tissue causes pressure on surrounding tissues and nerves leading to intense pain. Contrary to the information some of my patients have received, the pain can be present throughout a woman’s menstrual cycle, not just at menstruation. The pain can be both excruciating and debilitating.
Do You Have Endometriosis?
- Intense abdominal pain that may be aggravated before and/or during menstruation. Women with endometriosis generally have to take painkillers during their periods and even then may experience incapacitating pain. Menstrual cramps of any severity may indicate mild, moderate or severe endometriosis.
- Rectal or bladder pain, again may be worse around menstruation
- Bladder irritability – symptoms may be similar to a bladder infection, but keep recurring despite antibiotic treatment
- Infertility. Endometriosis can block the fallopian tubes. If this happens, IVF is necessary, in fact, that’s why IVF was initially invented. Endometriosis can cause other problems with fertility as well. As long as tubes are not blocked, these other issues can be overcome through natural treatment.
Natural Treatment for Endometriosis
- Preventing the escape of uterine tissue from the uterus
- Resolving tissue that has already lodged in the abdomen
- Relieving pain
- Reducing excess estrogen
- Aiding liver detoxification (not the kits from the health food store!) of hormones and hormone-mimicking pollutants
- Ensuring intestinal health so that toxins are efficiently excreted
Preventing Uterine Tissue from Escaping the Uterus
There are many theories as to why this tissue has found its way outside the uterus:
- Gravity – headstands, yoga during heavy menstruation
- Dioxin – research on monkeys exposed to dioxin, a byproduct of bleach, shows an increase in endometriosis. A study by the Environmental Protection Agency determined that exposure through bleached products like sanitary napkins and bleached coffee filters was insignificant relative to exposure through consumption of beef and dairy products.
- Retrograde flow i.e. menstrual flow going the wrong way, rather than down and out of the uterus through the cervix, menstrual blood, and tissue is going up and out through the fallopian tubes. Intercourse during menstruation and use of tampons are thought to contribute to retrograde flow. Retrograde menstrual flow occurs in approximately 90% of all women, so this theory alone is insufficient to explain why some women have endometriosis and others don’t.
- Decrease activity of overly active uterine lining cells. An enzyme called telomerase has been found to be overly active in women with endometriosis.
- Autoimmune – more recently theories have emerged suggesting that endometriosis may be an auto-immune disorder due to high levels of circulating anti-endometrial antibodies in these patients. This seems like a chicken and egg situation. The antibodies may be present because of the endometriosis, not as a cause of it. If endometrial tissue is in the abdominal cavity where it does not belong, the immune system would be expected to target it as foreign and create antibodies against it.
- Estrogen Dominance
Resolving Abnormal Tissue
The immune system is responsible for identifying and resolving this foreign. Acupuncture can be used to help stimulate immune system activity in the abdomen and enhance the resolution of this tissue. Diet can either enhance or inhibit immune system function; we want to optimize your diet to help the immune system to work better. Immune-enhancing herbs can also help expedite resolution of this abnormal tissue.
Acupuncture works amazingly well to relieve pain and has been proven by research to help this type of pain.
Reducing Excess Estrogen
Estrogen activity is increased when insulin levels are higher, so maintaining a steady blood sugar and increasing insulin sensitivity can modulate estrogen activity. Estrogen-like chemicals from pollution, plastics, pesticides and other chemicals can cause symptoms of excessive estrogen activity so reducing intake of these can help.
It’s the liver’s job (among about 200 others) to detoxify chemicals, toxins, and excess hormones to prepare them for excretion. Only once these substances have been sufficiently processed by the liver will they be removed from your body. If the liver is overwhelmed or undernourished, these toxins can build up in your system indefinitely. Many natural substances can aid liver detoxification.
Once toxins have been processed by the liver they get excreted through the bowels. Unhealthy digestive tracts from antibiotic use or a diet heavy in animal products that contain traces of antibiotics can cause problems such as Candidiasis or dysbiosis. An enzyme from certain bacteria known as beta-glucuronidase, can allow these toxins to get recycled rather than excreted. Commercial intestinal cleanses often do little to correct the intestinal bacteria and improve intestinal health, most only stimulate bowel movements with laxative herbs and/or fiber supplements.
Benefits of Natural Treatment for Endometriosis
- Addresses the underlying cause of endometriosis in order to cure the condition on a longer-term basis
- Prevents recurrence of endometriosis. The rate of recurrence after laparoscopic surgery is estimated to be between 30 and 40% within 5 years. Many women experience a recurrence within 1-1.5 years.
- Shrinks existing cysts and reduces pain
- Avoidance of side effects from drugs
- Better overall health and hormone balance
- Improved fertility. Endo can impair fertility by blocking the ovary from releasing an egg or blocking the opening of the fallopian tube so that an egg can’t make its way to the uterus to be fertilized. Blocked tubes may require IVF treatment. The condition also makes the lining of the uterus less receptive to implantation. Other than blocked tubes, naturopathic treatment can help other causes of infertility that are associated with endometriosis.
For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.
Endometriosis and Natural Treatment Research
Farland LV, Eliassen AH, Tamimi RM, Spiegelman D, Michels KB, Missmer SA. History of breastfeeding and risk of incident endometriosis: prospective cohort study . BMJ . 2017; 358:j3778.
● Among women experiencing at least one pregnancy lasting at least 6 months, breastfeeding was inversely associated with the risk of incident endometriosis
Chinese Herbal Medicine:
Flower A, Liu J, Lewith G, Little P, Li Q. Chinese herbal medicine for endometriosis. Cochrane Database of Systematic Reviews . 2012; DOI: 10.1002/14651858.CD006568.pub3.
● Two small studies in this systematic review suggest that Chinese herbal medicine may be equally effective compared to gestrinone and possibly more effective than danazol in relieving endometriosis-related pain.
Teenage girls who are too skinny are more likely to develop the painful reproductive disorder endometriosis than their heavier peers, research shows.
Source: Queensland Institute of Medical Research
Did you know that endometriosis problems can continue even after a hysterectomy?
August 5, 2008
Scientists have identified an enzyme abnormality that may be the cause of endometriosis
Women who have endo express an enzyme called telomerase in both the early and late stages of the menstrual cycle rather than only in the early stages as is normal. This means that the cells of the uterine lining will continue to divide and lose their ‘focus’ in supporting the establishment of a pregnancy. As a result the lining of the womb may be more hostile to an early pregnancy, and the cells that are shed at this late stage in the menstrual cycle may be more ‘aggressive’ and more able to survive and implant outside the uterus, causing pain in the pelvic or abdomen area. To read more click here – http://www.liv.ac.uk/news/press_releases/2008/08/endometriosis.htm
The good news is that there are natural ways to suppress telomerase activity.
October 1, 2009
Aromatase inhibitors improve pain control in endo
Pharmaceutical aromatase inhibitors can cause uncomfortable side effects about half the time. Natural aromatase inhibitors are much better tolerated and provide overall health benefits.
April 12, 2011
The Traditional Chinese herb Guizhi Fuling capsule plays an important role in the regression of endometriotic implants by immunological regulation in the rat model.
Source: Journal of Ethnopharmacology Volume 134, Issue 3, 12 April 2011, Pages 624-629
Supplementation with resveratrol as well as an oral contraceptive was found to significantly improve and even resolve dysmenorrhea and pelvic pain in endometriosis patients.
Source: Int J Womens Health. 2012;4:543-9. Epub 2012 Oct 10
Low vitamin D status was found to be associated with impaired fertility, endometriosis and PCOS.
Source: International Journal of Womens Health, Volume 3, Pages 25-35, 2011
N-acetyl cysteine (NAC):
Supplementation with N-acetyl cysteine was found to decrease cyst mean diameter, compared to a significant increase in untreated patients.
Source: Evid Based Complement Alternat Med. 2013;2013:240702.
Supplementation with resveratrol may improve the effect of oral contraceptives in the treatment of endometriosis-associated dysmenorrhoea. Source: Int J Womens Health 2012; 4: 543-549.
Supplementation with resveratrol as well as an oral contraceptive was found to significantly improve and even resolve dysmenorrhea and pelvic pain in endometriosis patients. Source: Int J Womens Health. 2012;4:543-9. Epub 2012 Oct 10
Stem cells have been identified in several tissues, including the endometrium, and may be involved in the development of endometriosis. Source: Histol Histopathol. 2012 Jan;27(1):23-9.
A combination of the GSTM1 null genotype and CYP1A1 MspI polymorphism was found to be associated with a small increased risk of endometriosis. Source: Mol Hum Reprod. 2001 Nov;7(11):1073-8.
Excess p40 in the peritoneal fluid of endometriosis patients may be related to the natural killer cell defect that is associated with the condition. Source: J Clin Endocrinol Metab. 1998 Mar;83(3):911-6.
Exposure to environmental pollutants, particularly dioxins and polychlorinated biphenyls, were found to increase the risk of endometriosis in women. Source: Environ Health Perspect. 2009 July; 117(7): 1070–1075.
The NRIP 1 gene encodes for the RIP140 protein and is essential for female fertility. NRIP1 gene variants were found to possibly act as predisposing factors for human endometriosis. Source: J Exp Clin Assist Reprod. 2005; 2: 11.
In women aged 20-40, the sum of all polychlorinated biphenyl (PCB) congeners were 1.6 times higher in the 40 women diagnosed with endometriosis than in controls. Source: Environ Health Perspect. 2006 July; 114(7): A404.
Women with endometriosis were found to not demonstrate the expected mid-luteal rise of HOXA10 protein expression, which may explain the infertility observed in many patients. Source: J Assist Reprod Genet. 2010 Dec;27(12):701-10. Epub 2010 Sep 7.
Abnormally high levels of DJ-1 protein expression may stimulate endometrial cell survival, proliferation, migration and invasion. Source: PLoS One. 2011; 6(3): e18074.
IGF2, ACTN4, AXL, and SHC1 are genes found to be differentially expressed between endometriosis and normal endometrium Source: Reprod Biol Endocrinol. 2008; 6: 59.
Loss of progesterone signaling in the endometrium may be part of the development of endometriosis, and progesterone resistance is commonly observed in endometriosis patients. Source: Semin Reprod Med. 2010 Jan;28(1):36-43. Epub 2010 Jan 26.
Dioxin, a contaminant of industrial combustion processes, is largely thought to play a part in the etiology of endometriosis. However, this study found that serum levels of 100 ppt or higher did not have significant risk for endometriosis. Source: Environ Health Perspect. 2002 July; 110(7): 629–634.
Inadequate immune and neuroendocrine responses are thought to play a part in the pathophysiology of endometriosis, particularly adhesion molecules, protein-glycan interactions and pro-angiogenic mediators. Source: Semin Immunopathol. 2007 June; 29(2): 193–210.
Iron overload has been observed in the peritoneal fluid, endometriotic lesions, peritoneum and macrophages of endometriosis patients, suggesting it may a contributing factor in the development of endometriosis. Source: Mol Hum Reprod. 2008 Jul;14(7):377-85. Epub 2008 May 28.
Development of endometriosis is facilitated by quantity and quality of endometrial cells in peritoneal fluid (PF), increase inflammatory activity in PF, increased endometrial-peritoneal adhesion and angiogenesis, and increased production of autoantibodies against endometrial cells. Source: Reprod Biol Endocrinol. 2003; 1: 123.
Level of exposure to polybrominated biphenyls (PBBs) was found to not increase risk of endometriosis. But, higher levels of polychlorinated biphenyls (PCBs) exposure did increase risk. Source: Ann Epidemiol. 2007 July; 17(7): 503–510.
In a study of infertile women with endometriosis, 8 individuals with endometriosis were found to be dioxin positive compared to 1 woman in the control, suggesting a link between dioxin exposure and endometriosis. Source: Hum Reprod. 1997 Feb;12(2):373-5.
Exposure to environmental toxicants induces an inflammatory-like endometrial response that may advance the development of endometriosis. Source: Fertil Steril. 2008 May; 89(5 Suppl): 1287–1298.
Polychlorinated biphenyls (PCB’s) were found to not be associated with endometriosis risk. Source: Environ Health Perspect. 2010 September; 118(9): 1280–1285.
The phytochemicals Diindolylmethane (DIM), its precursor Indole-3-carbinol (I3C), and cogener, 2-(Indol-3-ylmethyl)-3,3’diindolylmethane (LTR-1) were found to prevent or reduce symptoms of mastalgia and endometriosis. Source: United States Patent 7,384,972; June 10, 2008
Supplementation with N-acetyl cysteine was found to decrease cyst mean diameter, compared to a significant increase in untreated patients. Source: Evid Based Complement Alternat Med. 2013;2013:240702.
Acupuncture for Endometriosis
A systematic review and Meta-analysis of 10 studies looked at the effectiveness of acupuncture and endometriosis. Although lacking blinded RCT, a reduction in pain, as well as CA-125 levels, were associated with acupuncture treatment. Source: Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis.PLoS One. 2017 Oct 27;12(10):e0186616.
DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.