By Dr. Karen Coates
Understanding Endometriosis starts with a simple lesson in female anatomy. The uterus, or womb, is lined internally with a layer of cells called the endometrium. This layer is shed each month as menstrual flow at period time.
Problems arise when these endometrial lining cells are found on the outside of the uterus, within the pelvic cavity. Under the influence of the monthly hormone cycle, when a woman has a period bleed she not only releases blood into the vagina, but also releases tissue, cells and blood into the pelvic cavity. Unlike the uterine bleeding, which is dispelled into the vagina, this blood has no way of exiting from the body. This irritates the outside of the bladder and bowel, ovaries and fallopian tubes. It causes pelvic inflammation and adhesions, leading to the symptoms of endometriosis.
Symptoms of Endometriosis:
Endometriosis is rarely silent. The pain it creates at period time is difficult for most women to control, and daily activities start to suffer.
Period pain not responding to simple painkillers.
Mid-cycle pain in the lower pelvic area
Pain on opening bowels
Pain during sex
Bleeding from the bowel, especially around period time.
Complications of Endometriosis
Painful periods that interfere with work, social life and cause considerable distress.
Complications can include ovarian cysts called “chocolate cysts” made of congealed blood and fibrous material.
More than 30% of women with this condition will be infertile because of the involvement of the Fallopian tubes, leading to a blockage of the passage of eggs.
Diagnosis and Medical Treatment
This is an area of Medicine where mainstream management of established symptoms is recommended. A LAPAROSCOPY.
A small flexible telescope is inserted into the abdomen under a general anaesthetic. Endometriosis is easy to see and confirms the diagnosis. The abnormal tissue is removed through these telescopic tubes. In most cases women are able to return home on the same day as surgery.
During pregnancy endometriosis symptoms can disappear completely, only to return several months after delivery. Menopause will also bring relief, as the abnormal cells are no longer responding and bleeding with the menstrual cycle.
Mainstream choices for managing endometriosis include the oral contraceptive pill, hormonal drugs like danazol, progestin in tablet, injectable or as an intra uterine device (IUD). All of these choices come with their own risks, and side effects that need to be weighed up against the advantages of each drug.
It is after Surgery (and immediately after childbirth) that natural therapies become important to prevent the recurrence of the problem.
Medical research shows that Chinese herbal medicine has superior track record in preventing the recurrence of endometriosis. It is also far less likely to cause side effects related to drug treatment and protects fertility.
Foods that help in the Management of Endometriosis:
Broccoli (cruciferous vegetable family)
Western Herbal treatment can also be very effective, and is aimed at reducing the estrogen levels and promoting Progesterone production.
Chaste Tree (Vitex Agnes Castus)
Indole-3-Carbinol (from the Broccoli family of vegetables)
If deciding to deal with this potentially serious medical condition incorporating natural therapies it is important to seek the advice of an experienced herbalist in either Chinese Medicine or Western Herbal Medicine.
Natural Progesterone cream, a bio-identical hormone made from wild yam has also shown to be helpful in reducing the effect of estrogen on the endometrium. If you are considering this option be aware that more of a good thing is not necessarily better. Natural progesterone should only be accessed via a medical doctor with a special interest in natural and alternative hormonal options. It’s important to have both your symptoms and the dosage monitored carefully to optimize results.