Hysterectomy & alternatives

What you should know about endometriosis

by Marcelle Pick, OB/GYN NP and Marcy Holmes, NP, Certified Menopause Clinician

Every woman should understand the basics about endometriosis because of the insight it can offer into how our bodies work — and what we can do to keep ourselves healthy.

Endometriosis is on the increase, and there is debate about why. We suspect that the high estrogen levels in American women are a contributing factor. It often runs in families. In many women there is a correlation with immune dysfunction. And we know from clinical experience that emotional issues are often involved. But in all these causes we find the theme of hormonal imbalance. And the good news is that we can usually do something about that — without drugs or surgery — and usually see great improvement.

What is endometriosis?

Endometriosis (sometimes misspelled endometreosis) is an outgrowth of the normal menstrual cycle. Each month the tissue inside the uterus — the endometrium — thickens and then sloughs off with the onset of your period. In the case of endometriosis, the same type of tissue that lines the uterus occurs in other parts of the body.

Endometriosis can appear on the fallopian tubes, the ovaries, the outside of the uterus, the peritoneum, or the intestines. Each month this displaced tissue responds to the hormonal changes that regulate your menstrual cycle, engorging itself through the first half of the cycle, and often releasing a small amount of blood in the second half, which causes repeated irritation to the surrounding tissue. Over time this can cause scarring or adhesions to develop in the reproductive organs, pelvis, and intestines. It has been speculated that when the scarring occurs on reproductive organs it can cause infertility.

Symptoms of endometriosis

Endometriosis is not an easy diagnosis to make. Symptoms such as chronic pelvic pain, menstrual pain, bloating, painful sex, or pelvic discomfort between ovulation and your period do heighten the index of suspicion, but aren’t conclusive. Notably, some women have the condition without symptoms, while others have these symptoms but no endometriosis. An experienced practitioner can tell much from a pelvic exam, but the only definitive diagnosis is surgical. This is another reason we recommend a natural approach as a first step to see if it provides symptom relief.

The cause of endometriosis is not known, although there are several theories. It’s possible that more than one theory is correct, and there are probably multiple pathways to developing the condition. One very likely contributing factor that can be reduced with natural methods is the estrogen-like chemicals that surround us, known as xenoestrogens.

Our estrogenic environment

Estrogen’s natural function is to stimulate cell growth. But excess estrogen contributes to unnatural growth. We know that American women have the highest levels of estrogen in the world. We believe that most of that excess comes from so-called xenoestrogens, compounds whose molecular structure is so similar to estrogen that they have estrogenic effects in the body. These compounds include the growth hormones common in milk and meat production, agricultural pesticides, the chemicals given off by plastics when heated in microwaves, and many other sources. Not surprisingly, for most of us such xenoestrogens are pervasive. (See our article on endocrine disruptors for additional information on sources of xenoestrogens and ways to avoid them.)

Natural treatment of endometriosis

We have had a consistently high rate of success with a combination of dietary changes, nutrient support, emotional healing and alternative therapies such as acupuncture and phytotherapy. The basic thrust is to eliminate the underlying causes of endometriosis and support your body’s healthy metabolic function. These steps can help relieve the symptoms of endometriosis, but also are important preventative measures for your overall health. We recommend all women follow these natural steps regardless of whether or not they suspect endometriosis.

Some of the simplest steps are:

• Diet for endometriosis

  • Change your diet to minimize xenoestrogen exposure. As much as you can, eliminate non-organic dairy products, beef and chicken. (Note that because organic foods contain no added growth hormones, there’s no reason to limit their consumption.)

  • Increase nutrient-rich foods, especially cruciferous vegetables, soy, cold-water fish and fiber, all of which support hormonal balance and help clear excess estrogen from the body.

  • Follow a whole foods diet, being mindful of carbohydrates, to support healthy insulin metabolism and thereby support overall hormonal balance. This includes limiting alcohol intake.

• Maintain healthy levels of body fat to limit endogenous estrogen production. Body fat is a secondary production site for estrogen, so excess weight often means excess estrogen.


• Supplement with vitamins and minerals to make up for what is lacking in your daily food intake, including calcium and magnesium.


• Supplement with phytotherapy to gently normalize hormone levels.


• Supplement with omega–3 essential fatty acids as a natural anti-inflammatory.


• Minimize exposure to xenoestrogens in your environment. Don’t microwave food in plastic wrap or containers, and try to minimize the use of plastics for food storage.
  Read our article on endocrine disruptors for more information.


• If you have endometriosis, add acupuncture or physical therapy with pelvic massage to the above. Castor oil packs will help reduce pain and inflammation. We also recommend you check out the innovative therapeutic approach developed at Clear Passages.

Emotional factors

Twenty-five years ago the medical profession recognized very little of the deep connection between emotions and health. It was accepted that “type-A” personalities had a greater risk for heart disease, that “passive/depressive” women had more breast cancer, and that attitude affected a patient’s rate of healing. But there was resistance to going further.

Today there is much greater recognition of the impact of emotional experience on our health. There is a conclusive body of clinical evidence showing stress increases the risk of disease. A large-scale California study co-sponsored by the Center for Disease Control showed that emotional trauma in childhood almost predetermined health problems in adulthood. Dozens of such studies are now published every year.

In our clinical practice, we have long realized that for many women, in addition to the physical factors, there is a clear connection between endometriosis and unresolved emotional issues. Those issues are varied but are most often unresolved problems within your family, especially your family of origin. Dealing with those issues now, especially when combined with the dietary and other support efforts outlined above, can be a decisive component of your health. There are many alternative methods for help with emotional issues, as well as conventional counseling. For more on this, we encourage you to read our article on emotional experience.

Conventional medical treatment

The natural methods described above provide the body with the support it needs for hormonal balance, and many women find that it is all they need for relief from their endometriosis symptoms. However there are also many effective conventional remedies short of surgery. We suggest you start with the natural methods, and if you need further support consider the following treatments:

• Use of ibuprofen, naproxen, and other antiprostaglandins or NSAID’s that are available by prescription to decrease pain and inflammation when needed.

• Medical/hormonal management with contraceptive methods such as birth control pills, patch or ring, or Depo-Provera injections, which have synthetic progestins that help block the stimulation of the endometriosis implants. Hormonal treatments such as Lupron or danazol temporarily stop menstruation, block estrogen, and shrink the implants.

• Of course, in extreme cases surgical treatment may prove the only option, if less-invasive preventative and conventional approaches have failed to provide relief.

  • Surgical removal or lasering of the tissue implants, usually following a course of Lupron.
  
  
  • Endometrial ablation.
  
  
  • Total or partial hysterectomy if the endometriosis is diffuse in the pelvic area.

There are many alternative methods for help with emotional issues, as well as conventional counseling.

We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.

Related to this article:

References & further reading on endometriosis

 

Original Publication Date: 11/14/2003
Last Modified: 03/19/2008
Principal Authors: Marcelle Pick, OB/GYN NP
& Marcy Holmes, Certified Menopause Clinician