Endometriosis

Endometriosis occurs when endometrial cells—the cells that make up the lining of your uterus—travel outside the uterus to other parts of your body. These misplaced cells are stimulated by hormones just like the cells within your uterus and bleed during your period (menstruation). Blood from these cells must be absorbed by your body. With each period deposits build up and form scar tissue which can be painful. Endometriosis affects 10 to 20 percent of American women of childbearing age. It is found in 30 percent of infertile women.

Signs and Symptoms

One third of women with endometriosis have no symptoms. The most common symptoms include the following.

• Pelvic pain especially when you have your period
• Heavy or irregular menstruation
• Pain during sexual intercourse
• Infertility or miscarriage
• Pain with bladder or bowel function or intestional pain

What Causes It?

The cause is unknown but there are three theories.

• Abnormal functioning of your immune system
• Retrograde (or reflux) menstruation in which some menstrual blood flows backward through your fallopian tubes
• Genetic or heredity factors

What to Expect at Your Provider's Office

A physical examination may include gentle pushing on your abdomen and an internal examination. Definitive diagnosis is made with laparoscopy.

Treatment Options

Treatment Plan

Drugs that lower your hormone levels may give symptom relief. These and other drugs can help with pain. Laparoscopic laser techniques help shrink lesions. Total hysterectomy (removal of your uterus and ovaries) is recommended when necessary and when childbearing is no longer desired. It relieves pain 90% of the time but is not a guarantee that symptoms will end.

Drug Therapies

Prescription

• Oral contraceptives— relieve symptoms; various side effects
• Hormone-suppressing drugs—stop menstruation thus reducing symptoms; for example Danazol provides symptom relief for 80% to 90% of patients; do not take if pregnant; various side effects

Over the Counter

• Nonsteroidal anti-inflammatory drugs—relieve pain symptoms; for example ibuprofen; various side effects

Surgical Procedures

Laparoscopic laser techniques help shrink lesions. Total hysterectomy (removal of your uterus and ovaries) is recommended only when necessary but does not guarantee an end to your symptoms.

Complementary and Alternative Therapies

Providing liver support is the backbone of alternative treatment.

Nutrition

• Eliminate all known food allergens.
• Eliminate alcohol caffeine chocolate refined foods food additives sugar and saturated fats (meats and dairy products).
• Eat only organic poultry and produce.
• Increase intake of whole grains fresh vegetables essential fatty acids and vegetable proteins. Include liver-supporting foods such as beets carrots onions garlic leafy greens artichokes apples and lemons.
• Vitamin C (1 000 mg three times per day) decreases inflammation.
• Zinc (30 to 50 mg per day) and beta-carotene (50 000 to 100 000 IU per day) support immune function and enhance healing.
• Vitamin E (400 IU per day) is necessary for hormone production.
• Selenium (200 mcg per day) is needed for fatty acid metabolism.
• Iron supplementation may be necessary if bleeding is severe.
• Calcium (1 000 to 1 500 mg per day) and magnesium (200 mg two to three times per day) are needed for hormone metabolism.
• Essential fatty acids (1 000 to 1 500 mg twice a day).

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts).

Chaste tree (Vitex agnus-cactus) taken long-term (12 to 18 months) for maximum effectiveness. Combine 2 parts of chaste tree with 1 part of two herbs from each category. Drink 3 cups of tea per day or take 30 to 60 drops of tincture per day.

For liver support (include milk thistle and one other herb): Milk thistle (Silybum marianum) dandelion root (Taraxacum officinalis) vervain (Verbena hastata) or blue flag (Iris versicolor).

For reducing pelvic congestion: Squaw vine (Mitchella repens) motherwort (Leonorus cardiaca) red root (Ceonothus americanus) red raspberry (Rubus idaeus).

For management of severe pain and extensive endometriosis Turska's formula is the preferred combination and should be used only under a health care provider's supervision.

Homeopathy

Some of the most common remedies are listed below. Usually the dose is 12X to 30C every one to four hours.

• Belladonna for menstruation with sensation of heaviness and heat
• Calcarea phosphoricum for excessive periods with backache
• Chamomilla for heavy menses with dark clotted blood and pains
• Cimicifuga racemosa for unbearable pain radiating from hip to hip

Physical Medicine

• Contrast sitz baths. You will need two basins that you can comfortably sit in. Sit in hot water for three minutes then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets per day three to four days per week. (Do not perform this during menstrual flow.)
• Castor oil pack. Apply oil directly to abdomen cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes. Use for three consecutive days.
• Kegel exercises (contracting and releasing the pelvic muscles).

Acupuncture

Acupuncture may be helpful for endometriosis.

Massage

Therapeutic massage may help resolve pelvic congestion.

Special Considerations

Endometriosis often resolves during pregnancy.

Supporting Research

Facts About Endometriosis. U.S. Department of Health and Human Services. National Institutes of Child Health and Human Development. NIH Publication no. 91-2413.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:112–114.

Medicines from the Earth. Harvard Mass: Gaia Herbal Research Institute; 1997:182–183.

Protocol Journal of Botanical Medicine. 1996;1:30–46.

Tureck RW. Endometriosis: diagnosis and initial treatment. Hospital Physician Obstetrics and Gynecology Board Review Manual. April 1997;3:1–8.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.