Although theories abound, just why some women develop endometriosis and others don’t remains a mystery. Or why endometrosis produces painful or heavy periods in some and no symptoms in others. Or why some women with endometriosis are infertile and others are not. What doctors do agree on is what endometriosis is. Pieces of the lining of the uterus called the endometrium find their way outside the uterus and into the pelvis, where they implant themselves and grow.
For a mild case of endometriosis, either getting pregnant or using continuous birth control can help. Unfortunately, for severe endometriosis, conventional treatments–drugs and surgery–can be problematic.
By far the gentlest approach to endometriosis is through integrative medicine. At WholeHealth Chicago, we make use of a blend of supplements and herbs, traditional Chinese medicine, and some bodywork therapies that may relieve your symptoms and improve your chances of fertility.
What is Endometriosis?
Most common in women between the ages of 25 and 40, endometriosis is a condition in which cells from the uterine lining (endometrium) stray into other parts of the abdominal cavity. They can attach themselves to the ovaries, intestines, uterine ligaments, or other organs, and begin to grow there. As estrogen and other hormones of menstruation stimulate the endometrium and cause it to thicken with blood each month, the stray cells also fill with blood. The uterus sheds the engorged endometrium during menstruation, but the wayward cells have nowhere to go. The result can be cysts, bleeding, scarring and adhesions (fibers that connect parts of the body that normally are separate), all of which can cause pain.
Because of the abdominal damage it does, endometriosis is a major cause of infertility in women, and a young woman with endometriosis would be well advised to bear children sooner rather than later if possible.
Key Symptoms
- Severe cramps that begin before the menstrual period and peak after bleeding ends
- Intense pain during sexual intercourse
- Infertility
- Low back pain, especially during menstruation
- Diarrhea or constipation
- Pain during bowel movements
- Blood in the urine or stool during the menstrual period
- Nausea and vomiting shortly before the menstrual period
What Causes Endometriosis?
Scientists haven’t determined exactly what lies at the root of this condition. Some researchers speculate that women are born with endometrial cells outside the uterus, and that endometriosis symptoms become apparent when female hormones stimulate these cells.
Another theory holds that endometriosis is the result of a weak immune system that is unable to destroy the misplaced cells. Other experts support the “retrograde menstruation” theory, which suggests that menstrual blood, when backed up into the Fallopian tubes, releases endometrial cells into the abdomen.
Treatment and Prevention
Because endometriosis may have no symptoms, or manifest itself only as painful menstrual cramps, many women don’t know they have endometriosis until they’re evaluated for infertility or unexplained pelvic pain. Although the days when doctors told women their symptoms were “all in your head” or “just cramps” are gone, mainstream medicine has not been able to cure endometriosis.
Prescription medicines can relieve some of the discomfort, however. Basically, drugs are used to suppress menstruation and include danazol, progesterone, and birth control pills. In severe cases, surgical removal of the endometrial implants may be a necessary addition to drug therapy.
Because medications to stop menstruation can have unpleasant side effects, milder cases of endometriosis may respond well to supplements. These are quite safe, either taken individually or in herbal combinations. They can also be used with any prescription medications recommended by your doctor. They should be used daily throughout the menstrual cycle for best results.
Just a reminder: If you have a serious medical condition or are taking medication, it’s always wise to talk to your doctor before starting a supplement regimen.
How Supplements Can Help
You can begin with daily doses of two herbs traditionally paired together: chasteberry and dong quai. Working in tandem, they can help balance hormones that cause endometrial pain. They also relax the uterus, a benefit also true of the herb wild yam.
Because endometriosis is thought to be a condition of “estrogen excess,” taking a daily lipotropic combination, which makes the liver more efficient at clearing extra estrogen from the body, can help. A suggested combination might contain milk thistle, choline, inositol hexaniacinate, methionine, and dandelion.
In high doses, calcium and magnesium can relieve menstrual pain by lowering levels of prostaglandins (body chemicals produced by the uterine cells that cause cramps). If you decide to take a high-dose calcium/magnesium supplement for painful cramps, take it only during your period.
Other supplements, which you can include simply because they have so many positive effects throughout the body, may also help with endometriosis. Vitamin E balances hormones, reduces inflammation, and boosts the immune system. Evening primrose oil (or the less expensive borage oil) and flaxseed oil provide essential fatty acids that help control inflammation and block cramp-causing prostaglandins. Vitamin C can hasten the healing of tissues damaged by cysts and scarring; it also helps control heavy bleeding by strengthening capillary walls.
Self-Care Remedies
Eat soy products. Soy is a rich source of phytoestrogens (plant estrogens) that may compete with and block out the body’s own stronger estrogen.
Get regular exercise. Working out several times a week improves symptoms and may even prevent endometriosis.
Over-the-counter pain relievers, especially ibuprofen, can take the edge off menstrual pain.
Castor oil packs can be very helpful to relieve pelvic pain. Soak a piece of cotton flannel in castor oil, wring out the excess, and heat in a microwave oven (not too hot!). Spread the flannel over the lower abdomen and cover with a heating pad or hot water bottle. Lie back and enjoy the warmth as long as you desire. The flannel can be saved in a plastic bag for re-use.
Avoid tampons, which can block menstrual flow; use unbleached, unscented, nondeodorant cotton pads.
Avoid coffee and alcohol. These interfere with the liver’s ability to process excess estrogen.
Reduce your consumption of red meat, or avoid it altogether. It can increase your body’s estrogen load.
Eliminate chemicals and toxins as much as possible. Eat organic foods, for instance, and use toxic-free alternatives for everything from cosmetics to cleaning supplies.
Try avoiding plastic containers; some scientists believe they may release organic substances that mimic estrogen.
Consider acupuncture treatments. This therapy, in conjunction with Chinese herbs, has been seen to alter and balance the body’s hormones and to provide pain relief for endometriosis.
When to Call a Doctor
- If you have severe cramps, heavy bleeding, or other symptoms of endometriosis
- If you suspect that your symptoms are caused by endometriosis
- If you have pelvic pain, abdominal bloating, or alterations in your digestive process. This is especially important if these symptoms do not fluctuate with your menstrual cycle. (These may be caused by other conditions that need urgent treatment.)
Supplement Recommendations
From David Edelberg, M.D. at WholeHealth Chicago: Conventional medicine offers both hormone manipulation and surgery as treatments for endometriosis, but unfortunately a complete cure has yet to be discovered for this painful condition.
At WholeHealth Chicago, we appreciate that herbs and supplements, especially when combined with some significant lifestyle and dietary changes, can really make a difference. Our supplement recommendations have other health benefits as well, such as offering you additional antioxidant protection and warding off the tendency of your bones to develop osteoporosis.
The herbs and supplements on this list can all be used in combination with any strategies your gynecologist may be using to treat your endometriosis. However, it’s always a good idea to share information about supplements you may be taking with your doctor.
How to Take the Supplements
The herbs chasteberry (also called Vitex) and dong quai are traditionally combined for balancing the hormones that may be responsible for the spread of endometrial tissue and for increased endometrial pain. Some herbalists will add wild yam to soothe the uterus and reduce cramping. These herbs are meant to be used on a daily basis, for at least three to six months.
The daily use of a lipotropic combination can help the liver process estrogen, which at high levels is thought to stimulate endometriosis.
If your menstrual cramps are painful, consider the regular use of two common minerals, which are often combined into a single supplement. Calcium improves normal muscle tone, which can be beneficial for endometriosis because poorly toned muscles cramp more easily. Magnesium, a widely used muscle relaxant, is suggested in many conditions where muscle spasms are a problem, such as tension headaches or chronic back pain.
In addition, increase your daily intake of vitamin C (to strengthen the small blood vessels in your uterus) and vitamin E (to correct hormone imbalances) beyond the level in your basic daily multivitamin. And take both flaxseed oil and evening primrose oil (or the less-expensive borage oil: 1,000 mg a day) each day to control tissue inflammation and strengthen the blood vessels.
Lastly, consider using natural progesterone cream; it should be applied daily during the second half of your cycle, stopping when flow begins. It helps reduce the effect of excess estrogen by blocking receptor sites and balances the levels of estrogen and progesterone in your body.
Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
Be well,
David Edelberg, MD