Endometriosis affects 1 in 10 Australian women and more then often is it misdiagnosed or even undiagnosed. This chronic inflammatory condition can be completely debilitating to a women’s life, mentally, emotionally and physically. An Australian government report stated that endometriosis annually cost $7.7 billion, with 2/3 of these costs attributed to loss in productivity, as it is not unusual for women with significant pain to take one or two days off a month.
What is endometriosis?
Each month, the tissue inside the uterus called the endometrium, thickens as it intends to support a fertilized egg during pregnancy. If the egg is not fertilized and the woman does not become pregnant, then the uterus sheds this lining with the onset of her period. This is the bleeding that occurs during her monthly period and is usually a healthy sign and a normal process of being a woman.
In endometriosis, this endometrial tissue grows outside the uterus and in other parts of the body such as ovaries (the most common site) pelvis, fallopian tubes, intestines, bowel, bladder, brain and have even been found in the nasal cavity. This tissue responds to the hormonal changes that regulates our menstrual cycle as the tissue cells also contain progesterone, testosterone and oestrogen receptors. This tissue then responds in normal cyclical hormonal fluctuations, 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 adhesions, scarring, pain, cysts and fibrosis, possibly causing infertility (if the displaced tissue is attached to the reproductive tissue) and increased menstrual pain.
What causes endometriosis?
Endometriosis is driven by oestrogen and is seen most commonly in women of the reproductive age. Although the aetiology is unknown environmental factors, poor detoxification pathways, endocrine disrupters, adrenal health, diet and lifestyle choices and immune involvement are the areas on focus when it comes to naturopathic treatment. In addition, the development of endometriosis has been shown to increase 10-fold where there is a first-degree relative who also suffers from endometriosis. Other risk factors include:
- Fallopian tube or uterine defects
- Early menarche
- Shortened menstrual cycles (<27 days)
- Elongated menstrual flow (>7 days)
- Delay in childbearing
- Few children
- Heavy bleeding during menses
- History of pelvic infection
- Anaemia and hypoxia may also contribute
What is the clinical presentation?
- Chronic pelvic pain
- Pain often described as being worse then menstrual cramps and can be debilitating
- More displaced endometrial tissue along the midline of the uterus is thought to cause more pain due to the concentration of nerves along the midline
- Infertility issues which can affect one-third to one-half of women with endometriosis, regardless of the number of previous pregnancies
- Ongoing lower back pain
- Lower abdominal pain
- Pain during defecation or urination
- Pain during intercourse
- Irregular or heavy bleeding
- Dysmenorrhea (painful menstruation typically with abdominal cramping)
- Diarrhoea, constipation, vomiting, bloating or nausea- especially before or during your period
- Fatigue or malaise
- Pain upon exercise
There are many Naturopathic treatment options available that are very effective in managing your endometriosis. Whether you want to get pregnant, or simply want to reduce the symptoms of endometriosis, both herbal and nutritional medicines can make a huge difference in managing the condition.
- Support the liver- As endometriosis is an oestrogen-dependant condition, the liver needs to be supported in order to clear excess oestrogen
- Support adrenal health- chronic, prolonged stress can cause dysregulation of steroid sex hormones which can potentially lead to other female reproductive disorders. Also the demand for cortisol can deplete precious precursor material leaving sex hormones compromised.
- Immune health- Studies have indicated a link between autoimmune disease and the prevalence of endometriosis therefore keeping your immune system supported and healthy is warranted
- Reduce inflammation- Endometriosis is a chronic inflammatory disease, therefore one of the main focuses is to dampen this inflammation.
- Modify the diet by removing all sugars, processed foods and increasing the consumption of a whole food diet with lots of fruit and vegetables
- Improve digestive function and absorption via a GIT repair program
- Reduce your exposure to endocrine disrupters that can further imbalance hormones, such as:
- Bisphenol A (BPA)
- Increase phytoestrogens and oestrogenic lignans such as flaxseeds, whole grains, sesames seeds, sunflower seeds, cashews, kale, broccoli and berries. The lignan metabolite enterolactone provides oestrogenic support when estrogen levels are low, making up for some of the deficiency. When oestrogen levels are too high, the lignans attach to the oestrogen receptors, reducing the activity of your body’s natural oestrogen hormones and blocking their effect in certain tissues.
- Herbal medicine is often used to help suppress oestrogen production and support conditions involving progesterone deficiency (such as endometriosis)
- Evening primrose oil- Has a positive effect on the female reproductive disorders and inflammation as it contains gamma-linolenic acid (GLA). Borage oil, hemp seed oil and flaxseed oil also contain GLA.