What is endometriosis? Endometriosis is a gynaecological disorder effecting millions of women worldwide. This disorder occurs when the endometrium, the inner lining of the uterus, implants abnormally outside of the uterine cavity. The most common sites of endometrial implants are the ovaries, fallopian tubes, the bladder, the intestines, and the ligaments and muscles in the pelvis. The tissue outside of the uterus responds the same way to the menstrual cycle as the lining of the uterus. For instance endometrial tissue will grow and proliferate in response to an increase in hormones (estrogen), and will degrade and bleed when hormones decline (progesterone). The endometrial implants that bleed outside of the uterus cause inflammation and swelling of the surrounding area, scar tissue formation, and pain.
Endometriosis typically occurs in women of reproductive age, and is most commonly diagnosed between the ages of 25 and 35. For symptomatic women, diagnosis is confirmed with pelvic laparoscopy, a minor surgical procedure that allows for the examination of your pelvic organs and identification of endometrial lesions.
Symptoms of endometriosis:
Chronic pelvic pain
Low back pain
Pain with intercourse
Painful bowel movements
Gastrointestinal upsets such as diarrhea, constipation and nausea during menstruation
Because these symptoms can look like a variety of different diseases, diagnosis of endometriosis can be difficult and often delayed.
Causes of endometriosis: We unfortunately don’t know the exact cause of endometriosis, but several theories do exist.
Retrograde menstruation. This is where menstrual blood or endometrial cells flow backwards through the fallopian tubes and land on pelvic organs where they start to grow.
Coelomic Metaplasia. This theory suggests that the cells that line the peritoneal cavity transform into endometrial cells.
Immune system dysfunction. Reduced cell mediated immunity prevents the detection and eradication of misplaced endometrial cells.
The displacement and redistribution of endometrial cells though the blood or lymph fluid, or during pelvic surgery.
Genetic. Women that have a first-degree relative with endometriosis have a 6 fold increased risk in developing the disease in compared to those that do not have the family history.
Diet. There is a decreased risk of endometriosis in women that eat higher amounts of vegetables and fruit, and an increased risk of developing the disease when eating diets high in red meat. High intake of caffeine and alcohol also contribute to an increased risk of developing the disease.
Hormone imbalance. Because endometrial tissue grows and proliferates in response to high levels of estrogen, higher levels of estrogen in relation to progesterone may increase the risk of developing endometriosis.
Exposure to xenoestrogens. These are environmental toxins that act as estrogens in the body, and thus contribute to hormone modulated diseases. Examples of xenoestrogens are phthalates found in plastics and toxins in herbicides and pesticides.
Most likely the cause of endometriosis is multifactorial. Because of this, the naturopathic approach to managing endometriosis includes taking all of the risk factors and causal theories into consideration when developing a treatment plan. In addition, because chronic pelvic pain and infertility can trigger emotional stress, stress management is also an integral part of a comprehensive treatment plan.
Goals of naturopathic treatment:
Prevention of excessive endometrial tissue escape
Shrinkage of endometrial lesions
Decreasing exposure to environmental toxins
Treatment modalities used to reach goals:
Nutritional medicine – lifestyle and supplementation
Bioidentical hormone therapy
General naturopathic treatment plan:
1- To prevent excessive back flow of menstrual blood and endometrial cells through the fallopian tubes, head stands, certain yoga poses such as shoulder stands should be avoided on heavy flow days.
2- Pain management revolves around controlling inflammation, and decreasing muscle spasms associated with chronic pain signals.
Omega 3 fatty acids
Herbs such as curcumin and boswellia
Limited refined sugar, and saturated fat (red meat, dairy, egg)
High intake of vegetables and fruit
High polyunsaturated fats – nuts, seeds, fish, olive oil
Food sensitivity testing – to determine individual food triggers that contribute to systemic inflammation.
Decreasing muscle spasms:
Pelvic flood physiotherapy
Note: Acupuncture is a great adjunct therapy for calming any type of pain in the body.
3- To shrink endometrial tissue hormone balancing, immune modulation, and antioxidant support is key.
The goal of hormone balancing is to decrease estrogen – the hormone that is responsible for endometrial growth and proliferation. This can be achieved by supplementing with:
Indole-3-carbinol, and diindoylmethane, which helps with the metabolism of estrogen through the liver
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