Endometriosis - Part One

Endometriosis is a gynaecological condition that affects millions of women.  Before the term 'endometriosis' was coined, women simply suffered from 'painful periods' or dysmenorrhoea. The cause of endometriosis (from a Western medical perspective) is largely unknown, with theories abound; of retrograde menstruation, genetic errors, endocrine disease, immune disease and even environmental factors.

This condition is characterised by inappropriate tissue growth within the reproductive system, causing damage and inhibiting fertility. This tissue is endometrial tissue, which can be growing within the muscular wall of the uterus (adenomyosis) or in various other sites distal to the uterus (external endometriosis). Research suggests the following sites and statistics:

• Ovaries and fallopian tubes 40%

• Uterosacral ligaments and rectovaginal septum 30%

• Pelvic peritoneum 15%

• Pouch of Douglas $10%

• Small and Large bowel 10%

• Bladder 5%

Rarely, endometrial tissue can be carried by the lymph or circulatory system to the nose and lungs. This would present as cyclical bleeding from these sites as the endometrial tissue responds to hormones that stimulate menstruation. More and more women are being diagnosed with endometriosis, but as yet it is unclear whether the disease itself is on the rise, or rather the tests to detect it are more effective. Some tests for endometriosis include ultrasound, CT scan, MRI and laparoscopy. New tests using blood or urine are being developed.

Most commonly diagnosed in women around the ages of 20-25, endometriosis is often found during laparoscopy after terrible period pain and/or dysparenunia (painful intercourse).

Common signs and symptoms:

• - incapacitating sharp, stabbing pains for 2 – 14 days of each cycle

• - pain is usually in the lower abdomen, usually both sides, and can radiate down the legs and into the back

• - some women suffer mid cycle pain, or even continuous pain, and pain during intercourse

• - passing of clots

• - bleeding from various sites during menstruation
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• - painful intestinal movements or urination during menstruation
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• - infertility

• - 84% feel depressed, 75% feel irritable, 50% experience anxiety and anger, and 20% express feelings of despair.

Other disorders must be ruled out before endometriosis is diagnosed. The key symptom of pelvic pain could be due to other factors, such as primary dysmenorrhoea, PID, fibroids, ectopic pregnancy, miscarriage, UTI or cancer.

Western medicine offers 3 forms of treatment

1. Analgesic medication – only effective in mild cases

2. Medical treatment – primarily the use of the OCP and synthetic progesterone, or anabolic testosterone derivatives, which are continued for around 6 – 12 months, during which time the endometrial lesions atrophy. Common side effects of these medications are:

   - depression

   - weight gain

   - loss of libido

   - breast changes/tenderness

   - irregular vaginal bleeding

   - breakthrough bleeding

   - nausea and bloating

   - ankle and foot swelling

   - tiredness/drowsiness

   - acne or dry skin or urticaria

   - increased facial hair (hirsutism)

   - voice deepening

   - vaginal dryness

   - headache

   - ovarian cysts

   - high blood pressure

   - bone loss

   - palpitations

3. Surgical treatment – removal of excessive growth of endometrial tissue via diathermy, excision with CO2 laser, regular D&C, and radical excision of cysts, hysterectomy and salpingo-oophorectomy.

 

Endometriosis - Part Two

 

Chinese Medicine has long treated endometriosis, indeed, Chinese women had only acupuncture and herbal medicine to treat any of their menstrual disorders up until the 18^th century. Often the general diagnosis is 'Painful Menses' due to stagnation/accumulation of Blood. Significant results can often take some time, but good results should be seen fairly early into the treatments. Regular acupuncture and strong herbal medicines are necessary. For women who are trying to have a baby, separate herbal formulas and acupuncture treatments will need to be used throughout the cycle, with a focus being on clearing out stuck blood during menstruation. Some herbs used to relieve pain include:

• Chuan Lian Zi

• Yan Hu Suo

• Pu Huang

• Wu Ling Zhi

• Xiang Fu

• And two herbs specifically indicated for endometriosis are:

 

Ru Xiang and Mo Yao

 

A popular formula (specific grouping of herbs) to treat endometriosis is:

 

Gui Zhi Fu Ling Wan 

 

These herbs are combined a particular way with herbs/acupuncture that try to get to the root of the condition, which is usually related to the Kidneys, to Excess Heat or Damp Heat, or even Cold.

 

Because of the inflammatory factor, reducing foods that can irritate the immune system such ass dairy, wheat and lots of animal products can help.  Some supplements such as flaxseed oil, primrose oil, fish oil, and antioxidants can also be beneficial.  Oestrogen feeds endometriosis, so helping the body clear excess oestrogens is also helpful.  Acupuncture achieves this by stimulate points that influence the Liver (where oestrogen is metabolised).