Endometriosis is defined as the presence of endometrial-like tissue that is found outside of the uterus. Generally the tissue will go to the ovaries, outside of the uterus, bowels and other abdominal organs. So back up- what the heck is endometrial tissue?
Endometrial tissue is simply the tissue that normally lines the uterus, to prep it for implantation of a fertilized egg. Up to 10%, or approximately 5.5 million North American women are reported to have endometriosis, although I’m quite sure this is under-reported and under-diagnosed.
Signs and Symptoms
- Extremely painful or disabling menstrual cramps- pain and cramping can occur before, during and after menstruation
- Chronic pelvic pain, including lower back pain
- Pain during or after sexual intercourse
- Painful bowel movements or urination, especially during menstruation
- Intestinal pain
- Heavy menstrual flow
- Premenstrual spotting or bleeding between menstrual periods
- Infertility (30%-40% of Endo sufferers are infertile)
- Fatigue, diarrhea, constipation, bloating or nausea, especially during the menstrual period
Causes of Endometriosis
The causes of endometriosis are largely unknown. Most of what you will see as causes are really just hypotheses that haven’t been totally confirmed yet.
Retrograde Menstrual Flow
This particular theory was created by Sampson in the 1920s. Retrograde menstruation is simply menstrual blood containing endometrial tissue flows back through the fallopian tubes and into the pelvic cavity instead of out of the body through the vagina. The cells are displaced and end of sticking themselves to the surfaces of other abdominal organs like the bowels and bladder, or even the lungs in extreme cases. These cells then thicken and bleed as endometrial cells do normally within the uterus before menstruation. This theory doesn’t totally hold up because many women will experience retrograde flow without developing endometriosis.
A second theory is that genetics play a role, making some women more susceptible to developing the disease. At this point in time, there is little evidence to further the reliability of this theory.
This is a big one- not just for endo but for many other hormonal imbalances as well. Estrogen appears to promote the growth of endometriosis, and often a good estrogen detox will drastically reduce symptoms. The estrogen builds up due to many factors, including the use of xenoestrogens. Xenoestrogens are man-made and very naughty estrogens that build up in our bodies and cause a lot of problems.
The theory that endometriosis is caused by an autoimmune problem is a relatively new theory. Autoimmunity is defined as the system of immune responses of an organism against its own cells and tissues. Any disease that results from such an aberrant immune response is termed an autoimmune disease. Endometriosis has all the specific criteria of an autoimmune disease including blood markers of inflammatory cytokines and tissue specific autoantibodies (buggers made by your body that attack your body). This particular theory in conjunction with estrogen dominance is what I see all the time with clients who have endo. It is vitally important to address both of these issues with diet, lifestyle and therapeutic supplementation in order to see results.
The first and most distressing symptoms of endometriosis for some women is pain- a lot of it. Doctors will suggest over the counter pain relievers like Advil, or may prescribe pain medications to ease painful menstrual cramps. Over- and extended-use of these medications bring on their own health problems including ulcers, other digestive problems, bleeding problems and more.
Hormonal Birth Control
This is a very normal medical “treatment” for many hormonal disorders. Most often the hormonal birth control pill will be given. Doctors use this medications to “balance” hormones and reduce symptoms. The problem here is that is does nothing to actually treat the root cause of disease, oral contraceptives merely mask symptoms until you stop the medication. Check out these great natural remedies for Endometriosis.
Surgery – Laparoscopy
If your doctor believes surgery to be necessary, this is the first means. A laparoscopy is a surgery that involves a laparoscope, or a small viewing tool that goes into the abdominal cavity through a small incision. The surgeon will use this tool along with other instruments to remove endometrial growth outside the uterus. Many women with endometriosis receive this surgery. In my practice, I have never seen a woman who received this surgery and didn’t get worse again afterwards. Many women have this surgery several times, and if relief isn’t seen, the doctor may opt for a hysterectomy. For What to Expect at a Laparoscopy, click here.
Surgery – Hysterectomy
A hysterectomy, or removal of the uterus, cervix and/or ovaries is sometimes used for extreme cases of endometriosis. Unfortunately, if the ovaries are left in tact, they will continue to produce estrogen, continuing the cycle of endo pain. For women still in their reproductive years, I highly recommend looking at all other options (natural and allopathic) before agreeing to a hysterectomy.
There are many ways the management and balancing of endometriosis can take place naturally. The following is a short list of remedies that may be helpful. For more in depth explanation of these remedies, see my post Natural Remedies for Endometriosis.
DIM, or DIINDOLYLMETHANE is a phytonutrient (plant nutrient) found in cruciferous vegetables such as cabbage and broccoli. It is also available in capsule form. DIM is very useful as it is similar to estrogen at the molecular level. The metabolism of both DIM and estrogen require almost the same steps, so DIM supports healthy estrogen metabolism and prevents the build up of excess estrogens.
Reducing inflammation as much as possible is imperative for endo management. So much of our Standard American Diet (SAD Diet) is full of inflammatory foods like grains, pasteurized dairy, sugar and food additives. These will all aggravate endo pain. Instead, consuming a diet full of fresh vegetables, gluten-free or grain-free living, no dairy, no refined sugar and lots of superfoods will decrease inflammation. More on anti-inflammatory diet for endometriosis here.
I can’t say enough about this vitamin (or any of the others, for that matter). Vitamin C decreases pelvic pain with it’s anti-oxidant action. Vitamin C will also support a healthy immune system (hello, autoimmunity!) and decreases the fragility of your capillaries (small blood vessels) and tumor growth.
This potent rhizome has been getting a lot of positive press in the last year or so. Many studies have been conducted and proven this herb’s effectiveness against a myriad of problems including systemic inflammation, cancer, immune modulation, digestive difficulty, skin problems and more. The miracle of this herb for endometriosis is its ability to support the liver in detoxification, to reduce inflammation and to support a healthy immune system.
Sometimes known as the “women’s herb” this is a fantastic hormone-balancing herb useful for many symptoms and conditions. Vitex aka Chastree Berry increasing luteinizing hormone, or the hormone that spikes around ovulation. This gives Vitex a progesterone-favouring effect. This is helpful for preventing the build up of excess estrogen in the body.
The seeds of the milk thistle plant are an excellent herbal remedy for endometriosis. Milk thistle is a well known liver tonic, and we know that excellent liver health is imperative for detoxing excess estrogen and reducing pain and inflammation. Milk thistle can be combined with other herbs in capsule, tincture or tea form.
Gladstar, R. (1993). Herbal Healing for Women. New York: Fireside.
Hobbs, C., & Keville, K. (2007). Women’s Herbs Women’s Health. Summertown: Botanica Press.
Holford, P. (2011). Balance Your Hormones. London: Piatkus.
Schauch, M. (2012). Making Sense of Women’s Health. Hillsburgh: ActNatural Corporation.
Zelman, Tompary, Raymond, Holdaway, & Mulvihill. (2010). Human Diseases: A Systemic Approach 7th ed. Upper Saddle River: Pearson.