endometriosis

By: Dr. Chantell Groenewald M. Tech Hom (UJ)

​What is Endometriosis?
 
Endometriosis is an oestrogen-mediated inflammatory disease that occurs when tissue that lines the inside of your uterus (endometrium) is found on other organs outside the uterus. The endometrial tissue can be limited to the pelvic cavity, most commonly involving the:

• ovaries
• lining of the pelvic cavity
• broad ligament
• uterosacral ligaments.

 
       Less commonly it may involve the:

• fallopian tubes
• small and large intestines
• ureters (tubes that transports urine from the kidneys to the bladder)
• bladder
• vagina, and
• cervix.

 
Endometrial tissue can spread beyond the pelvic organs including the lungs as well as the membranes covering the lungs and heart. This functioning extra-uterine endometrial patches responds cyclically to menstrual hormones, it thickens, breaks down and bleeds just like the endometrium lining the uterus often causing painful periods and infertility. The blood associated with the extra uterine endometrial tissue breaking down is trapped within the pelvic cavity causing:

• inflammation,
• formation of scar tissue,
• adhesions, and
• distortion of organs in the pelvic cavity.

 
 
What causes of Endometriosis?
 
The generally accepted hypothesis for the cause of endometriosis is retrograde flow of menstrual tissue through the fallopian tubes which is then inserted in ectopic sites in the pelvis and less commonly outside the pelvic cavity. An estimated 90% of woman experience retrograde flow, hence why a genetic predisposition has been postulated for the survival and growth of this ectopic endometrial tissue.
 
What are the diagnostic criteria for Endometriosis?
 
Endometriosis is diagnosed in an estimated 25-50 % of women who suffer from infertility and 75-80% of woman who suffer from chronic pelvic pain. Endometriosis can only be diagnosed through a pelvic laparoscopy (surgically inserted viewing tube into the pelvic cavity) as well as a biopsy of suspected ectopic endometrial tissue. An estimated 1-7 % of women who are asymptomatic will be diagnosed with endometriosis during unrelated pelvic surgery.
 
What are the signs and symptoms of Endometriosis?
 
The main symptom of endometriosis is chronic pelvic pain which is often worse just before and during menses. Another leading symptom is infertility, with an estimated 20-50% of infertile women being affected. Symptoms may vary depending on where the ectopic tissue has implanted, this includes:

• Painful periods (Dysmenorrhea)
• Heavy or irregular menstrual bleeding
• Spotting before periods
• Painful defecation (Dyschezia)
• Bloating, Nausea and Vomiting
• Cycles of alternating constipation and diarrhoea
• Rectal bleeding during menses
• Painful urination (Dysuria)
• Urinary frequency
• Blood in urine (Hematuria)
• Painful intercourse (Dyspareunia) often worse during menses

 
 
What are the natural treatment protocols for Endometriosis?
 
To fully understand the treatment protocols that may assist in the symptomatic treatment of endometriosis, it is important to understand that ectopic endometrial tissue responds to normal cyclical menstrual hormones. Ectopic endometrial tissue however differs from the normal endometrium lining in that it exhibits variations in gene expressions that undergoes pathological changes which is partly responsible for the pain and structural changes associated with endometriosis. One such gene expression variation explains the oestrogen dominance observed in endometriosis. Keeping this is mind, let us take a closer look at some of the natural treatment protocols for endometriosis:
 
1. Losing weight
Fat cells can act as endocrine glands and secrete oestrogen. Although these levels might not be very high it is still significant enough to raise blood levels of oestrogen, especially in obese woman. Weight loss will also assist in decreasing insulin resistance which is important for optimal ovarian function. A few tips on an effective diet program to combat endometriosis include:

• An anti-inflammatory diet is crucial considering endometriosis is an inflammatory driven disease.
• Foods high in oestrogens such as soy and commercially raised animal products should be avoided
• Inflammatory foods should be eliminated from the diet, this includes foods such as diary, wheat, processed foods, sugar etc.
• Avoid fresh produce that was not organically grown seeing as pesticides contain xenoestorgens that high jack oestrogen receptors in the body further exacerbates and oestrogen dominance.
• Include foods that combat inflammation such as omega 3 fatty acids
• Include phytoestrogens in the diet, seeing as they can bind to oestrogen receptor sites with a much weaker effect than oestrogen from the body.
• Avoid food that you may be sensitive to, as this leads to further inflammation. A food intolerance test or food allergy test is advisable. 

 
2. Detox the liver and heal your gut
The liver is responsible for metabolising oestrogen. If the liver is not functioning optimally, high levels of oestrogen will further exacerbate oestrogen dominance. There are various supplements including Chedlidonium, Taraxicum and Carduus Marianus, that may be beneficial in supporting liver function.
 
After oestrogen has been metabolised by the liver, it is excreted via the gut. Leaky gut syndrome causes an up regulation of an enzyme called B-glucuronidase which breaks up bound oestrogen to be excreted and allows these smaller particles to be re-absorbed into the system. A gut cleanse diet is essential in the healthy functioning of our hormonal system.
 
 
3. Supplements & Herbal treatment
Supplements that may be recommended by a qualified physician include:

• Chaste tree: Chaste tree may be beneficial in reducing oestrogen dominance by balancing out the oestrogen vs progesterone ratio of the menstrual cycle,
• Omega 3 fatty acid: Due to its anti-inflammatory properties,
• B vitamins: To balance hormone levels,
• Liver support: A well formulated herbal mixture to help facilitate phase 1 and 2 detoxification of the liver and support the healthy functioning of the liver,
• Indole 3 carbinol is an antioxidant that helps eliminate excess oestrogen from the body.

 
4. Homeopathy
There are several homeopathic remedies indicated for the treatment of endometriosis. The correct remedy is chosen based on each individual case. Studies suggest that a thorough case taking based on the symptom picture will lead to a similimum prescription to aid in the treatment of endometriosis.
 
5. Environmental factors
Environmental factors include toxins that have a hormone like action on the body. These xenoestrogens are used in but not limited to food production, pesticides, food packaging production and cosmetics. Here are some tips to reduce exposure to xenoestrogens:

• Choose cosmetics and toiletries that do not contain parabens
• Choose organic veggies that have not been exposed to pesticides
• Choose animal products that have been reared without any growth hormones or routine antibiotics
• Stay away from foods packaged in disposable plastic
• Rather use a glass water bottle than a plastic water bottle.

 
6. Exercise
Exercise has a dual purpose, it helps to reduce excess cortisol and assists in weight loss. Both have hugely beneficial effects in reducing oestrogen dominance.

Endometriosis can have little to no symptoms in some women while the disease can have debilitating effects in others. Infertility, subfertility and chronic pelvic pain being the leading symptoms of the disease. Studies have shown women who suffer from endometriosis are at a higher risk of developing cancer, specifically ovarian cancer. This is a disease that responds well to natural and alternative treatment. You are the first step to a healthier you.
 
“Our food should be our medicine and our medicine should be our food.” Hippocrates