“Endometriosis? Oh that’s just a painful period isn’t it?” So commonly women with endometriosis are snubbed off as their condition just being a menstrual issue and told to take some painkillers, and that is once they have been given a diagnosis. For the average woman with endometriosis, it will take 10 years for a diagnosis to be given. In the meant time, these women are suffering from so much more than just painful, heavy periods.
Endometriosis is a whole body inflammatory, autoimmune condition.
What is endometriosis
Endometriosis is so much more than just heavy and painful periods. It is a condition in which endometrial tissue (that should be lining the uterus) grows outside the uterus, commonly on the ovaries, bowel, pelvic ligaments, bladder and endometrial tissue has even been found in patient’s lungs. Because oestrogen promotes the growth of endometrial tissue, symptoms will often fluctuate within a women’s menstrual cycle, however, it is important to notes oestrogen is not the cause, it just aggravates and drives the condition.
Symptoms may include
- Painful periods and abdominal, back or pelvic pain without menstruation and during sex.
- Ovulation pain
- Heavy menstrual bleeds, with or without clots, or longer bleeds lasting up to a week.
- A dragging, heavy feeling in bottom and thighs
- Abdominal bloating and IBS, in fact often women have been given a diagnosis of IBS before an endometriosis diagnosis
- Headaches around menstruation
- Depression and/or anxiety (often driven by inflammation in the body)
- Fatigue, particularly around the period
Sometimes women experience no pain or heavy bleeds, and this is really important to note as this condition is so under diagnosed.
Current treatment options for women are surgery or hormonal birth control. If a woman’s symptoms are bad enough, this may even involve a hysterectomy.
However, endometriosis is not a hormonal condition. Therefore, these treatment options have limited therapy as hormonal birth control is only masking the issue by suppressing endometrial growth, and surgery is just removing the tissue but not addressing the cause of endometriosis.
To treat endometriosis effectively we need to start seeing it as an autoimmune inflammatory condition.
An autoimmune and inflammatory disease is a group of conditions that are characterised by loss of tolerance to our self, and therefore the body’s own immune cells drive tissue destruction. This can be seen in Hashimoto’s thyroid disease, rheumatoid arthritis and Crohn’s disease. In endometriosis, there is an increase in inflammatory immune markers, and anti-endometrial and anti-ovary antibodies have been found, that can drive the endometrial tissue inflammation.
Causes of autoimmune inflammatory conditions usually have a genetic factor, and then these genes are switched on, by bacterial and viral infections such as Epstein-Barr virus (EBV), gut and parasite infections, stress and/ or emotional trauma, and potential dietary triggers. Endometriosis is no different, with bacterial infections commonly found in women suffering from endometriosis, and I have clinically found there has usually has been a past history of stress or trauma in the woman’s life.
So, for women with endometriosis rather than just be posed with surgery and hormonal control, we need to be looking at finding the drivers of their immune activation and the treatment for these.
Drivers of and treatment for endometriosis can include one or more of the following:
- Find and treat their bacterial and/ or viral infections- common infections n endometriosis are EBV, Small intestinal bacterial overgrowth (SIBO), along with E.coli, Enterococcus, Streptococcus and Staphylococcus amongst others. Treatment could be conventional antibiotics or herbal antibacterial, antimicrobials and antivirals along with specific probiotic strains. This needs to be followed by gut healing once the infection has been eradicated.
- Reducing dietary triggers- Dairy, Gluten and refined sugars have been found to increase inflammation in the body, and often the removal of these foods can make a huge difference in a woman’s pain within a couple of months of removing them from the diet.
- Reducing inflammation and calming the immune system. Fantastic nutrients and herbs for this include turmeric, NAC, green tea extract and quercetin
- Balancing hormones by reducing excess oestrogen and increasing progesterone- while I have mentioned above oestrogen is not the cause of endometriosis excessive amounts can worsen symptoms. Liver detoxification can reduce excess oestrogen, as well as increasing progesterone, through herbs such as peony and chaste tree, or even natural progesterone cream.
- If stress or emotional trauma is an issue for you, speaking with a psychologist or counsellor may be important for your healing. Or energetic healing such as kinesiology or reiki may also be helpful.
Other treatment strategies to consider are:
- Eating a whole foods, anti-inflammatory diet – filled with at least 7-9 cups of vegetables per day with gluten-free grains such as quinoa and buckwheat, and starchy vegetables for carbohydrates and lean protein with essential fats such as chicken, fish, beans nuts and seeds. Include lots of warming spices such as turmeric, ginger and cinnamon for moving pelvic congestion and antioxidants.
- Remove or reduce alcohol- as it inflames the body, as well as increasing oestrogen in the body by impairing metabolism and increasing histamine.
- Magnesium and zinc, as these are beneficial for oestrogen detox, reducing pain and supporting the nervous system.
- Herbs such as withania, passionflower, and rhodiola can also be helpful if a woman is very stressed.
- It is important to note that many women with endometriosis are iron deficient, however, iron can make some viral and bacterial infections worse, so always speak to your naturopath first before taking as with all of the above recommendations.
- Work with an integrative health team- the above strategies do not need to be used in isolation from the medical system. These can be combined together for the benefit of your health. Most of the my patients with endometriosis will have surgery, but combined with dietary and supplement strategies above, they have the benefit of both worlds.
Bianco, B., Andre, G.M., Vilarino, F.L., Peluso, C., Mafra, F.A., Christofolini, D.M., & Barbosa, C.P. 2012. Human Immunology, 73 (3): 306-15. doi: 10.1016/j.humimm.2011.12.009
Eisenberg, V.H., Zolti, M., Soriano, D. 2012. Is there an association between autoimmunity endometriosis? Autoimmunity Review, 11 (11): 806-14. doi: 10.1016/j.autrev.2012.01.005
Morenon, I., Franasiak, J.M. 2017. Endometrial microbiota- a new player in town. Fertility and Sterility, 108 (1): 32-39. doi: 10.1016/j.fertnstert.2017.05.034.
Are you suffering from heavy and or painful periods? Or maybe you are experiencing headaches around your menstruation with bloating, fatigue, anxiety and just generally feeling unwell.
Tess is a highly skilled naturopath in women's health and natural fertility. She uses her skills and knowledge in blood pathology interpretation, nutrition, herbal medicine, mind and body therapies for an integrative approach to your health. She is passionate about finding the root cause of her patient's symptoms and for individualised treatment. She is available for consultations in person or through Skype anywhere in Australia.
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