Endometriosis is a painful condition in which uterine tissue from the uterus attaches itself to other organs. The uterine tissue may appear in the fallopian tubes or the ovaries, or it may implant itself on the outer walls of the uterus itself. In rare cases, the tissue travels outside the pelvic region and appears in organs like the bladder, the lungs, and other areas.
These masses of tissue can be painful, in and of themselves, but to make matters worse, they continue to behave as if they’re inside the uterus. They continue to ﬁll up with blood over the course of the menstrual cycle, and every month, they shed blood just as the uterus does. Unlike normal menstrual blood, which leaves the body through the vagina, the blood from the abnormal growth has nowhere to go. Instead, it accumulates inside the pelvic cavity, where it often forms cysts. As menstrual cycles repeat themselves and the tissue continues to bleed each month, the cysts may grow so large that they bind organs together. Sometimes a cyst ruptures and leads to ago- nizing pain. Two out of three women have endometrial growth on the ovaries.
Pain in the pelvis and the lower back is the deﬁning characteristic of endometrio- sis. The pain usually varies with the menstrual cycle and is at its worst during
ovulation, menstruation, or sexual intercourse; sometimes it is so intense as to be inca- pacitating. A woman with endometriosis may experience heavy or prolonged men- strual bleeding, and this loss of blood can lead to anemia. Digestive problems are common in cases of endometriosis, as is nausea and vomiting. There is a strong con- nection between endometriosis and infertility, although it is unknown whether the excess tissue actually prevents conception, or if infertility somehow creates conditions hospitable to endometriosis.
No one knows for sure what causes endometrial tissue to leave the uterus and travel to other parts of the body. One prevailing theory is that the disorder is caused by ret- rograde menstruation, in which menstrual fluid fails to exit the body properly. Instead, some of the endometrial lining that is normally shed during menstruation backs up in the fallopian tubes and enters the pelvic cavity, where the tissue deposits itself and begins to grow. It is also possible that endometrial cells travel to the pelvic cavity via the bloodstream or the lymphatic system. Others believe that endometrio- sis is caused when the body is still an embryo. In a normal fetus, the cells that are meant to form the uterus differentiate themselves from others and begin to travel to the appropriate site. But according to this theory, the endometrial cells of some fetuses don’t make the trip and end up in the wrong places. It is also thought that environ- mental estrogens may be a causative factor. These xenoestrogens are endocrine dis- rupters that have estrogenic effects in the body. This category of environmental estrogens includes plastics, detergents, household cleaners, pesticides, herbicides, and hormones found in meat products. In addition, studies have shown immune system imbalance to be a factor. Speciﬁcally, women with endometriosis have higher levels of antibodies that target their own ovaries and endometrial tissue. They also tend to have lower activity of the natural killer cells that usually keep abnormal cells in check. No matter what the cause, it does appear that all cases of endometriosis are linked to hormonal balance and that elevated estrogen levels are a problem.
It is important that liver function be optimized in women with endometriosis. The liver is responsible for breaking down estrogen (and other hormones) and secreting the metabolites into the large intestine for elimination. If the liver does not metabo- lize estrogen and its metabolites properly, they are recycled throughout the body.
While the liver is the dominant player in estrogen metabolism, the ﬂora or “friendly bacteria” in the large intestine are also important in estrogen metabolism. They pre- vent the reactivation and the recycling of these unwanted estrogens. Conversely, “unfriendly bacteria” secrete an enzyme called beta-glucuronidase that causes estro- gen to be recycled back through the body via the large intestine. A low-ﬁber and high- fat intake increases the activity of this enzyme.
While endometriosis is not a simple condition to treat, natural therapies often lead to signiﬁcant improvement. The complementary treatments described here focus on regulating hormones and balancing the immune system and also suggest ways to pro- vide gentle relief of pain and other symptoms.
• Pain in the abdomen and the lower back, associated with menses
• Pain with sexual intercourse
• Prolonged or excessive menstrual bleeding
• Digestive problems
• Nausea and vomiting
• Pain with urination and bowel movements
• Retrograde menstruation
• Endometrial cells that travel through the bloodstream or the lymphatic system
• A genetic defect
• Hormonal imbalance (relatively
high estrogen and low proges- terone), due to poor liver function, diet, xenoestrogens, or ovulatory dysfunction
• Imbalanced immune system
• Flora imbalance (dysbiosis)
The following tests help assess possible reasons for endometriosis: Immune system imbalance—blood
Hormone testing (especially for estrogen and progesterone)—saliva, blood, or urine
Digestive function (particularly, ﬂora balance and beta-glucuronidase activity)—stool analysis
Food and environmental allergies/sensitivities—blood, electrodermal
It is important to eat certiﬁed organic foods as much as possible, due to the estrogenic
effects of pesticides, herbicides, and hormone-laden meats.
Whole grains, beans, and vegetables should form the basis of your diet. All these foods are high in ﬁber and will help to balance the friendly bacteria involved with estrogen metabolism.
Eat plenty of cold-water ﬁsh like salmon, tuna, and mackerel. These ﬁsh are good sources of essential fatty acids (EFAs), substances that reduce inﬂammation and pain. For additional EFAs, add 2 tablespoons of ﬂaxseeds to your daily protocol, along with
10 ounces of water. Flaxseeds have been shown to help balance estrogen levels.
Eat fruits and vegetables, such as apples, cherries, broccoli, cauliﬂower, and brus- sels sprouts. They contain the phytochemical indole-3-carbinol, which supports the liver’s detoxiﬁcation of estrogen.
Regularly consume beets, carrots, artichokes, dandelion greens, onions, and garlic, as these foods stimulate liver detoxiﬁcation.
Eat organic cultured yogurt to increase the levels of friendly ﬂora in the large intestine.
Once a day, have a green drink to support detoxiﬁcation.
Drink a glass of clean water every two to three waking hours to support detoxiﬁcation.
Food to Avoid
Avoid red meat and dairy products, all of which contain high levels of dioxins that act as environmental estrogens.
Caffeine consumption appears to be a risk factor for endometriosis. According to researchers at the Harvard School of Public Health, women who con- sume 5 to 7 grams of caffeine a month had a signiﬁcantly
greater incidence of endometriosis. This is equivalent to about 2 cups of coffee a day.
To keep pain under control, stay away from inﬂammatory substances like sugar, caffeine, and alcohol.
Don’t eat anything that depresses your immune system. Processed foods, fried food, reﬁned sugar, and alcohol all limit your body’s ability to ﬁght your disorder.
Super Seven Prescriptions—Endometriosis
Super Prescription #1 Natural progesterone
This balances out estrogen, regulates the menses, and relieves pain. Apply 1⁄4 tea- spoon (20 mg) to your skin twice daily from days 6 to 26 of your cycle (stopping during the week of your menstrual ﬂow. It is best used under the care of a health- care professional.
Super Prescription #2 Vitex (chasteberry)
Vitex balances the estrogen/progesterone ratio. Take 160 to 240 mg of a 0.6 per- cent aucubin standardized extract or 80 drops daily. Do not use Vitex if you are cur- rently taking the birth control pill.
Super Prescription #3 Indole-3 carbinol
Take 300 mg daily. It assists the liver in estrogen detoxiﬁcation.
Super Prescription #4 Dandelion root (Taraxacum ofﬁcinale)
Take 300 to 500 mg in capsule form or 1 ml of tincture with each meal (three times daily). It improves liver detoxiﬁcation.
Super Prescription #5 Vitamin E
Take 400 IU twice daily. It helps with estrogen metabolism and inﬂammation.
Super Prescription #6 Essential fatty acids
Take a daily combination of ﬂaxseed (1 to 2 tablespoons) or ﬁsh oil (3,000 to 5,000 mg), along with gamma linoleic acid (GLA) from evening primrose oil or borage oil at a dose of 300 mg. These essential fatty acids decrease inﬂammation.
Super Prescription #7 D-glucarate
Take 500 mg daily. This phytochemical assists the liver in estrogen breakdown.
B-complex vitamins are involved in estrogen metabolism. Take a 50 mg complex twice daily.
A high-potency multivitamin supplies many of the nutrients required for hormone metabolism. Take as directed on the container.
Vitamin C improves autoimmunity. Work up to 6 grams daily. Reduce the dosage if diarrhea occurs.
Motherwort (Leonurus cardiaca) is a good herb to use for acute uterine pain. Take
5 ml three times daily.
Red raspberry (Rubus idaeus) is an astringent herb that may help uterine inﬂam- mation and pain. Drink it as a tea, three cups daily.
If you have heavy menstrual bleeding, take nettle (Urtica dioica), a blood- building herb, to prevent anemia. Begin using the herb after the last day of your men- strual cycle, and take 500 mg two or three times daily for two weeks. Women with severe endometriosis often ﬁnd that the pain keeps them up at night. If you need to get to sleep, try tea made with skullcap (Scutellaria lateriﬂora), passionﬂower (Pas- siﬂora incarnata), or valerian (Valeriana ofﬁcinalis).
Many sufferers report long-lasting results from constitutional homeopathic remedies, so it is highly recommended that you see a licensed professional for an individual assessment and remedy. For immediate relief of pain or other symptoms, use one of the following remedies, as appropriate. Take a 6x, 12x, 6C, or 30C potency twice daily for two weeks to see if there are any positive results. After you notice improvement, stop taking the remedy, unless symptoms return.
Arnica (Arnica montana) is for a deep, bruising pain.
Colocynthis will reduce cramping pain in the lower abdominal. The person feels better with pressure on the abdomen and when lying with the knees drawn up.
Dioscorea Villosa is for uterine pain that radiates out from the uterus. The woman arches her back with the pain and feels better standing up and worse lying down.
Cimicifuga Racemosa is for severe menstrual pain that gets worse as the ﬂow increases. There are shooting and cramping pains that radiate across the pelvis or into the thighs.
Lachesis is helpful for menstrual pain and large, purplish clots. The woman feels warm and jealous.
Magnesia Phosphorica is for pelvic pain, cramping, and bloating that feel better when heat is applied. The woman feels worse in the cold air or when the painful area is touched.
Pulsatilla (Pulsatilla pratensis) is for menstrual pain when the pain is changeable. The woman feels weepy and better when comforted and has a strong craving for sweets.
Sepia is for hormone imbalance, where the woman feels irritable, has pain with intercourse, and craves sweets, as well as salty and/or sour foods.
• Large Intestine 4 is a powerful point for relief of pain anywhere in the body.
Although it can’t cure endometriosis, a massage of the belly and the lower back is an effective means of easing an acute attack of pain. Find a massage therapist whom you like and trust; if ﬂare-ups occur at a predictable point in your cycle, you may want to make a standing appointment for treatment.
Work the areas corresponding to the uterus, the fallopian tubes, and the ovaries.
A hot bath can help relieve digestive problems, as well as pain. Depending on your particular needs, you can add any of the essential oils listed under Aromatherapy in this section for additional potency.
Other Bodywork Recommendations
When you feel an acute episode of pain coming on, lie down and rest, with a hot com- press on the affected area.
One study found that auricular (ear) acupuncture was as effective as hor- mone therapy in treat- ing infertility due to endometriosis.
Acupuncture is highly recommended to help reduce the pain associated with endometriosis. In addition, Chinese herbal therapy from a qualiﬁed practitioner can be very helpful.
To relieve general endometrial pain not caused by a digestive problem, use rosemary or marjoram. Both of these herbs have a pleasant warming effect on the body. Add either of the oils to a bath, or dilute them in a carrier oil and use in an abdominal massage.
If you’re constipated, black pepper can revive your digestive system.
For stomach cramps caused by diarrhea or other gastrointestinal problems, use neroli or chamomile to relax your muscles.
Many women with endometriosis come to dread sexual intercourse, as it often pro- vokes severe pain. A few drops of ylang ylang or patchouli in a bath or a massage oil can help you relax, both emotionally and physically. (You may want to try different sexual positions until you ﬁnd one that’s most comfortable for you. But if sex con- tinues to hurt, stop. Never force yourself—you’ll only cause greater problems for you and your partner in the long run.)
Lavender encourages a good night’s sleep. You can use this oil in any preparation you like; many people place a sachet ﬁlled with the dried ﬂowers under their pillows.
People who suffer from chronic pain live with constant stress—more than their friends and family realize. Stress, too, can contribute to painful flare-ups. If you have endometriosis, it’s important that you devote time every day to managing the tension that accompanies a chronic illness.
General Stress-Reduction Therapies
Yoga is an excellent stress reliever, and the gentle motions will also contribute to pain relief.
Pilates offers a gentle way to stretch and reduce stress.
One of the best ways to handle pain is to so thoroughly engage your mind that you’re distracted from the bodily agony. Find a hobby or an activity you like, such as cooking or singing in a choir, and participate in it regularly. Some people ﬁnd that writ- ing in a journal can distract them for hours.
Bach Flower Remedies
Select the appropriate remedy, and place 10 drops of the liquid under your tongue. Hold the drops in place for thirty seconds and swallow. Use as often as needed.
If you are overwhelmed by fatigue, take Hornbeam. Holly will reduce anxiety and anger.
• Moderate exercise is a natural pain reliever. Try to take a walk every morning, or ﬁnd some other activity you like well enough to perform regularly.
• Use sanitary napkins instead of tampons. Tampons may encourage retrograde menstruation.