Conditions

Endometriosis

Endometriosis is a condition in which cells of the endometrium (the lining of the uterus) are found growing in other parts of the pelvic cavity. Even though these cells are not located in the uterine lining, they continue to act as if they were, following the regular monthly cycle of becoming engorged with blood and then bleeding during the menstrual period. Since this extraneous blood has no way to leave the body, cysts form within the pelvic cavity. As the cysts grow, they may form adhesions that bind together tissue and organs that are not meant to be bound together.

Signs and Symptoms:

• Severe abdominal pain
• Severe uterine pain
• Severe lower back pain
• Abnormal/heavy bleeding during menstrual period
• Passage of clots and small pieces of tissue
• Nausea
• Vomiting
• Constipation
• Painful sexual intercourse

Diagnosis:

The following procedures are used to diagnose endometriosis:

• Medical history
• Physical examination
• Laparoscopy (essential for confirmation)
• Ultrasound/MRI to detect pelvic masses

Treatment Options:

Appropriate and early diagnosis and aggressive treatment prevent significant complications.

Traditional Treatments:

• If the pain during menstrual periods is not too severe, it can usually be managed with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen. Take these drugs with food to prevent possible stomach upset. More severe pain may require prescription medications.
• Treatment for endometriosis focuses on controlling symptoms without adversely affecting a woman's fertility. There are two principal approaches: drug therapy to suppress ovulation for up to nine months, to keep the cysts from growing and allow them to heal, or surgery to remove or destroy the lesions. There is some controversy within the medical community as to which approach should be preferred.
• A primary drug for stopping ovulation is danazol (Danocrine), which works by blocking the receptor sites for female sex hormones, so that a woman no longer experiences monthly cycles. Potential side effects include masculinizing changes (such as smaller breasts, a lowered voice, and abnormal hair growth) as well as cramping, swelling, liver problems, drying of the vagina and mood swings.
• Another class of drugs used to suppress ovulation include nafarelin (Synarel) and leuprolide (Lupron). With repeated use, these drugs "empty" the pituitary gland of the hormones that stimulate release of the sex hormones. As a result, tissues that rely on such stimulation are not signaled to function, so they become dormant. There are many possible severe side effects ­ discuss them with your doctor before taking these drugs.
• Oral contraceptives are sometimes prescribed for endometriosis, to be taken continuously, without a break each month, for up to six months.
• Surgical procedures employed to treat endometriosis include laparoscopy with either electric cautery (burning) or laser excision of the abnormal tissue. Adhesions can be a problem following any type of surgery.
• The only permanent means of stopping all signs of the disease is complete removal of both ovaries. Obviously, this kind of surgery is reserved for the most severe cases and/or women who have completed childbearing.

Complementary and Alternative Therapies:

Providing liver support is the backbone of alternative treatment of endometriosis. Enhancing the liver's ability to metabolize hormones may help restore normal hormone ratios. Endometriosis is best treated early and alternative therapies alone may not be sufficient to eradicate this condition.

Nutritional Supplementation:

• Vitamin E aids hormonal balance. Use the d-alpha-tocopherol form. Start with 400 IU daily and increase slowly to 1,000 IU daily.
  Warning: People with high blood pressure should consult their doctor before taking supplemental vitamin E. If you are taking blood thinners you should not use supplemental vitamin E.
• Vitamin K is needed for normal blood clotting. Take 200 mcg daily.
• Vitamin C decreases inflammation and supports immune function. Take 500 to 1,000 mg of vitamin-C formula that contains bioflavonoids.
• Zinc supports immune functions and enhances healing. Use zinc gluconate lozenges. Do not exceed a total of 100 mg daily from all sources.
• Selenium (200 mcg per a day) is needed for fatty acid metabolism.
• Iron supplementation may be necessary if bleeding is severe. Take only with physician's approval and take as directed by physician.
• Calcium (1,500 mg daily) and magnesium (1,000 mg daily, at bedtime) are needed for hormone metabolism and to modulate inflammation.
• Essential fatty acids (1,500 mg daily) to support hormone production and decrease inflammation.

Alternative Therapies:

• Alfalfa is a good source of vitamin K and needed minerals, including iron.
• Astragalus, garlic, goldenseal, myrrh gum, pau d'arco, and red clover have antibiotic and antitumor properties.
  Warning: Do not take goldenseal during pregnancy. If you have a history of cardiovascular disease, diabetes, or glaucoma, use goldenseal only under a doctor's supervision.
• Burdock root, dong quai, bupleurum, and red raspberry leaf help to balance hormones.
• Nettle is rich in iron.
• Butiao is a Chinese formula that is used to treat excessive uterine bleeding and ease abdominal cramping. For six months, take the equivalent of 500 mg three times daily during the two weeks before the anticipated onset of your period.
• Carthamus and persica is another excellent herbal combination used in Chinese medicine. Take 250 to 500 mg three times daily for one to two weeks following menstruation.
• Pine-bark and grape-seed extracts have natural anti-inflammatory properties. Take 50 mg of either three times daily for the tow weeks prior to the anticipated onset of your menstrual period.
• Siberian ginseng can help to revitalize hormone function and restore energy.
• See your local homeopathic practitioner for a constitutional remedy.
• Yoga positions such as the cobra, bow or cat hump can help to control the pain associated with periods.

General Recommendations:

• Regular daily exercise helps ease symptoms. Moderate low-impact exercise, such as walking and stretching, have been shown to be beneficial.
• Use sanitary pads, not tampons, which can contribute to pain and cramping.
• The use of topical natural progesterone cream can be helpful for some women with endometriosis. Discuss this with your gynecologist.
• Use a heating pad, hot water bottle, or a hot bath to help relieve pain.
• If you are taking medication for endometriosis, report any new or worsened symptoms to your doctor immediately.

Warnings:

• People with high blood pressure should consult their doctor before taking supplemental vitamin E.
• If you are taking blood thinners you should not use supplemental vitamin E.
• Do not take goldenseal during pregnancy.
• If you have a history of cardiovascular disease, diabetes, or glaucoma, use goldenseal only under a doctor's supervision.