Endometriosis
By Dr. Paulette Roscoe
Endometriosis occurs when cells from the lining of the uterus, called
the endometrium, migrate to other parts of the pelvic cavity: ovaries,
bladder, gastro-intestinal tract, the outer uterus and, occasionally,
to the lungs via the bloodstream. After the endometrial cells have transplanted
themselves, they continue to respond to the body's monthly hormonal
cycle as though they had never left the uterus. Estrogen sends a signal
to the displaced tissue to fill with blood, which is then released at
menstruation. Because the drops of blood have nowhere to go, the tissue
may become the site of excruciating pain and inflammation. These sites
are called "implants" and, though often very small -- the
size of a pin head -- they can create a disabling pelvic pain.
What causes endometriosis?
There are several factors implicated in endometriosis, and new evidence
is pointing towards environmental pollutants. One proven cause is exposure
to dioxin, an industrial chemical compound associated with pulp and
paper mills. In a study with monkeys, 79 percent developed endometriosis
after exposure to dioxin compared with 33 percent in the nonexposed
group. Endometriosis has also been linked to candida (systemic yeast
infection). And radiation is another culprit: in the 1960s, the U.S.
space programs did a study on monkeys in which 53 percent of the animals
developed endometriosis after being exposed to radiation compared with
26 percent in the test group. PCBs were linked to endometriosis and
by a 1992 German study; PCBs are common in our environment, specifically
in refrigerants. During the last century, the number of cases of endometriosis
has steadily risen as has the intensity of patients' symptoms. It is
now a major cause of pain and disability in women and may also be linked
to infertility. "The disease of endometriosis," says Mary
Lou Bullweg, founder of the Endometriosis Association, "might have
been a mild, mostly tolerable disease in the past and has become a severe
and distinctly intolerable disease with the additional effects of modern
pollutants in our bodies." What are the signs of endometriosis?
The warning signs of endometriosis are menstrual cramps that worsen
progressively over time; pain at ovulation; and severe pelvic pain a
few days before and after menstruation. The type and timing of the pain
can vary from woman to woman. The type of pain can help determine where
the endometrial spots are located. For example, painful bowel movements
during menstruation suggest the spots are in the large intestine; similarly,
painful urination during menstruation indicates the bladder. When the
ovaries are the site, there may be excessive menstrual bleeding or spotting
between periods. Symptoms tend to gradually increase as the endometriosis
grows. And what causes the pain? One theory postulates that the inflamed
tissue produces prostaglandins, a natural substance that can cause contractions
and pain. While many women have endometriosis, only some experience
pain. The only way to establish a solid diagnosis is to perform a laparoscopy:
an operation in which the surgeon inserts a small telescope into the
abdomen to look for endometrial implants and to take samples.
Conventional treatments
When symptoms are minor, no treatment is necessary. For more severe
pain, conventional medicine uses drugs and surgery. The symptoms of
endometriosis decrease during pregnancy and at menopause, so the drugs
prescribed try to mimic these bodily states. Birth control pills, progesterone
or menopause-inducing drugs are the common choices. Surgery involves
a laparoscopy to clear away implants, thus reducing pain or relieving
a blockage that causes infertility. Unfortunately, this surgery does
not always work and/or can create the painful side effect of adhesions
(scar tissue). If you decide to go the surgical route, find a surgeon
who is completely committed to removing all endometrial implants, no
matter how small; a thorough operation can take up to 4 hours.
Alternative treatments
Holistic therapies seek to establish balance throughout the entire system.
They are based on the belief that, given the right tools, the body can
heal itself. In the case of endometriosis, naturopathic care can produce
surprisingly good results. On a preventive level, avoid contact with
known toxins and radiation. For example, keep the number of X-rays you
receive to a minimum, and protect yourself from low-level radiation
sources like computer screens. Reduce your exposure to organochlorines
and dioxin -- i.e., PVC plastic solvents, pesticides, refrigerants and
close proximity to pulp and paper mills.
Diet
As always, the preferred diet focuses on whole grains, fresh vegetables
and fruits, seeds, nuts and protein from soy and fish. Reduce your dairy
and meat intake in order to avoid the different forms of estrogen and
steroids in these products.
Detoxify
There is a definite link between pollutants in the body and the severity
of endometriosis symptoms. For this reason, a detoxifying program is
very important: a 1 to 3 month regime of cleansing diet, possible fasting,
and herbs and supplements to detoxify the liver, lymph system, bowel
and kidneys. The liver is responsible for converting hormones and detoxifying
the body, so it is vital to limit all substances that impair the liver's
function, such as excess sugar, alcohol and caffeine.
Supplements
Vitamin E can help break down the excess estrogen in your body; it can
also limits the growth of adhesions and keep scar tissue soft. Gamma-linolenic
acid (GLA) helps regulate the production of prostaglandins, which is
released during times of stress and is associated with pain and inflammation;
GLA is found in evening primrose oil and flax seed oil. Vitamin B complex
helps promote the efficient metabolism of estrogen by the liver. And
vitamin C decreases stress and reduces excessive bleeding and cramps;
it is also a potent antioxidant.
Herbs
Herbs such as chasteberry, false unicorn root, crampbark and black cohash
play various roles in promoting the relief of symptoms by treating the
underlying causes. Herbs can help increase circulation to the pelvis,
thus helping drainage in the region. They also can act as hormonal balancers,
and improve liver function and digestion.
Other therapies
Progesterone in various forms can help block the body's monthly estrogen
stimulus to the endometrial implants and thus limit the growth of the
cells. The treatment is gradual: 4 to 6 months before symptoms are relieved.
Bike riding and sitz baths are two mechanical therapies that promote
drainage of the pelvic cavity. Both stationary and regular bike riding
have the direct effect of toning the muscles of the region. Sitz baths,
which involve alternating cold- and hot- water immersions, open and
close the blood vessels in the lower body. This helps drain away inflammatory
agents and bring healing nutrients to the pelvic cavity. These holistic
therapies are gentle, safe and effective, and offer considerable relief
from the pain of endometriosis.
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