By Juanita Jolly, Balance Complementary Medicine
A focus on Endometriosis: period pain is not normal!
Endometriosis occurs when the endometrium (cells lining the uterus) grow in other areas of the pelvic region other than the uterus, where they are influenced by the menstrual cycle. Cyclic bleeding of ectopic endometrial tissue produces lesions which, although usually within the pelvic cavity, have been found elsewhere including the lungs, CNS, kidneys, digestive tract, rectum, bladder, vagina, cervix, vulva, thigh and arm. Most frequently the involved sites are ovaries, fallopian tubes, and the external surfaces of the bladder and uterus. Fibrosis and adhesions within the area may result, and may interfere with the ovum being released.
Endometriosis is commonly associated with, although is not a strict cause of, infertility.
Endometriosis is diagnosed by laparoscopy, usually when investigating causes of pelvic pain or infertility. Pain may be severe, radiate to the buttocks and perianal region, although it develops gradually and is often asymptomatic for years. The condition is under-diagnosed and is often mistaken for dysmenorrhoea (bad period pain).
While the cause remains uncertain, retrograde menstruation, oestrogen dominance, genetic predisposition, and autoimmunity are widely accepted theories. Because ectopic endometrial implants respond to external and internal hormones, medical treatment aims to suppress oestrogen production to bring about amenorrhoea (lack of period), which halts retrograde menstruation and cause atrophy of implants/lesions.
Endometriosis is categorised as:
- Mild – Small, localised implants/lesions
- Moderate – Larger, more extensive implants; scar tissue may be present
- Severe – Large, widespread implants; extensive scar tissue
When endometriosis is confined to the muscular wall of the uterus, it is known as adenomyosis.
Aetiology / risk factors
There is no known cause of endometriosis that they know of yet however there are some theories that have been put forward which may or may not contribute including:
- Obesity or being overweight
- Elevated oestrogen levels or oestrogen activity is suspected of causing endometriosis
- Autoimmune conditions
- Studies indicate that TCDD (dioxin) and formaldehyde (environmental toxicants), alter the action of oestrogen in reproductive organs and increase the incidence of endometriosis
- Retrograde (or reflux) menstruation
- Genetic predisposition (daughters of mothers having the disorder)
Signs and symptoms
Endometriosis is asymptomatic in one-third of cases. Symptoms typically begin several years after
onset of menstruation, progress as the ectopic endometrial deposits increase, and subside after menopause.
Most common symptoms include:
- Pelvic pain cycling with menstruation, such as ovulation pain, pain during intercourse.
- Dysmenorrhoea (period pain)
- Pain with bladder/bowel function
- Intestinal pain
- Tenderness when affected areas are palpated
Naturopathic and Chinese medicine’s approach to endometriosis is to improve circulation and blood flow to the affected area, reduce inflammation and pain, and support healthy hormone metabolism. A good medical Gynaecologist is essential for both the proper diagnosis and management of endometriosis. Your Naturopathic and Chinese medicine practitioner will work together with your specialist’s treatment plan for a best of both worlds approach.
Acupuncture may provide much relief from the pain and discomfort that a woman experiences throughout the month. From a Chinese medicine perspective, endometriosis can have many causes. Acupuncture is performed once to twice a week for 3 months at different stages of the menstrual cycle. Herbal medicine, nutrients and a healthy hormone diet prescribed specifically for the patient can work on relieving, pain and supporting healthy hormone metabolism.
Diet and lifestyle
Dietary and lifestyle guidelines may assist in the management of endometriosis:
- Endometriosis is considered to be an oestrogen-dominant condition. Indole-3-carbinol is a natural compound that improves oestrogen clearance and will aid in the management of endometriosis. It can be found in foods such as broccoli, cabbage, cauliflower, and other brassicas.
- Obesity, and associated insulin resistance, may contribute to endometriosis. Healthy dietary and lifestyle modifications aiming at correcting blood glucose levels, reduce adipose tissue and spare skeletal protein reserves will improve symptoms. Fat reduction decreases the peripheral conversion of androgen to oestrone which contributes to endometrial growth.
- Eliminate all known food allergens, as reacting to foods can lead to an inflammatory response and contribute to pain. The most common allergens are dairy, wheat, citrus, corn and soy.
- Eliminate alcohol, caffeine, chocolate, refined foods, food additives, sugar, and saturated fats (fatty meats and dairy products). These foods overload the liver which is responsible for the clearance of oestrogens and are also very inflammatory.
- Avoid exogenous oestrogens found in oestrogen-fed poultry and pesticide-sprayed fruits and vegetables. Avoid plastic wherever you can; wrap your food in paper towel and then in plastic wrap if you have to as the paper towel will help reduce the absorption of plastic into food. Eat only organic poultry and produce.
- Increase intake of whole grains, fresh vegetables, essential fatty acids (cold-water fish, nuts, and seeds), and vegetable proteins (legumes such as tofu), and go for organic lean meats. Include liberal amounts of liver-supporting foods such as beets, carrots, onions, garlic, dark leafy greens, artichokes, apples and lemons.
- Reduce alcohol as much as you can and get rid of any refined sugars in the diet as these foods are very inflammatory and don’t do you any favours for pain!
- During the menstrual period have only nourishing and warming foods such as soups or stews and warm drinks or at room temperature. From a Chinese medicine perspective cold or raw food and drink can “stagnate the flow of energy in the uterus” leading to lack of circulation in the pelvic area and increased pain.
About the Author: Juanita Jolly
Juanita is the principal practitioner and clinical director. A highly qualified doctor of Traditional Chinese Medicine and a Naturopath, Juanita has undertaken extensive studies in both Naturopathic and Traditional Chinese Medicine / Acupuncture. Juanita has completed further post-graduate studies in Japanese acupuncture, TCM obstetrics, fertility support, cosmetic acupuncture, cellular health testing and specialised comprehensive health status screening.
Special interests: Complex health conditions, hormonal health, fertility (men and women), IVF support, children’s health, digestive issues/allergies, and cosmetic acupuncture.
Find out more about Juanita from Balance Complementary Medicine at www.balancemed.com.au