28 Apr 2010

Shedding light on endometriosis

3 mins to read
Naturopath Siobhan Jordan explores this common gynaecological condition which affects up to 10% of women and uncovers some natural strategies to help manage this often painful and debilitating problem.


What is endometriosis and what are the symptoms?

Endometriosis is a condition in which the endometrial tissue that lines the uterus (i.e. the endometrium) grows in areas outside of the uterus. This errant endometrial tissue can grow in places such as the ovaries, the pouch of Douglas (between the rectum and uterus), the vagina, the vulva, the bladder, the bowel and the fallopian tubes. Less commonly, it may spread to areas such as the lungs or limbs.

In the same way that the endometrium (which sheds every month with your period) is responsive to hormonal changes, so is this migrant endometrial tissue. The tissue may bleed, but without an outlet to leave the body it can lead to inflammation and eventually the formation of scar tissue (which may form adhesions).

The adhesions cause pain as they connect organs and other internal structures not normally attached. Some movements, such as going to the bathroom or having sex, can become especially painful.

Symptoms and their severity vary and can include:

  • Pelvic pain which begins several days before your period
  • Pelvic pain during ovulation
  • Period pain
  • Heavy and/or irregular menstrual bleeding which can include blood clots
  • Pre-menstrual syndrome
  • Lower back pain
  • Pain during sexual intercourse
  • Diarrhoea or constipation, especially at the time of your period
  • Pelvic and/or abdominal pain outside the time of your period
  • Rectal bleeding and pain when having a bowel motion
  • Infertility, which affects 30-40% of women with endometriosis

Unsurprisingly, in the knowledge of the probability of significant pain and discomfort, women may also experience stress and anxiety in the lead up to their periods.

Remember, if you are experiencing symptoms such as intense period pain, painful sexual intercourse and pelvic pain that exacerbates during your period see your healthcare professional for assessment.

How can I manage endometriosis more naturally?

Although no permanent treatment for endometriosis exists, in conventional medicine common treatments to manage endometriosis and its symptoms include pharmaceuticals such as hormonal medications (e.g. the oral contraceptive pill), anti-inflammatories and painkillers. Surgery (e.g. to remove adhesions) is also possible.

Natural therapies, as prescribed by a health professional such as naturopath or traditional Chinese medicine (TCM) practitioner, may also play a supportive role for some women in their management of endometriosis.

For example, a recent review by Cochrane researchers found some evidence suggesting that post-surgery administration of Chinese herbs may have comparable results with fewer side effects than orthodox medications.

Acupuncture in the management of pain associated with endometriosis is also under the research spotlight.

In Western herbal medicine, a naturopath or herbalist may prescribe herbs that might assist in pain management, hormonal imbalance, have an anti-inflammatory action and/or aid menstrual flow. Prescriptions will vary depending on the individual but may include herbs such as ginger, dong quai, peony and calendula.

What causes endometriosis?

The exact causes of endometriosis are not known but possible causes include:

1. Genetic susceptibility
Genetic susceptibility may have a key role in the development of endometriosis, with some research suggesting that some individuals may carry faulty genes that allow for endometrial tissue to survive and grow outside of the endometrium.

2. Retrograde menstruation
Also known as ‘backward menstruation’, here some of the menstrual fluid flows back into the fallopian tubes and into the pelvic cavity. In women with endometriosis it is thought that the endometrial tissue in the menstrual fluid adheres to other structures such as the ovaries and starts to grow.

However, as it is thought that retrograde menstruation occurs in most women and as not all women have endometriosis, other factors must be involved.

3. Immune system irregularities
Another theory is that endometriosis is the result of a malfunctioning of the immune system, where the immune systems of women with endometriosis fail to halt the growth of endometrial tissue outside of the uterus.

Did you know?
Australian researchers have found that women who have a sister with endometriosis are 2.3 times more likely to have the condition than other women.

References available on request



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