Endometriosis – the facts and a multidimensional approach

This article will focus on endometriosis and how this insidious disease negatively impacts the lives of millions of women world-wide. Many aspects of the condition will be discussed, including symptoms and possible causes, with conventional treatment options.  Given the complexity of the disease, and the difficulty many have in reducing symptoms and healing the disorder, I feel it is essential to offer holistic advice which could benefit the patient, which will include lifestyle and dietary changes which could help, in addition, homeopathic remedies, which have been seen to dramatically improve the condition in many patients.  As always, an integrated approach to treatment may be beneficial.

Over the last few days, the devastating impact the gynaecological condition endometriosis is having on the lives of thousands of women in the UK has been revealed; it affects over 1.5 million women in the UK. Awareness is being raised, following a research study conducted by the BBC, having consulted more than 13,500 women, and the debilitating effect it is having on their education, career, sex life, and mental health, with around half stating they have experienced suicidal thoughts.  Described by suffers as: ‘A bursting of darkness that stops you in your tracks, excruciating pain, irregular bleeding, pain ‘like hot knives stabbing through me, like fireworks going off inside me, like something twisting and stretching and taking over me.’ ‘Pain is like barbed wire wrapped around your insides and someone’s pulling it while at the same time an animal is trying to eat its way through you.’ Unimaginable pain, therefore, which has to be seriously acknowledged and effectively treated.

There is a huge call to address the situation with the diagnosis time an unacceptable 7.5 years on average. Clearly, given the devastating impact on physical and emotional health, this must be dramatically reduced.  Minister for Women’s Health Caroline Dinenage said: ‘Too often across society women’s bodies are seen as an inconvenience, with their symptoms and health concerns not taken seriously enough. Thankfully, awareness of endometriosis and other painful and debilitating menstrual conditions is increasing – but there is still a long way to go.’ (Endometriosis UK:2019.)

What is it?

Endometriosis is an often-painfuldisorder in which tissue that normally lines the inside of the uterus — the endometrium — grows outside the uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs. Withendometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. (Mayo clinic)

Symptoms

The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that’s far worse than usual. Pain also may increase over time.

Common signs and symptoms of endometriosis include:

  • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
  • Pain with intercourse. Pain during or after sex is common with endometriosis.
  • Pain with bowel movements or urination. You’re most likely to experience these symptoms during a menstrual period.
  • Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
  • Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.

Other signs and symptoms.arefatigue, diarrhoea, constipation, bloating or nausea, especially during menstrual periods.(Mayo Clinic)

Risk factors

Several factors place you at greater risk of developing endometriosis, such as:

  • Never giving birth
  • Starting your period at an early age
  • Going through menopause at an older age
  • Short menstrual cycles — for instance, less than 27 days
  • Heavy menstrual periods that last longer than seven days
  • Having higher levels of oestrogen in your body or a greater lifetime exposure to oestrogen your body produces
  • Low body mass index
  • One or more relatives (mother, aunt or sister) with endometriosis
  • Any medical condition that prevents the normal passage of menstrual flow out of the body

(Mayo Clinic)

Conventional Treatment

Conventional options include pain medication, hormone therapy, including hormonal contraceptives, gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, progestin therapy, aromatase inhibitors, surgery. For in-depth details on all of these options please refer to Mayo Clinic website.

The homeopathic and holistic approach

Treatment, as ever, from a homeopathic and holistic point of view, would focus on the whole person and their unique symptoms. A full case would be taken which would involve everything, physical and emotional concerning the patient, and what is ‘peculiar’ to their individual experience. A constitutional remedy would be given. (This is a remedy which covers the person, in their totality.) Sometimes, other remedies will be given to cover the acute phase of the illness. Progress will be monitored on a regular basis.  There are many remedies with an affinity to the female reproductive system, but they would have to fit the presentation of the presenting symptoms, there is no one size fits all. For example, in cases where fertility is impaired remedies such as oophorinum and folliculinum have been seen to encourage ovulation, with successful outcome. (British Homeopathic Association: 2001) Other remedies seen to be effective, (both locally and constitutionally) in specific cases following an audit were, apis, for pelvic pain, candida 30c, carcinosin for one woman who had a strong family history of cancer, lachesis, pulsatilla, sepia, sulphur, nux vomica and calcarea carbonica. In addition, cimicifuga, an interesting symptom of which is ‘the more the flow, the greater the pain’ has also seen to be effective in these circumstances. (British Homeopathic Association: 2006) Homeopathy, using potentised oestrogen has also proven to be effective in reducing endometriosis induced pelvic pain, according to a double blind, placebo control study: (Homeopathy for endometriosis pain:2017)

Lifestyle advice

The Royal College of Obstetricians & Gynaecologist guidelines for the ‘Investigations and Management of Endometriosis (2006) state: ‘Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies’ (Royal college of obstetricians and gynaecologists:2006.)

General lifestyle changes should involve reducing stress and simplifying day to day existence as far as possible. Incorporate gentle exercise, and time to yourself, however making sure you integrate with friends, laugh and play, this is not just the premise of children! This also applies to crying, should you feel you need to. Try not to let the illness define you; you are not a label, you are unique, and so is your presentation of this condition, which is why it important for your healthcare provider to listen to your concerns, both emotional and physical. We are not a collection of parts, we are thoughts, feelings, emotions, which more often than not, affect our physical body.

To help reduce pain and inflammation and oxidative damage, diet, supplements and physical therapies can be incorporated. It is found that a holistic, body-system-based functional medicine approach to healing the root causes of endometriosis to be the most effective in reducing pain and unhealthy tissue, and healing damage. Unlike a pharmaceutical or surgical approach, this is a long-term, sustainable approach and includes reducing inflammation and oxidative damage (the tissue damage caused by chronic inflammation), supporting healthy hormone levels, and improving the body’s natural detoxification processes—through diet, supplements, and physical therapies.

Dr Aviva Rom, midwife and MD, (https://avivaromm.com/about/) uses the following anti-inflammatories supplements, to treat her patients:

  • Curcumin (an extract from turmeric, also a great antioxidant)—1200-2400 mg/day
  • Bromelain (an enzyme from pineapple)—200-800 mg/day
  • Quercetin (an extract from apples, onions, and omega 3 fats from fish oil)—250 mg three times/day
  • Omega 3 fats from fish oil (a DHA and EPA combination)

She then recommends a combination of these antioxidants to help prevent and reverse local tissue damage from inflammation:

  • N-acetylcysteine (NAC)—600 mg three times/day
  • Pine bark (pycnogenol)—30 mg twice/day
  • Green tea (ECGC)—up to 300 mg three times/day

As an experienced expert in this field, she also suggests that a diet that is anti-inflammatory and low in toxins is essential, which could involve removing known triggers such as dairy produce, gluten, corn, sugar and possibly red meat, opting rather for chicken or fish, which tends overall, to be less of a cause of inflammation in those with endometriosis.  but again, check if these are applicable to you first by consulting an allergy specialist or nutritionist. Caffeine may add to endometriosis symptoms in some women, so if you’re drinking coffee each day, try a couple of months without it. Green tea is a good antioxidant-rich alternative if you just must have some caffeine. (https://goop.com/wellness/sexual-health/a-guide-to-understanding-and-holistically-treating-endometriosis/)

To conclude, I would suggest a multimodality, individualised approach to treatment, which could include all of what has been mentioned above, certainly any therapeutic method which improves the physical and emotional health of the patient. It is also essential that a woman be listened to and nurtured, her concerns discussed and not dismissed. I also feel it is essential that education and training for those in the medical sphere should be improved for this condition, given that it is often missed, and dismissed, for more than seven years, on average. Training in complementary therapies to help support the complexities included in the diagnosis, where clearly the strict drug approach is inadequate is necessary, failing this, appropriate referrals. Quality of life could be vastly improved for those afflicted by adopting this approach and clearly that is a wonderful step forward.

To contact a homeopath in your area, please visit www.findahomeopath.org

Gill Graham

www.consultanthomeopath.com

References

British Homeopathic Association, (2001): Endometriosis[on-line] Available at:  https://www.britishhomeopathic.org/charity/how-we-can-help/articles/womens-health/endometriosis-2/

British Homeopathic Association, (2006 )Endometriosis:[on-line] Available at:  https://www.britishhomeopathic.org/charity/how-we-can-help/articles/conditions/e/endometriosis-3/

Contemporary Obgyn, (2017) [on-line] Available at: Homeopathy for endometriosis pain: https://www.contemporaryobgyn.net/endometriosis/homeopathy-endometriosis-pain

Endometriosis UK, (2019) [on-line] Available at:https://www.endometriosis-uk.org/news/bbc-research-announced-today-wake-call-provide-better-care-15-million-endometriosis-37606#.XZuml-dKhn0

Mayo Clinic. Endometriosis.[on-line] Available at:   https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

Royal college of obstetricians and gynaecologists (2006) The investigation and management of endometriosis[on-line] Available at:  https://www.pelvicpain.org.uk/wp-content/uploads/2018/03/InvestigationEndometriosis2006-guidelines.pdf

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