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DESCRIPTION
Endometriosis is a chronic, progressive disorder in which tissue (cells) resembling the inner lining of the uterus (endometrium) grows and appears at unusual locations in the lower abdominal cavity. This tissue may be found on the outer surface of the uterus, the ovary surfaces; fallopian tubes; on the intestinal wall and bowel; the urinary bladder; the pelvic floor; and/or the peritoneum (the membrane that lines the walls of the abdominal cavity); and within the uterine musculature. The most common site of endometriosis is believed to be the deep pelvic peritoneal cavity, or the cul-de-sac behind the uterus low in the pelvic cavity; and rarely, at other sites far away. The presence of endometrial implants outside the pelvic area is uncommon.
The 4 stages (classification) of endometriosis (minimal, mild, moderate or severe) are used to describe the anatomic location and the severity of the disorder. Endometriosis can affect females between puberty and menopause, but is most common between ages 20 and 30, but occurs primarily between the ages of 25 and 40 when estrogen accumulates at its highest levels. Curiously, European women rarely get it.
WHAT HAPPENS...
During the normal menstrual cycle, a continually changing hormonal environment stimulates the endometrium to grow in preparation for a possible pregnancy. This same cycle causes a follicle within one of the ovaries to ripen, and an egg is released. Finger-like tissues on the fallopian tube grasps the egg, and the tiny, hair-like cilia inside the tube transport it toward the uterus, the lining of which is now spongy and well supplied with blood. If the egg is not fertilized within 24 hours or so of being released, the uterine lining proceeds to "die" and to be sloughed off, and to pass through the vagina during the menses.
Though not inside the uterus, the abdominal implants of endometriosis also respond to the hormonal changes controlling the menstruation. Like the uterine lining, these fragments build tissue each month, then break down and bleed, which causes scar tissue to form around the site. Unlike blood from the uterine lining, however, blood from the implants has no way to leave the body. Instead, it must be absorbed by surrounding tissue, which is a comparatively slow process. In the meantime, the blood accumulates in body cavities. The entire sequence, from bleeding through absorption, can be painful.
As the menstrual cycle recurs month after month, the implants may get bigger. They may seed new implants and form localized scar tissue and adhesions - scar tissue that attaches to pelvic organs and binds them together. This contributes to the pain of endometriosis, and it can cause extreme pain in a subsequent pregnancy, as the uterus enlarges and the organs within the abdomen are pushed into different positions. Sometimes a collection of blood called a sac or cyst forms. Endometrial or "chocolate" cysts are common on the ovaries. These are usually found to contain moderate amounts of oxidized blood, which looks something like chocolate syrup. If a cyst ruptures, it can cause excruciating pain.
Because endometriosis depends on hormonal cycles, and pregnancy temporarily interrupts those cycles, many women find their symptoms improve during pregnancy. In some cases, the improvement may be permanent, presumably because the break from cycles of growth, bleeding, and scarring finally allows the implants to heal and be shed. In other cases, however, the relief is only temporary, and once the hormonal cycles return to normal, the symptoms of endometriosis recur.
An estimated 5 to 7 million (about 10 percent) American women suffer from endometriosis. Endometriosis usually affects women during their reproductive years and is a common cause of infertility. Many of these women do not seek medical attention because their symptoms are mistaken for normal menstrual discomfort. Many women who develop endometriosis have a greater history of yeast infections, hay fever, eczema, and food sensitivities.
Endometrial growths are usually benign (not cancerous), yet it is believed that women with endometriosis are at greater risk of developing breast cancer, melanoma, lymphoma and ovarian cancer.
FREQUENT SIGNS & SYMPTOMS
These symptoms vary widely from woman to woman. Some experience little to no pain, while others suffer excruciating pain in the pelvic region. Severity of pain is usually tied to the size and location of the lesions, which can continue to develop and seed new growths. Lesions may attach to multiple organs, pulling them together and causing even more pain, especially during pregnancy. The following symptoms may begin abruptly or develop over many years:
- Increased pelvic pain during menstrual periods, especially the last days, or the pelvic pain may occur at anytime. The pain can be incapacitating in the uterus, lower back, and organs in the pelvic cavity prior to and during the menses. Intermittent pain can be present throughout the menstrual cycle.
- Pain with sexual intercourse. Blood following intercourse.
- Cysts may form on the ovaries which contain oxidized (decomposed) blood. As these cysts rupture they cause excruciating pain.
- Pre-menstrual spotting. Excessive bleeding, including the passage of large clots and shreds of tissue during the menses.
- Nausea, vomiting, and constipation during the menses.
- Blood in the urine.
- Iron deficiency anemia is common. Women with cycles shorter than 27 days and those with periods lasting over a week are at increased risk of anemia.
- Back pain.
- Pain with intestinal contractions.
- Blood in the stool (sometimes). Bowel inflammation from scarring.
- Intestinal gas.
- Sometimes depression and insomnia.
- Infertility. Most women who have Endometriosis have never been pregnant, and as many as 40 percent of women with infertility problems have endometriosis.
- Vulnerability to endometriosis seems to run in families; the condition often passes from mother to daughter.
- Endometriosis is exacerbated (made worse) by anything that irritates the uterus, such as pelvic infection, constipation, uterine fibroids or cancer, or the presence of an IUD or a tampon. Even ingesting caffeine, alcohol or fried foods increase the problem.
CAUSES
The actual cause for endometriosis is unknown, but the following theory is most accepted among medical professionals.
The Reflux Menstruation Theory:This theory was developed by John Sampson, M.D. in 1920.
Normally during ovulation, the uterus lining thickens to prepare for implantation of a fertilized egg. If this does not occur, the lining tissue peels away from the uterus and is expelled in the menstrual flow.
According to this theory, in some cases, this material (the menstrual fluid) builds up and passes backward into and out of the fallopian tubes into the pelvic (peritoneal) cavity. Here it floats freely and the endometrial cells attaches and implants themselves to other tissues and grows.
The transplanted tissue reacts each month as if it were still in the uterus, thickening and peeling away. New bits of peeled-off tissue create new implants. The growing endometrial tissue between pelvic organs may cause them to adhere together, producing pain and other symptoms.
While this theory offers an answer to the question of what causes endometriosis, it has never been proved.
Another popular theory states that endometriosis is caused when endometrial cells spread to other parts of the body through blood and lymphatic channels.
Still another theory postulates that endometriosis is in effect a congenital condition. See An Alternative Theory & Treatment for Endometriosis for more information.
Despite disagreement over the cause, more is known today about this condition than ever before. Once labeled the "working woman's disease," endometriosis is now known to affect 12 million American women - approximately 10 percent of the female adult population - from all walks of life. Many women seek medical help because they mistake the symptoms of this disease for normal menstrual discomfort.
Most women who suffer from endometriosis have never been pregnant, and as many as 30 percent of women who report infertility problems actually have endometriosis. The exact relationship between infertility and endometriosis remains somewhat unclear, however. There is debate in the medical community over whether endometriosis causes infertility, or whether delaying childbearing results in endometriosis - or both.
RISK INCREASES WITH
Women who don't become pregnant or delay childbirth.
Family history of endometriosis. It seems to often be passed from mother to daughters.
Cervical stenosis (narrowing or closing).
PREVENTIVE MEASURES
There are no known preventive steps. Early diagnosis and appropriate treatment help prevent the spread of the endometriosis.
Home treatment can ease the pain of the disease. Women who suffer from endometriosis are advised to apply a heating pad to the lower abdominal area to relieve pain and increase circulation during painful periods. Exercise regularly and use relaxation techniques to lower stress. Sometimes sexual activity can help ease the pain, but in some cases, intercourse can make symptoms worse.
See below for a nutrient program and other recommendations outlined below which may help to keep endometriosis under control if it is diagnosed in the early stages.
EXPECTED OUTCOME
Without treatment, endometriosis becomes increasingly severe. It subsides after menopause when estrogen production decreases.
Symptoms can be relieved with medication, and the disorder is sometimes curable with surgery. Hormone therapy or hysterectomy (removal of the uterus) may be done.
Women with severe disease have less success with treatment.
POSSIBLE COMPLICATIONS
Sterility (from tissue implants constricting the fallopian tubes).
Disabling, but never life-threatening.
Bowel or bladder problems.
Adhesions of pelvic organs.
Recurrence of endometriosis after surgery.
Implants on the ovary can lead to large cysts and pelvic masses called endometriomas.
Medication in the form of hormonal therapy with danazol, which suppresses estrogen and and initiates false menopause, will produce menopausal symptoms complete with hot flashes, vaginal dryness and decreased sexual drive. Many women are reluctant to take this drug.
TREATMENT
GENERAL MEASURES
Diagnosing the disorder may take time, requiring repeated examinations or surgical diagnostic procedures, such as laparoscopy. A laparoscope (telescope instrument with fiber optic light) is the most commonly used procedure to diagnose endometriosis. The laparoscope is inserted into the abdomen through a small incision in the naval and visual examination of many abdominal organs is possible. Laparoscopic procedures are usually done on an outpatient basis.
Treatment after diagnosis will vary depending on the stage of the disease and the patient's age and desire to have children.
If you want children, consider pregnancy as soon as possible. Pregnancy may offer some relief from the disorder. Delaying pregnancy may result in infertility.
Use sanitary napkins instead of tampons. Tampons may make backward menstrual flow more likely. They can also aggravate pain and cramping.
Use heat to relieve pain. Place a heating pad or hot-water bottle on your abdomen or back, or take warm baths to relax muscles and relieve discomfort. The warmth relaxes the muscles that cramp and cause pain. For some women, cold therapy is more helpful. Place an ice pack on the lower abdomen.
Laser surgery or electrocoagulation may be used to remove the abnormal growths. This is an excision option less traumatic than hysterectomy that is used to treat milder cases. A laparoscopy is used with laser surgery to identify and vaporize adhesions, cysts, and endometrial implants. The procedure has yet to be perfected; repeated laparoscopy may be necessary. Advances in this technique are being made at a rapid rate, however, and the need for repeat procedures may soon be a thing of the past.
If endometriosis is severe and disabling, or if drug therapy fails, and you do not wish to have any more children, hysterectomy may be recommended. However, hysterectomy does not always relieve all the symptoms, especially if there are implants of endometrial tissue throughout the pelvic region.
Additional information or help in finding a support group is available from:
Endometriosis Association International Headquarters
8585 North 76th place
Milwaukee, WI 53223
(414) 355-2200
(800) 992-ENDO
(800) 922-3636 (North America & Caribbean)
(414) 355-6065 (fax)
website: http://www.endometriosisassn.org.
MEDICATION
You may use non-prescription drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), to relieve minor pain.
Stronger pain relievers may be prescribed.
Oral contraceptives, progestogens, danazol, gonadotropin-releasing hormones (Gn-RH) are commonly used drugs for treating endometriosis by suppressing ovarian function.
Danazol (Danocrine) "shuts off" the normal hormonal cycles, in an attempt to control the blood flow and pain, and in hopes of keeping the abnormal tissue from spreading and inducing the growths to heal and shrink. Some health care providers prescribe oral contraceptives (birth control pills) for essentially the same reason. Danazol has been shown to improve symptoms for 89 percent of women who take it and to reduce the size and number of implants. Weight gain and a deepened voice are possible side effects, but are usually reversible when the medication is stopped. However, symptoms may also reappear after medication is stopped.
Nafarelin, available as a nasal spray called Synarel, relieves symptoms and helps shrink endometrial lesions. In a trial involving 247 women treated with nafarelin for 6 months, 85 percent had their implants shrink or disappear and their symptoms relieved. 6 months after treatment, however, symptoms reappeared in half of those who had been helped. Possible side effects are similar to some of the discomforts of menopause, including hot flashes, vaginal dryness, and lighter, less frequent, or no menstruation. Other effects include headaches and nasal irritation.
An injectable drug named leuprolide (Lupron) is similar to nafarelin. Treatment consists of one injection a month for 6 months. In clinical studies, the effectiveness of leuprolide has been found to be about the same as that of danazol, according to the manufacturer. Potential side effects are similar to those caused by nafarelin.
A synthetic male hormone is sometimes used to temporarily stop menstrual cycles completely. This type of hormone causes excess facial hair growth and a deepening of the voice.
ACTIVITY
Daily moderate exercise, such as walking or stretching, is beneficial and helps in relieving pain and reduces estrogen levels which may slow the growth of endometriosis. According to a report in the Journal of the American Medical Association, strenuous exercise lowers the level of estrogen in the body, and this may help suppress the symptoms of endometriosis. The more aerobic exercise a woman engages in and the earlier she starts, the lower her risk of developing the disease in the first place. This study found that women who exercised more than 7 hours a week had 1/5 the average risk of developing endometriosis. Unfortunately, this beneficial effect was limited to those who began exercising before the age of 26.
Some activity restrictions may apply following surgical therapies.
DIET & HOLISTIC RECOMMENDATIONS
Some diet changes may help and diet may be very important in managing endometriosis. Consider following an Estrogen Reduction Diet.
Eat a diet consisting of 50 percent raw vegetables and fruits. In addition, eat only whole-grained products (no refined flour products) and raw nuts and seeds.
Include "green drinks " made from dark green leafy vegetables in your diet.
Use kelp to add iron to the diet. The heavy monthly bleeding that is common in women with endometriosis often leads to iron deficiency.
Avoid alcohol, caffeine (it seems to aggravate pain in some women), animal fats, butter, dairy products, fried foods, foods that contain additives, all hardened fats, junk or fast foods, red meats, poultry (except organically raised and skinless), refined and processed foods, salt, shellfish, and sugar.
Some nutrition researchers have theorized that endometriosis is related to an inability to absorb calcium properly.
Fast for 3 days each month before the anticipated beginning of the menstrual period. Use steam-distilled water and fresh live juices. See Pre-menstrual Syndrome (PMS) and Fasting for more information.
NUTRITIONAL SUPPLEMENTS
Nutritional supplements can help balance hormones and reduce estrogen levels. When used properly, they can dramatically reduce bleeding, pain, and cramps that may accompany fibroids and endometriosis. Taking supplements, however, does not mean that you can ignore your diet. The best approach for fibroids, endometriosis, and optimal health is to eat healthy foods and take nutritional supplements. See supplement chart below for more information.
Food and Nutrition: Supplement the diet with vitamin C, vitamin B-6, folic acid, calcium, magnesium, essential fatty acids such as linoleic acid, and evening primrose oil. Avoid caffeine, sugar, alcohol, and acid-forming foods (red meat, dairy products, heated or treated oils, and excess carbohydrates, especially refined products).
Try a short juice fast to clear out the body, and follow up with cultured foods such as miso or tempeh, unless you have a food allergy to soy products. After cleansing the body, plenty of fresh greens, fresh fruits in season, and a reasonable quantity of whole grains provide strength. Include changes to stabilize hypoglycemia (low blood sugar), such as eating smaller meals. As always, eating little or no animal fat decreases harmful excess estrogen.
The following food items are especially good:
Soybean (Glycine max) and Other Beans:
Soybeans are high in estrogen-like plant compounds, genistein and daidzein. These prevent your body from taking up the more harmful forms of estrogen circulating in your blood. These phytoestrogens take the place of the bad estrogen, binding to the cell's estrogen receptor sites and prevent more harmful estrogens from binding to these receptors. They also protect the body from pollutants that chemically mimic estrogen.
Bean sprouts supply more genistein (the more active of the two phytoestrogens) than soybeans. As beans germinate, their genistein content increases. If the sprouts have fungi, the genistein content may increase as much as hundred-fold!
Pinto beans, yellow split beans, black turtle beans, lima beans, anasazi beans, red kidney beans, red lentils, black eyed peas, mung beans, adzuki beans, and fava beans are other sources of these important phytoestrogens.
If you have endometriosis eat as much edible beans as possible as often as possible. Eat salads made of bean sprouts. Take bean soups, baked beans, and Mexican foods rich in beans such as burritos.
Flax (linum Usitatissimum):
Flaxseed contains generous amounts of compounds called lignans. These are believed to help control endometrial cancer.
Flaxseed might be particularly helpful for anyone who is not a vegetarian, Vegetarians have high blood and urine levels of lignans. Consuming meat suppresses lignans substantially. Flaxseed helps to supplement this deficit.
Peanut (Arachis hypogaea):
Peanuts contain many of the healthful substances as soybeans and other beans. Many people prefer the taste of peanuts over soybeans.
The papery red membrane surrounding Spanish peanuts is a source for oligomeric procyanidins (OPCs), substances that may help control hormone dependent cancers and possibly endometriosis.
Alfalfa (Medicago sativa):
Alfalfa sprouts contain phytoestrogens. Use them liberally on salads. Eating them also reduces the risk of contracting cancer. (Do not consume alfalfa if you or your family has a history of lupus.)
Evening Primrose Oil (Oenothera biennis):
EPO contains gamma-linolenic acid (GLA) and tryptophan, substances that promote good health in women. Though there is good evidence suggesting that lower doses of evening primrose oil (EPO) are of value for reproductive imbalance (breast tenderness, PMS), higher doses are reportedly more effective for reproductive damage (inflammation, pain). Other sources of essential fatty acids such as flax, borage, or black currant seed oil are important for a rounded intake of healthy oils, but these do not act as quickly in women with endometriosis. For this reason, higher doses of the more expensive EPO may have to be used for the short term.
Amanda M. Crawford, author of 'Herbal Remedies for Women' recommends the following nutritional supplements daily for women suffering from endometriosis:
Nutritional Supplements
For EndometriosisVitamin B Complex
(containing 2 milligrams B-6)Use as directed on label. Folic Acid 150 micrograms. Liquid Potassium
(Taken in recommended doses)3 times a day. Flax Seed Oil Start at 1/8 teaspoon doses, increase to 1 teaspoon per dose or more as tolerated. Vitamin E
8-10 milligrams alpha-TE
(alpha tocopherol equivalent)May use 200-600 IU (up to 1,200 IU maximum). Magnesium
(containing 2 milligrams B-6)400 milligrams. Calcium 800 milligrams. Vitamin A 800 RE (retinol equivalent); may use 5,000 IU
(up to 50,000 IU for four months or less).Vitamin D 10 RE; may use 400 IU
(up to 1,000 IU maximum)Vitamin C 300 milligrams (up to 1.0 grams). Evening Primrose Oil (for GLA - Gamma-Linolenic Acid) Eight 500 milligram capsules per day
For six to ten weeks (most effective).
A good natural multi-vitamin and mineral supplement.
Zinc citrate with a dosage of at least 15 mg per day.
Vitamin A. Studies have shown that women with excessive menstrual bleeding have significantly lower blood levels of vitamin A than the normal population. And that many women will return to a normal bleeding pattern after two weeks of vitamin A treatment. Recommended dosage is 1,000-5,000 IU per day of vitamin A.
B-complex vitamins help regulate estrogen levels and reduce menstrual pain and cramps. In clinical studies, Vitamin B-6 has led to a reduction in PMS-related cramping, fluid retention, weight gain, and fatigue. Recommended dosage is 50-100 mg of B-complex vitamins daily, with an additional dose of up to 300 mg of vitamin B-6 for women with fibroids or endometriosis.
Vitamin E. Vitamin E to be useful in treating women with heavy menstrual bleeding from fibroids and endometriosis. Recommended dosage is 400-800 IU per day.
Vitamin C, with bioflavonoids, has been used to treat heavy menstrual bleeding. It strengthens capillaries and reduces risk of iron deficiency and anemia in women who bleed excessively by helping absorb dietary iron. Recommended dosage is 1,000-5,000 mg of vitamin C per day in divided dosages. Bioflavonoids also help regulate excessive estrogen levels in the body. Therapeutic bioflavonoid dosages are 750-2,000 mg per day.
Ground whole flaxseeds and cold-pressed organic, rich, golden flaxseed oil are also excellent sources of the two essential oils, linoleic acid (omega-6 fatty acids) and linolenic acid (omega-3 fatty acids). These prostaglandins help to reduce menstrual cramps, breast tenderness, bloating and the effects of PMS. Flax is weakly estrogenic, and the lignans in flax reduce production of estrogen and compete with more potent estrogen for tissue receptors. Recommended dosage is 2 tablespoons of flaxseed oil, or 4-6 tablespoons of ground flaxseeds per day. Dosage should contain 1000 mg per day.
Iron. Women who suffer from heavy menstrual bleeding due to fibroids and endometriosis tend to be iron deficient. In fact, some medical studies have found that inadequate iron intake may even cause excessive bleeding. Women who suffer from heavy menstrual bleeding should have their red blood count checked to see if they need supplemental iron in addition to a high-iron-content diet. Heme iron, the iron from meat sources like liver, is much better absorbed and assimilated than non-heme iron, the iron from vegetarian sources. To be absorbed properly, iron must be taken with vitamin C. Recommended dosage is 25 mg per day of iron with 30 mg of vitamin C per day.
Calcium and Magnesium. The uterus is susceptible to calcium deficiency. It is made up of muscle, and muscles that are deficient in these two minerals tend to be hyperactive and more likely to cramp. Calcium maintains muscle tone, and magnesium optimizes calcium in your system by increasing its absorption. The recommended daily allowance (RDA) for calcium in menstruating women is 800 mg per day, rising to as much as 1,500 mg per day in post-menopausal women. Calcium can interfere with magnesium absorption. The recommended dosage for magnesium is half as much magnesium as calcium or approximately 400-750 mg per day.
HERBS
Thankfully, many cases of endometriosis can be treated with herbs, but you must be patient—most of the women I know who chose to treat this disorder herbally found that successful treatment took many months. For best results, work with a natural health care professional who has experience with this disorder and can help you develop a complete healing campaign that includes dietary changes, massage and possibly acupuncture. Caution: You should not take any of the herbs if you are taking, The Pill, Fertility drugs, HRT or any other hormonal treatment or other medication unless they are recommended by an experienced practitioner.
Herbs seem to promote tissue healing through a blend of effects. In addition to using phytoestrogens and other hormone-balancing plants, therapy aims to augment circulation to and from the areas of damage. Nutritive herbs provide building materials for the cells. Particular hepatic herbs may be chosen if a woman needs to eliminate toxins. Finally, it is important to improve immune-system function so that white blood cells will cluster around and eat up debris or imperfect cells.
Some herbs that are useful for the treatment of endometriosis are: dandelion, Oregon grape root, pasque flower, false unicorn, blackhaw bark, black cohosh, motherwort, vervain, yarrow, hops, valerian, and borage.
Here is a summary of the beneficial effect sought from a herbal treatment and the herbs that are involved:Amanda M. Crawford, author of 'Herbal Remedies for Women' recommends two herbal formulae that are useful for endometriosis. According to her, Herbal Formula #1 decreases excess estrogen during the luteal phase of the cycle. Herbal Formula #2 balances progesterone and shrinks and heals endometrial lesions. Herbs in both formulas share complementary effects throughout the month; these relax painful spasms, stimulate liver function, build healthy immune-system response to cellular debris, or nourish a woman undergoing the physiological demands of self-healing.
- Herbal Hepatics and the Liver: These herbs focus on hormone metabolism, improving the bile-bowel functional relationship, and treating gastrointestinal toxicity, flora, and pelvic blockage. Choose from Rosmarinus (rosemary leaves and flowers), Taraxacum (dandelion root and leaf), Carduus marianum (milk thistle seeds), and Verbena officinalis (vervain herb). Other hepatics, cholagogues, and alteratives may replace any one of these, as necessary.
- Cleansing: There may be a need for elimination beyond reliance on the hepatics listed above. This includes fasts alternating with rebuilding diets containing kelp, seaweed, sprouted seeds, and easily digested whole foods to speed recovery. A castor oil pack is effective in assisting recovery when placed over adhesions or the site of greatest pain.
- Anti-inflammatories and Nervines: The primary symptom of pain impedes healing and must be treated with effective herbal nervines and analgesics while the more comprehensive state of health is slowly improving. The anti-inflammatory herb Matricaria recutita (chamomile flower) is useful here. Muscle relaxants such as the Viburnum spp. (cramp bark), Valeriana (valerian root), and Humulus (hops flower) are effective, though Humulus has a cold quality in common with other bitters. The heat-producing Zingiber officinalis (ginger root) relaxes muscles. The dried herb of Anemone pulsatilla (pasque flower herb) prepared as a tea, capsule, or tincture is a standard remedy in Europe for reproductive pain and infection. No ill effects are reported from using these herbs.
- Lymphatic Circulation: This will assist delivery of the other herbs to improve the blood and lymph drainage. Gahum aparine (cleavers), Calendula (calendula flower), and Echinacea spp. (purple coneflower root, seed) all work against a possible secondary infection due to stasis (stagnation), and Echinacea's effects on collagen repair in connective tissue adds to its alterative and immune-system normalizing functions.
- Tonic Diuretics: Elimination through the kidneys allows the body's mechanisms for self-regulation to work optimally, while preventing buildup of stimulating herbs. Sohdago virgaurea (goldenrod herb tea) prevents overtaxing the kidneys.
- Digestive Aids: Two types, demulcents and bitters, act in their respective ways. Demulcents such as Althaea officinahs (marshmallow root) soothe inflammation and reduce pain by reducing stimuli to pain sensors in the digestive mucosa. This has a reflex soothing effect through spinal nerve pathways to muscles other than digestive structures, which may be in spasm. Bitters such as Verbena (vervain) or Achillea (yarrow herb) change the intestinal flora, or tone the bowel wall while stimulating general digestive function.
- Skin Alteratives: Smilax ornata (sarsaparilla root) gives tone rather than stimulation of the immune system. It is considered by herbalists to be a tonic for lymphatic circulation and hormonal balance, with an affinity for clearing skin conditions. Larrea mexicana (chaparral) and Berberis aquifohum (Oregon grape) are two stronger skin alteratives with an effect on immunity.
- Expectorants: Mildly expectorant diaphoretics may overlap with the benefits of alteratives by warming the circulation. Herbs chosen for strengthening elimination through the respiratory organs may have other benefits. British medical herbalist Sue Godwin writes that Cimicifuga racemosa (black cohosh) may play a role in dissolving adhesions while carrying out its better-known actions of clearing lungs, relaxing muscle, calming nerves, and normalizing reproductive cycles. Cimicifuga is useful for its antispasmodic role in the treatment of endometriosis.
- Astringents: Both metromenorrhagia (bleeding between periods) and internal bleeding (endometrial or from ruptures) are affected. Fresh plant tincture or preparation of Capselia bursa-pastoris (shepherd's purse) will decrease abnormal bleeding, as will Hamamelis Virginia (witch hazel bark), Agrimonia cupatoria (agrimony herb), Hydrastis canadensis (goldenseal root), and Vinca spp. (periwinkle herb). Since goldenseal is endangered and good quality agrimony is hard to find in many regions, fresh Capsella bursa-pastoris (shepherd's purse) tincture may be the best bet. Other herbs which are used as astringents include American Cranesbill, Beth Root, Burr Marigold, Lady's Mantle, and Periwinkle.
- Nervine Tonics: These reduce tension and take the edge off pain since the symptoms can be so difficult to manage. These synergize with analgesics and include Leonurus cardiaca (motherwort herb, also a bitter), Scutellaria spp. (skullcap herb), and flower essences. Flower essences are a gentle way of using the essences of plants in water. They are believed to affect one's thoughts and emotional states.
- Uterine Tonics: The uterine tonics tones and strengthen the whole system, both on the tissue of the organs and on their functioning. Examples are Black Cohosh, Blue Cohosh, Castleberry, False Unicorn Root, Life Root, Motherwort, Raspberry, and Square Vine.
- Emmenagogues: These stimulate and promote normal menstrual flow. Useful in this function are the herbs such as Blue Cohosh, False Unicorn Root, Life Root, Motherwort, Parsley, Pennyroyal, Rue, Southernwood, Squarewood, Squaw Vine and Yarrow.
- Hormonal Normalizers: These balance and normalize the functioning of the endocrine glands and aid the proper functioning of the reproductive system. Castleberry (Vitex agnus-castus), also known as Chaste Berry or Chaste Tree is an important herb in this connection. It normalizes estrogen and progesterone activity and is useful for all aspects of menstrual dysfunction.
- Demulcents: These are used to provide soothing and healing action on the system's mucous membranes. Herbs used include Bearberry, Blue Cohosh, Corn Silk, Golden Seal, Irish Moss, and Marshmallow.
- Antiseptics: Examples are bearberry, couch grass, Echinacea, garlic, juniper, wild indigo, and yarrow.
- Alteratives and Lymphatic Tonics: Examples are blue flag, burdock, cleavers, Echinacea, poke root and sarsaparilla.
Herbal formula #1
(Take from ovulation through the end of menses)Vitex agnus-castus (chasteberry seed) 1 ounce Viburnum opulus (cramp bark) 2 ounces Achillea millefolium (yarrow flower) 2 ounces Scutellaria lateriflora (skullcap herb) 2 ounces Dioscorea villosa (wild yam root) 1 ounce
Herbal formula #2
(Take from the end of menses to ovulation)Vitex agnus-castus (chasteberry seed) 2 ounces Caulophyllum thalictroides (blue cohosh root) 1 ounce Smilax ornata (sarsaparilla root) 1 ounce Carduus marianum (milk thistle seed) 2 ounces Mitchella repens (partridgeberry herb) 1 ounce Dioscorea villosa (wild yam root) 2 ounces Optional:
Valeriana officinalis (valerian root)
If the pain is severe but you are sensitive to Valeriana, you may replace it with double the amount or more of Passiflora (passionflower herb)1 ounce or more
These must be continued for a minimum of three months before effects may have a lasting benefit, but the therapy should improve symptoms of pain within the first few days. The complete treatment would take into account the length of the disease and its progression. Consult a qualified practitioner before starting any treatment. If you are pregnant, do not take any herbal supplement without consulting with your health care provider or midwife. Some of these herbs should not be used during pregnancy.
Vitex (Chaste tree berry) is one of the most important herbs in formulas treating endometriosis. Vitex dosage is 225 mg daily from chaste tree extract increases the production of the luteinizing hormone that triggers ovulation at mid-cycle, promoting progesterone production. It also inhibits release of the follicle-stimulating hormone that stimulates estrogen production in the first half of the menstrual cycle. So it normalizes the secretion of hormones and helps to bring estrogen and progesterone into balance during peri-menopause.
Alfalfa is a good source of vitamin K (necessary for blood clotting and healing) and needed minerals, including iron. Many women with endometriosis are iron deficient.
Astragalus, garlic, goldenseal, myrrh gum, pau d'arco, and red clover have antibiotic and anti-tumor properties. Goldenseal contains berberine, which relaxes uterine muscles. Shepherd's purse has been used to help stop menstrual bleeding. (If your bleeding is excessive or irregular, consult your health care provider as it can be dangerous and should never be allowed to continue without medical help.) Yellow dock is a good source of iron. White willow contains salicin. Salicylic acid, the precursor of aspirin, was purified from this plant. White willow bark reduces inflammation, pain and fever, and helps treat primary menstrual cramps and headaches. Like aspirin, it can produce unwanted side effects of gastric indigestion, nausea and diarrhea, so use the herbs carefully.
Milk thistle (Silybum marianum) is an excellent herb for the liver, which needs to work efficiently to balance the hormones. A number of studies have shown that its use can result in an increase of new liver cells to replace old damaged ones.
Burdock root, dong quai, and red raspberry leaf help to balance hormones. Burdock is a good herb to also treat your liver since the liver helps clear estrogen from the body.
Nettles is rich in iron and is helpful in treating iron anemia caused by blood loss.
To reduce bleeding, inflammation, muscle cramps and pain that generally accompany this disorder, the herbs useful for easing these symptoms are cramp bark and wild yam. For herbs to help stop cramping and menstrual pain are evening primrose oil and ginger. Red raspberry reduces bleeding and is thought to strengthen the uterus.
Horsetail also reduces excessive bleeding, especially menstrual bleeding. And it may do more than that for women with endometriosis — herbalists believe that it keeps scar tissue flexible, thus preventing further scarring. During the tuberculosis outbreaks of the early twentieth century, horsetail was used to reduce the amount of scarring on people's lungs. Pills containing horsetail are commonly sold to strengthen nails and hair, and may also strengthen connective ligaments such as those that hold the uterus in place.
Echinacea (Echinacea purpurea) is the herb of choice for the immune system and it helps to increase the white blood cell count. It seems to be more effective when taken on and off. Suggested usage is ten days on and three days off for maximum immune system benefits. Women with endometriosis need to rebuild their immune systems. Taking echinacea is a good herb to do this because this herb not only improves the immunity, but also helps repair connective tissues and fibers.
Castor oil packs are also very helpful in treating endometriosis. No one can explain exactly how they work, but experience has shown me time and again that they often make the difference between the success of a natural treatment and its failure. A recent study from Washington University in Washington, D.C., showed that castor oil packs can improve the function of the immune system in the pelvic area.
Endometriosis Herb Formula Tincture, 100% Organic - 2 fl. oz.
Endometriosis herb formula for use with ovarian cysts. This formula is supportive for women who are at risk for endometriosis or who have endometriosis.
AN ENDOMETRIAL HERBAL TREATMENT PLAN:
A good customized formula includes the primary herbs echinacea, vitex, wild yam, red raspberry, motherwort and nettles, with burdock and milk thistle added for liver function. Castor oil packs and hot and cold sitz baths with a few drops of lavender or chamomile essential oil (in the hot bath only) to increase circulation in the pelvic area should be added to the herbal formula use. For sitz baths you can use two large plastic tubs that can be bought at a hardware store. One for cold water one for hot water. Stress and anything else that lowers immunity, such as not getting enough sleep or not eating well, should be avoided since it can make endometriosis much worse. Just one cup of coffee can start the cramping again. It will take lots of discipline and habits changes to improve your endometriosis dramatically. After treatment you may still feel a twinge of pain when you don't eat right or you sleep poorly or feel stressed. Keep working on your herbal treatment plan to prevent endometrial symptoms from worsening.
Endometriosis Tea
1 teaspoon each vitex berries, echinacea root, wild yam rhizome and cramp bark
1/2 teaspoon each horsetail stalks, red raspberry and motherwort
1 quart water
Combine herbs and water in an uncovered pot and bring to a boil. Turn down the heat and let simmer gently for about 5 minutes. Remove from heat, cover and steep for 15 minutes. Strain out herbs. Drink at least 2 cups daily. This formula can also be taken as a tincture or in capsules.
Castor Oil Pack
1/4 cup castor oil
8 drops lavender essential oil
Soft cloth
Combine castor oil and lavender essential oil. Soak cloth in this mixture, then fold it and place it in a baking dish in a 350°F oven for about 20 minutes — it should be quite warm, but not uncomfortably so. Place the folded cloth directly over the afflicted area and cover it with a towel to keep it warm. (A hot water bottle on top of this also works well.) Use the pack once a day for 30 to 60 minutes. Rinse off the oil after each application.
Sitz Bath
10 drops rosemary essential oil
Add essential oil to a bathtub and stir well to distribute. Sit in tub with hot water up to your waist for 5 to 10 minutes (this is a good time to read a book). Then sit in a tub of cold water, also up to your waist, for at least 1 minute. (The large plastic tubs sold at hardware stores work fine.) Continue for 2 to 5 rounds. Perform this treatment every day, if possible. Lavender or chamomile essential oils could be used in place of rosemary. If you want, you can make a strong tea of these herbs and use that instead of the essential oils.
OTHER HERBAL-ALTERNATIVE MEDICINE THERAPIES:
CureZone.com: Endometriosis Prevention & Curing Protocol (Herbs/Alt. Therapy)
HOMEOPATHIC REMEDIES FOR ENDOMETRIOSIS
Treatment is constitutional. The initial remedies include:
- Lachesis for pain in the left ovary that is worse before periods, or to reduce lower abdominal pain premenstrually.
- Calcarea for a dull aching pain in the lower back, left side of the groin or womb during periods.
AYURVEDIC TREATMENTS FOR ENDOMETRIOSIS
In Ayurveda, endometriosis is believed to be the result of a vata imbalance. To correct a vata imbalance, Ayurvedic practitioners recommend establishing a regular daily routine, reducing workload, increasing the rest and sleep, practicing meditation, and adding to the diet a little more oil, sweet tasting foods (but not refined sugars), salt, and cooked warm foods such as cereal and stews. It is important to maintain a biological rhythm. Go to bed at about 10 PM and rise at 6 AM. This is the time when the earth's energy complements human energy. A program to remove excess waste (ama) and detoxification is also useful. Drink plenty of warm to hot water; and avoid meat, cheese, caffeine, and alcohol. On the fourteenth or fifteenth day of the cycle, use a laxative of four or five teaspoons of castor oil or senna tea followed by a light diet for the rest of the day.
For prevention of endometriosis, ayurvedic practitioners recommend that a woman reduce her activities as much as possible for the first three days of her period each month, though this might be unpractical to most busy women today. For exercise, a gentle walk is preferred over a jarring aerobics classes at this time.
TRADITIONAL CHINESE MEDICINE (TCM)
Chinese medical practitioners believe that endometriosis is due to blood stasis, qi stagnation, phlegm and dampness, damp heat, or some combination of these, but in turn this can be based on some organs being empty or not strong enough. It's almost always a combination of patterns, a concurrent insufficiency, or vacuity.
The Chinese herbal treatment, when combined with acupuncture, can regulate the condition and stagnation of the blood which usually lies at the root of endometriosis.
AROMATHERAPY
Endometriosis adhesions may be reduced by oils of rose, chamomile, lavender, jasmine and neroli. All of these have healing and antispasmodic action on the muscles and tissues.
OSTEOPATHY
Some osteopaths perform osteopathic techniques via the vagina to reduce certain types of endometrial adhesion. Osteopathic techniques may also be useful to encourage various drainage of the pelvis, reducing uterine congestion and relieving period pain.
OTHER ALTERNATIVE THERAPIES FOR ENDOMETRIOSIS
Shiatsu Massage is useful in controlling the pain in endometriosis.
Rolfing can help by improving circulation, allowing more space around the reproductive organs and promoting relaxation.
Naturopathic Medicine: The stress here is on nutritional support and dietary detoxification programs.
Self-hypnosis can be useful to control endometrial pain and induce relaxation.
Relaxation techniques, including breathing are useful for combating pain associated with endometriosis. Biofeedback and self-hypnosis are two more natural approaches to try.
An acupressure massage on the back is an effective treatment for a woman in the throes of painful cramps. Rubbing a tender area located about an inch to the right of the spine about mid back will reduce pain after 30 seconds. In the majority of cases, the pain will completely subside after three or four more minutes of massage, and the treatment usually relieves menstrual cramps for three to six hours.
Exercise every day of the month can help prevent cramps in the first place. Anything that improves circulation-especially aerobic activities like jogging, walking, swimming and cycling-brings more oxygen to the blood and helps relax the uterus.
ENDOMETRIOSIS SUPPLEMENTAL PRODUCTS
Information on endometriosis, a chronic, progressive disease wherein cells that resemble those that line the uterus are found in other areas of the pelvis.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm - 16 fl. oz.
WaterOz Ionic Zinc is a pure liquid Zinc supplement. Zinc moves through all the fluids in the body, it creates a defense against infection-causing bacteria and viruses trying to enter the body and stops bacterial and viral replication.U O Clear (Ovarian Cyst & Fibroid Support), 500mg - 60 Caps
The herbs work synergically to strengthen the body's natural capability of female systems self-cleaning functions, especially for uterus and ovary.Vitamin C 1000 with Bioflavonoids, Nature's Way, 100% Natural, 1000mg - 250 Vcaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Endometriosis Herb Formula Tincture, 100% Organic - 2 fl. oz.
Endometriosis herb formula for use with ovarian cysts. This formula is supportive for women who are at risk for endometriosis or who have endometriosis.PROGESTA, Natural Progesterone Cream - 2 oz.
Progesta is a unique natural progesterone supplement that provides incredible feminine support for overall mental health, normal feminine cycles and more.Choline and Inositol, 100% Natural, Nature's Way 250mg/250mg - 100 Caps
Nature's Way Choline Inositol is 100 percent natural crystalline inositol and choline bound to tartaric acid for superior absorption.Soy Isoflavone Standardized Extract, 100mg - 60 Caps
Soy Isoflavone Extracts continue to gain popularity for their phytoestrogen isoflavones.Vitex Fruit (Chaste tree), 400mg - 100 Caps
Vitex is a woman's dietary supplement, traditionally used for menstrual difficulties. Vitex has been heavily researched in Europe. It is widely used to promote overall health and balance in a woman's life.Dong Quai Root, Nature's Way 565mg - 100 Caps
Dong Quai is often used in the treatment of menstrual cramps, or dysmenorrhea and PMS, hot flashes, and other menopausal symptoms. Dong Quai is thought to be more effective when used in traditional herb formulas, such as Dong Quai and Paeonia, and Bupleurum and Dong Quai, which are prescribed for treating certain menopausal symptoms, menstrual pain, fibrocystic breast disease, and pelvic inflammatory disease.Wild Yam Root, Certified 425mg - 180 Caps
Wild yam has many effective uses. It is known to relax the muscles and promote glandular balance in women. Wild Yam contains natural plant components known as phytochemicals which help the body balance hormone levels.PMS Formula w/ 5-HTP & Vitamin B-6 - 100 Caps
This formula represents the powerful synergy of current scientific research and traditional herbal medicine.Prostactive, Saw Palmetto W/ Nettle Root 140mg - 50 Softgels
Prostactive Plus is a concentrated 12:1 extract made from the berries of the Saw Palmetto tree blended with Nettle Root extract, providing a unique synergistic effectiveness. This extract is a best selling Saw Palmetto product in Europe.Magnesium Citrate Complex, Nature's Way 250mg - 100 Caps
Nature's Way Magnesium Citrate is an advanced chelate form which enhances absorption of magnesium by providing excellent solubility.Alfa Max, Alfalfa Extract, Nature's Way 525mg - 100 Caps
Nature's Way Alfa-Max is much more digestible than raw alfalfa because the plant cellulose has been removed. Eight Alfa-Max capsules contain approximately 43% protein (by weight) and 2,600 IU of Vitamin A (as natural beta-carotene). Alfa-Max delivers 52% of the USRDA for vitamin A.Ginger Root Tincture, 100% Organic - 2 fl. oz.
Ginger Root helps to promote gastric secretions, thus aiding with food absorption and excellent for indigestion, flatulence, nausea (including travel sickness), and colic.Sage Tincture, 100% Organic - 2 fl. oz.
Sage is used as a mouthwash and gargle for mouth infections, bleeding gums and sore throats.Shepherds Purse Tincture, 100% Organic - 2 fl. oz.
Shepherd's Purse is mainly used to stop bleeding of all kinds.Pain Formula Tincture, 100% Organic - 2 fl. oz.
Use the Pain Formula to alleviate pain naturally.Menstrual Cramping Formula Tincture, 100% Organic - 2 fl. oz.
The Menstrual Cramping Formula was developed to help alleviate menstrual cramps. It contains eight beneficial herbs.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has symptoms of endometriosis or endometriosis is suspected. This is so that the condition can be controlled at the earliest possible stage of development. Medical treatment recommended for endometriosis depends on how far the condition has progressed.
The following symptoms occur during treatment:
- You are taking medication for endometriosis, report any new or worsened symptoms to your health care provider immediately, especially problems such as difficulty breathing or chest or leg pain. These symptoms may indicate the presence of a blood clot. Frequent checkups are needed to monitor possible side effects such as thinning of the bones. Be aware, however, that it is normal for endometriosis symptoms to worsen temporarily when a woman begins taking medication.
- Intolerable pain.
- Unusual or excessive vaginal bleeding.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects. Symptoms recur after treatment.
NOTE: Bulk herbs are available through Mountain Rose Herbs and Nutritional Supplements are available through Herbal Remedies. To find supplements not listed above, click on the links below:
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Click Here To Visit Herbal Remedies Product Page
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