What Is Endometriosis?

Endometriosis happens when the endometrial tissue is found growing outside of the uterus.  This tissue is shed each month during menstruation if it’s where it normally should be.  When it spreads to the pelvis, ovaries and fallopian tubes it can’t be shed. Lesions, or nodules, then cause severe, chronic pain or infertility.  It is difficult to diagnose endometriosis without surgery. Ultrasound and other imaging can’t rule it out but new options are emerging.

Debilitating pain during menstruation, during and after intercourse, and bladder or bowel problems also occur.  One out of ten or up to 200 million women are affected.  There is a lack of knowledge in the public and medical community about endometriosis.  This means many women don’t get the help they need & there are likely many more suffering than are reported.  Pelvic pain in women is often minimized.

Difficult to Diagnosis

Symptoms associated with endometriosis are not unique to the condition itself.  I saw two patients this week who experience chronic pelvic pain.  When there are hormone-related symptoms and digestive issues, both need to be examined.  Each of these women suspects endometriosis as a possibility.  One would like to avoid surgery while the other is ready for more information now.

Laparoscopic surgery is currently the only way to properly diagnose endometriosis.  During this surgery lesions can be removed if discovered.  There is currently no cure in conventional medicine.  Anti-inflammatory drugs are used along with birth-control pills to suppress estrogen & ovulation. The Merina IUD is used to suppress the uterine lining. Surgery is the gold standard but is usually followed up with hormonal treatment because endometrial lesions regrow within 5 years in 50% of cases.

Functional Medicine For Endometriosis

There is convincing evidence that endometriosis is autoimmune.  Addressing underlying cause shows positive outcomes clinically.  I’ve seen this.  We do this by improving immune function and reducing inflammation naturally.  This can be done with or without other treatments like surgery.

Diet Has A Huge Impact

Avoid dairy and gluten: Both A1 casein from cow dairy and gluten contribute to endometriosis.  Eggs can also disrupt immune function in some people by stimulating the release of inflammatory cytokines.  Other autoimmune triggers that can be ruled out through an elimination diet are nuts and seeds or nightshades.

A few of my favourite ways to address underlying causes:

N-acetyl cysteine (NAC) acts as a liver support to remove excess estrogens.  It also supports gut health and acts as a natural anti-inflammatory.  In a clinical trial it was used to treat endometriosis.  Lesions were reduced by 1.5 mm in those treated whereas the control group saw a 6.6 mm increase in size. Of those treated, most cancelled their laparoscopic surgery after the trial because of the significant reduction in pain.  The researchers concluded, “NAC represents a simple, effective treatment for endometriosis, without side effects, and a suitable approach for women desiring a pregnancy”.

Turmeric is a well known anti-inflammatory.  In research specific to endometriosis it reduces the size of lesions and a reduction in activity. More research shows that it blocks the stimulating effect of estrogen. Turmeric is best taken in a concentrated form where the active components are bioavailable.

Zinc is another anti-inflammatory and is has been found to be deficient in those with endometriosis.  Zinc can also reduce prostaglandins and help repair the gut lining which is important for immune function.

Berberines also repair intestinal permeability and is anti-inflammatory.  Its anti-microbial action treats bacteria in the gut reducing endotoxins which may contribute to endometriosis. Berberines can only be taken short-term and not during pregnancy and breastfeeding.  Please talk with a health professional.

New Technologies for Research & Diagnosis

I’m checking out a female run company called Dotlab. I pulled this quote off their website:

“When did we accept that a woman can wait years for answers to her health? Did it begin when her physician mistook her chronic pain as “all in her head?” Was it when she paused at the thought of laparoscopy for diagnosis, not ready to face the physical, emotional, and financial burdens of surgery? At DotLab, we’re ending the delay because an easy test means an early, actionable answer.”

Another tool is an app called Phendo. It was created by researchers at Columbia University.  It seeks to understand disease from the perspective of the patient.  NextGen Jane is another project.

Menstrual blood is being researched to diagnose because it has not only endometrial lining but also, cervical and vaginal cells. Hopefully we’ll be seeing more clinical trials using this information to shed light on endometriosis and other diseases.  Early detection is an important step in reducing the suffering.

 

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