Endometriosis
Endometriosis is a chronic condition that can not only cause severe pain felt in unpredictable places but often comes on with severe fatigue, nausea, headaches and mood changes. It can be sudden, and relentless and affect your day-to-day life. I know, sounds horrible, but there are things that can be done to help.
The endometrium
The endometrium is the innermost lining of the uterus. Its thickness increases and decreases in response to hormones during the menstrual cycle. The endometrium thickens full of oxygen-rich blood in preparation for implantation of the embryo. If pregnancy does not occur, the lining sheds and the period begins. The menstrual cycle then starts again.
What is endometriosis?
1 in 9 Australian women develop Endometriosis by their 40’s. It occurs when cells similar to the endometrium are found in places outside of the uterus – most commonly in the ovaries, fallopian tubes, and pelvis, and less commonly in areas outside the pelvic cavity. Because these cells in the wrong place behave like endometrial tissue, they thicken, break down and bleed. The blood is unable to escape, and irritation, adhesions and fibrous tissue can form, causing pain, and sometimes masses. Because endometrial tissue responds to hormones, symptoms are often cyclical, but this is not always the case as some may experience pain at any time during the cycle and it can even become constant. (1).
How is endometriosis diagnosed?
There are 4 stages or grades of endometriosis, depending on the severity of the disease (1):
- Stage/grade I (mild): small amounts of endometriosis around the inside of the pelvis.
- Stage/grade 2 and 3 (moderate): Endometriosis is more widespread and can be found in the ovaries and other parts of the pelvis. There can be scarring and adhesions.
- Stage/grade 4 (severe): Endometriosis has spread to most of the pelvic organs and sometimes further outside.
Doctors will usually ask about the nature and location of the pain. The following physical exams may be done (1):
- Pelvic exam
- Ultrasound
- MRI
- Laparoscopy
Signs and Symptoms
Endometriosis can cause many different and unexpected symptoms. Some are mentioned below
- Headaches
- fatigue
- bowel changes (constipation, diarrhoea bloating, nausea)
- infertility
- pain on intercourse
- painful urination
- excess bleeding (2).
Causes
The exact cause of endometriosis is unknown, however, there may be conditions that could offer some explanation:
- Retrograde menstruation. This is where menstrual blood containing endometrial cells flows back up the fallopian tubes and into the pelvic cavity (3).
- Transformation of peritoneal cells. In a theory known as ‘induction theory’, experts think hormones or immune factors transform peritoneal cells (cells lining your abdomen) into endometrial-like cells (3).
- Embryonic cell transformation. Hormones may transform embryonic cells (cells in the early stage of development) into endometrial-like cells at puberty (3).
- Surgical scar implantation. After any type of pelvic surgery endometrial cells may attach to surgical incision scars (3).
Possible risk factors
- long and heavy periods
- frequent periods or short cycles
- early monarch – starting your period before 11
- Having your first pregnancy when you are older
- problems with the immune system
- low body weight
- alcohol use (2)
How is endometriosis normally treated?
Although there is currently no known cure doctors may do one or more of the following:
- Hormone therapy
- Surgery
- Pain medication (NSAIDS)
- Hysterectomy (3)
How does Chinese Medicine view endometriosis?
In Traditional Chinese Medicine, endometriosis is referred to as phlegm and blood stasis. This causes blockages, reduces blood flow to the related organs and can cause pain, infertility, digestive symptoms and emotional issues. There can be many reasons for phlegm and blood stasis, from diet, lifestyle and environmental factors, surgical intervention and even emotional causes. Chinese Medicine diagnoses and treats each patient individually. Acupuncture and herbs are used to remove obstructions, improve blood flow and reduce pain.
What does the research say on Chinese Medicine and Acupuncture in endometriosis?
A systematic review and meta-analysis (4) on the effects of acupuncture for the treatment of endometriosis pain stated that the current literature suggests acupuncture reduces pain and serum CA-125 levels – a cancer protein tested in the blood that can be used to detect early signs of ovarian cancer.
A systematic review and meta-analysis (5) from the International Journal of Gynaecology and Obstetrics on complementary treatments for women with symptomatic endometriosis, looked at complementary interventions, exercise, yoga, electrotherapy and acupuncture to help alleviate the symptoms of endometriosis. Although the results were inconclusive it did demonstrate a positive trend in the treatment of symptoms of endometriosis. However, a Meta-analysis of acupuncture showed a significant benefit in pain reduction as compared with placebo (P=0.007).
At On Point Natural Medicine, we work with our patients to create a treatment plan which may include:
- Acupuncture and Chinese herbal medicine assist with pain, and circulation and improve mood
- Diet advice, chosen specifically to your diagnosis and aimed at reducing inflammation, and pain and improving mood
- Stress management using breathing techniques, meditation, neural resetting and exercise
Author
Adrian Taricani
Registered
Acupuncturist, Chinese Medicine Practitioner, Sports and Massage Therapist On Point Natural Medicine.
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Learn More:
Symptoms, Diagnosis, Management and Treatment.
- Endometriosis” 2018. Mayo Clinic. Available
- Xu, Y., Zhao, W., Li, T., Zhao, Y., BU, H. & Song, S. (2017). ‘Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis.’ PLoS One, 12(10). Available
- Ticiana A.A. Mira, Mariana M. Buen, Murilo G. Borges, Daniela A. Yela, Cristina L. Benetti-Pinto (2018). ‘Systematic review and meta-analysis of complementary treatments for women with symptomatic endometriosis’. Available
