Endometriosis and Women's Health
By Carolyn Dean, MD, ND
Most women have heard of endometriosis and many have at least a general
concept of what it is. In my practice, I remember many women calling it
"the working women's disease." That's because there
was a theory a couple of decades ago that endometriosis was related to
a high stress lifestyle.
What is Endometriosis?
Stress may have a role in endometriosis but let's go back to the
basics first. Endometriosis, in the simplest possible terms, is tissue
from the uterine lining growing where it shouldn't. During healthy
menstruation, women shed their endometrial lining, or the endometrium,
each month. The material is expelled from the body as part of the monthly
menstruation. While many women would probably like to bypass this inconvenient
and sometimes painful monthly routine, it is the key to life itself.
However, in the 5.5 million North American women with endometriosis,
cells from the uterine lining have migrated from where they're supposed
to be -- inside the uterus -- to other parts of the body, most often within
the pelvic area, on the bowel, bladder, ovaries and the outside of the
uterus. It's sometimes called retrograde menstruation. Rogue endometrial
tissue has been known to migrate as far as scar tissue on the arms and
legs.
This misplaced tissue develops into growths that respond to the menstrual
cycle in the same way the lining of the uterus does. Triggered by hormonal
signals, the tissue builds up and sheds each month.
While menstrual blood flows out of the body through the cervix and vagina,
endometriosis tissue and the cells it sheds have no way of leaving the
body. Trapped between layers of tissue, they cause inflammation, scar
tissue, adhesions and bowel problems. Endometriosis can lead to intense
pain and reproductive difficulties.
More than 5 million North American women suffer from
symptoms of endometriosis that include:
- Pain before and during periods
- Pain during intercourse
- Chronic pelvic pain
- Cramping at any time of the cycle
- Painful bowel movements
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- Fatigue
- Painful urination
- Infertility
- Gastrointestinal upset such as
diarrhea, constipation and nausea
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The Essential Estrogen Balance
While the cause of endometriosis is unknown and there is no cure, it
can be relatively simple to treat and control the symptoms. The standard
medical treatment involves taking synthetic hormones, such as the birth
control pill, that stop menstruation and therefore stop the buildup of
blood and endometrial tissue outside the uterus. But there are new ways
of approaching endometriosis that are much kinder to the body and address
an underlying problem that certainly relates to the condition.
Current scientific theory points to estrogen dominance as a major factor
in endometriosis. Bringing progesterone and estrogen into natural balance
will frequently result in symptom relief and, in some cases, even shrink
rogue endometrial tissue.
Quite simply, this usually means using a prescription natural progesterone
cream -- called bioidentical progesterone -- from a compounding pharmacy.
(You can find a compounding pharmacy near you by contacting the International
Academy of Compounding Pharmacists at www.iacprx.org.)
Testing Your Estrogen Levels
Along with progesterone cream has come a new method of hormone testing
that better captures the fat-soluble hormones than blood tests. Highly
accurate saliva testing can give a women and her doctor a much better
picture of her estrogen and progesterone levels compared to relatively
antiquated and unreliable blood hormone tests.
As a general benchmark, a range of 30 to 50 mg of bioidentical progesterone
cream from days 8-26 of the menstrual cycle are usually sufficient. Medical
supervision is necessary to individualize treatment. Doctors who use bio-identical
hormones do not subscribe to the one-size-fits-all pharmaceutical method
of drug prescribing.
I said earlier that stress might play a role in endometriosis, even
though it almost certainly isn't the cause of the disease.
What we now know about hormones is that when women have a great deal
of stress, their production of the stress hormone cortisol and estrogen
increases dramatically!
The Effects of Estrogen Overload
Normal estrogen levels may cause some breast swelling or nipple tenderness
in the few days before the onset of your period. It's often the way
you know it's coming. However, when you have an overproduction of
estrogen, often called estrogen dominance, those estrogen symptoms are
magnified.
In addition to stress-triggered estrogen production, we are seeing women
with out-of-whack hormones related to environmental estrogens, known as
xenoestrogens.
We have seen xenoestrogens wreak havoc in wildlife and fish affecting
sexual development and fertility. It's only in the past decade that
we turned the magnifying glass on ourselves and found sperm abnormalities
and serious female fertility issues created by xenoestrogens.
Xenoestrogens most often enter the body through the food supply such
as meat and dairy products from "hormonally-enhanced" animals.
That's why recent Italian research showed that women with the highest
consumption of meat and dairy products increased their risk of endometriosis
by 80 to 100 percent, while those who ate a diet rich in green vegetables
and fresh fruit reduced their risk by 40 percent.
Get Your Estrogen Back on Track Naturally
As a naturopathic doctor as well as a medical doctor, I advise diet,
exercise and detox before accepting a prescription for bioidentical progesterone.
Sometimes, clearing up lifelong constipation is all that's needed
to turn the tables on endometriosis.
I recommend a detoxification program
for women with endometriosis that includes:
- A high fiber diet
- Onions and garlic
to help chelate toxins from the body
- Exercise
- Sauna therapy
- Epsom salt baths
and hydrotherapy
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- Liver support with milk thistle
(up to 240 mg. daily, in divided doses)
and other safe herbs in liver support formulas
- Eliminating elements of stress
that can cause adrenal fatigue and toxic stress levels
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Endometriosis also often responds
to treatment with other supplements, including:
- Black cohosh (40 to 80 mg. daily) to help relieve painful menstruation
- Calcium and magnesium (up to 1,500 mg. of calcium and up to 900 mg
of magnesium in divided doses) to help the liver more efficiently metabolize
hormones
- Iron (up to 60 mg. daily in divided doses, if necessary) to help relieve
iron deficiency that may result from excessive bleeding. (use a brand
that chelated and/or combined with iron-rich herbs)
- Endometriosis is one of those diseases that has many "hitchhikers,"
or other conditions that often accompany it.
The Endometriosis Association says it is now becoming apparent
that women with endometriosis are more apt to be troubled by:
Interestingly, many of these accompanying conditions are associated
with candida
yeast overgrowth, an area of particular interest to me.
The Endometriosis Association agrees that many women with endometriosis
also suffer from allergies,
chemical sensitivities, and frequent
yeast infections.
Many yeast experts, including the late Dr. William Crook, author of
The
Yeast Connection and The Yeast Connection and Women's Health,
believed there was a strong connection between the two conditions. In
fact, Dr. Crook and many practitioners, including me, have achieved excellent
and lasting results by treating endometriosis and yeast overgrowth simultaneously
with a yeast-free diet, natural antifungals like caprylic acid, olive
leaf extract and probiotics.
Yeast overgrowth may not be the main cause of endometriosis but it's
one of those hitchhikers that you want to avoid if possible.
Carolyn Dean, MD, ND, is health advisor to Woman's
Health Connection at
www.yeastconnection.com and is featured on the website's "Ask
A Pro" page. Her latest books are
The Miracle of Magnesium and Natural Prescriptions for Common Ailments.
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