Amber has always had a hard time with her periods, with lots of pain and heavy bleeding. She is often tired, tends to be constipated and often has low back and abdominal pain. When she and Roger decided they wanted to start a family, they both hoped pregnancy would change her hormones and help her difficult periods. But after 2 years of trying to conceive, she couldn’t get pregnant. When she went to her gynecologist she eventually discovered she has endometriosis. Now what?
Endometriosis is a condition in which cells like those lining the uterus (endometrium) grow in other areas of the body, usually on the ovaries, bowel, and in the abdominal cavity. This displaced endometrial tissue thickens, breaks down and bleeds with each menstrual cycle, just like it does in the uterus. The blood has no way to exit your body. Surrounding tissue can become irritated, eventually developing scar tissue.
This process can cause pain – sometimes severe – especially during your period. Women often have very painful periods (dysmenorrhea), pain with intercourse, and pain with bowel movements or urination. This pain is believed to be due to an inflammatory process, perhaps due to high levels of prostaglandins.
Other symptoms may include fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods. But often there are no symptoms, so you may not even know you have endometriosis.
Does Endometriosis Affect My Trying to Conceive?
Yes. One-third of women who have endometriosis have difficulty getting pregnant. Endometriosis may obstruct the Fallopian tube and prevent the egg from meeting up with the sperm. In actuality, how endometriosis affects fertility is not well understood. It is believed that the inflammation, tissue damage, adhesions and scarring contribute to infertility.
Even so, most women with mild to moderate endometriosis are able to have children. Endometriosis can worsen with time, so sometimes it is helpful to not delay having children as it is possible you may have more trouble conceiving later.
How is endometriosis diagnosed?
* Pelvic exam: feel scar tissue or cysts on the ovaries. Often difficult to feel.
* Ultrasound: this will provide an image of your reproductive organs. It may show cysts on the ovaries, which may be associated with endometriosis.
* Laparoscopy: a camera is surgically inserted into your abdominal cavity to look for endometrial tissue. This is the only way to know for sure. This will show where and how much is present.
What causes endometriosis?
* The cause of endometriosis is not known
* It may be do to menstrual blood going the wrong direction, up the Fallopian tubes and into the pelvic cavity
* It is associated with high estrogen levels or low progesterone
* It is associated with low vitamin D levels
* It is associated with inflammation and immune system dysfunction
What can you do?
Correct any hormone imbalance. Find a health care provider who understands how to properly test for hormone imbalances, and correct them naturally when possible. This includes lifestyle choices, such as good nutrition, exercise, adequate sleep and stress management. Avoid xenohormones. These are chemicals in the environment that mimic your hormones and cause unnatural effects.
Vitamin D. Make sure your levels are adequate by checking 25(OH)D with a blood test. If you are low, eat more foods high in vitamin D, get more sunlight, and take Fermented Cod Liver Oil. If necessary, supplement with vitamin D3, but always make sure you are getting adequate amounts of the other fat soluble vitamins (vitamin A, E and K2) in your diet to prevent toxicity.
Inflammation. The site of endometrial implants create an inflammatory reaction. This is believed to be related to excess prostaglandins. If you have pain, anti-inflammatory drugs or herbs may be helpful. Even more important is to address the cause. It is important to work with a health care provider who understands how to address the inflammation and stop this cycle that can lead to further tissue damage.
Immune System. It may be that the immune system is attacking the body, creating what is know as an autoimmune reaction. It may be that the inflammatory damage to the tissues is creating an immune reaction. Most likely it is both. This is best addressed with good nutrition and choosing a lifestyle that supports your overall health. Specific herbs and whole food supplements may be helpful, and are best recommended by a knowledgeable health care provider.
Surgery. This may be recommended when other treatments are not effective, such as pain medication and hormone therapy. Hormones therapy is used to suppress your own hormones and the symptoms. Surgery may be used to try and help pain and infertility from the adhesions and scarring. The problem is that surgery does not treat the cause of the problem, and recurrences are common.
As usual, if you truly want resolution and healing of a medical problem you have to take some responsibility for returning your body to a state of vibrant health. This includes lifestyle choices that you can make.
* Stress Management
* Quality sleep
* Good attitude
* Avoid environmental toxins
To Your Vibrant Health!
Veronica Tilden, DO