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Endometriosis and Women's Health
By Carolyn Dean, M.D., N.D.
Most women have heard of endometriosis and many have
at least a general concept of what it is. In my practice,
I remember it being called "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 definitely has a role in endometriosis, as do
most chronic diseases, but let's go back to the basics.
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.
Stress enters the picture to cause uterine tension
and toxicity, often prompted by poor lifestyle choices
and worsened by nutrient deficiency-especially magnesium.
Cycles of stress and deficiency create a pattern of
hormonal imblance throughout the body and in some women
focus on the uterus. Specifically in endometriosis,
uterine muscle tension and spasm in the fallopian tubes,
due to magnesium deficiency, can contribute to uterine
blood and tissue migration.
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
Fatigue
Painful urination
Infertility
Gastrointestinal upset such as diarrhea, constipation
and nausea
The Essential Estrogen Balance
While modern medicine insists 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 stops menstruation
and therefore stops 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. According to many
integrative medicine practitioners, bringing progesterone
and estrogen into natural balance will frequently result
in symptom relief and, in some cases, even shrink rogue
endometrial tissue.
Treatment usually means obtaining a prescription from
your doctor for a natural progesterone cream -- called
bioidentical progesterone -- available 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 captures the fat-soluble hormones
more accurately 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 plays a huge role in endometriosis
and de-stressing needs to part of the treatment.
What we now know about hormones is that when women
have a great deal of stress, their production of the
stress hormone cortisol as well as 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. Unfortunately
many women do not have integrative medicine doctors
to turn to and need naturopathic solutions they can
implement on their own. 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
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
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 hormonesand to
prevent spasms and tension in muscles and nerves
Vitamin B complex with extra panthothenic acid to support
the adrenal glands.
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:
Chemical sensitivities
Chronic fatigue syndrome
Asthma and eczema
Infections
Food intolerances
Mononucleosis
Mitral valve prolapse
Fibromyalgia
Autoimmune disorders, including lupus and Hashimoto's
thyroiditis
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, M.D., N.D., 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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