> Health and Disease > Women's Health Issues > endometriosis

As a physician, I am humbled when faced with the chronic pain of patients with endometriosis. Researchers estimate that endometriosis affects 10 to 35 percent of women during their reproductive years-500,000 in Canada alone. Its social burden is enormous.

The good news is that cultural studies and clinical research show that there are a variety of dietary, lifestyle and powerful nutritional measures for women to take to manage their risk of developing endometriosis and remain in control of their lives.

Endometriosis is derived from the word endometrium, or uterine lining. Normally the tissue lining of the uterus grows each month; if a woman is not pregnant, this lining disintegrates and sheds as menstrual flow at the end of the cycle. In endometriosis, pieces of this normal lining are found outside the uterus. Unlike the menstrual fluid from the uterus, endometrial tissue bleeds onto surrounding organs, causing swelling and inflammation. This repeated occurrence over time leads to the build-up of destructive scar tissue, cysts and adhesions.

Symptoms of endometriosis vary widely. The most common symptom is pain. Usually described as excessive menstrual cramps, the pain is dull and achy and persists throughout the month. It’s especially worse before or during menstruation. There does not seem to be any correlation between the intensity of the pain and the severity of the endometriosis. Other common symptoms include painful intercourse, abnormal bleeding, infertility and painful bowel movements or urination.

Theories abound as to the causes of endometriosis, but its origin is yet to be determined. The "retrograde theory" maintains that some of the menstrual blood backs up through the fallopian tubes during menses, where it lodges in the pelvic cavity and continues to grow. Most recently, exposure to environmental pollutants and toxins found in many herbicides and pesticides has been connected to a rise in endometriosis rates. These chemicals may mimic estrogen, contributing to a hormonal imbalance and a disruption of the immune system.

Mainstream Methods

While various imaging methods including ultrasound, magnetic resonance imaging (MRI) and computered tomography (CT) scan may offer diagnostic clues, the only way to truly diagnose endometriosis is with a laparoscopy. This is a surgical procedure done under general anesthesia during which a slender, wand-like instrument with a light (laparoscope) is inserted into the lower abdomen through a small incision to explore for the location, depth and size of endometrial tissue implants.

The aggressiveness of a conventional treatment protocol depends on the severity of a woman’s symptoms, the location and degree of endometriosis, her age, her circumstances and personal preferences, including her plans to have children.

Mainstream practitioners normally recommend over-the-counter, prescription-strength pain relievers or oral contraceptives to quell mild cramping and menstrual pain. In cases of severe pain, they prescribe narcotic medications. The problem with these solutions is two-fold–they have side effects and they address the symptoms, not the condition itself.

Conventional medicine falls back on laparoscopic surgery when drug therapy fails to treat endometriosis or control pain. Most experts agree that the more extreme removal of the uterus, ovaries and fallopian tubes (hysterectomy or oophorectomy) should be reserved only as a last resort.

Whole-Body Healing

Dr Tasnim Adatya is a licensed primary health care practitioner in Oregon.

Source: alive #212, June 2000