Endometriosis is a relatively common disorder of the female reproductive system that is said to affect around 1 in 10 women. Unfortunately I am one of those women, and I have struggled with this often-debilitating disease for much of my adult life. Many people have heard of endometriosis, but don’t actually know what it is. To put it simply, it occurs when the endometrial tissue from inside the uterus grows outside the uterus. It most commonly occurs in the pelvic cavity on and around structures such as the ovaries, fallopian tubes, bowel, bladder, and rectum. In rare cases it can even grow on the lungs and even the brain! Think of it like weeds, growing like wildfire in places it shouldn’t with often-detrimental effects on the garden it’s invading. With each menstrual cycle, this tissue acts as endometrial tissue does. It thickens, breaks down and bleeds. However when it occurs in places where it doesn’t have an exit, it creates internal bleeding that causes inflammation, adhesions and pain.
Symptoms of endometriosis include:
- Severe menstrual pain
- Painful intercourse
- Chronic pelvic pain (regardless of period)
- Heavy menstrual bleeding
- Pain upon urination or bowel movements
One of the most frustrating things about endometriosis is how difficult it is to diagnose. In most cases, the ONLY way of diagnosing endometriosis is through surgery. This is why many women suffer for years before being diagnosed. Most women will just attribute it to extra painful periods, and think what they’re going through is normal. My road to diagnosis was an all too common one… long and painful. I had pretty bad periods and cysts when I was a teenager, and was put on the pill to keep them at bay. After going off the pill in my early 20’s, my menstrual pain progressively got worse. Over time I began developing urinary and bowel symptoms randomly throughout my cycle, and even ended up in the hospital on multiple occasions with agonizing stomach pain. After multiple blood tests, CT scans, colonoscopies and endoscopies, the doctors still had no idea what was wrong with me and haphazardly labeled it IBS (a common misdiagnosis for women with endometriosis). It wasn’t until grad school when I was deep into the study of medicine, when I made the connection. Eventually I brought myself to a pelvic pain specialist, who after taking a long medical history and physical exam told me she thought I had endometriosis and that she wanted do laparoscopic surgery to diagnose and treat it. I was nervous to undergo surgery for something we weren’t even sure I had, but after years of suffering I had to just trust the doctor, and go with it. When I woke up from the five-hour surgery, I was relieved to hear that I did in fact have endometriosis. I know it seems strange that this news gave me relief, however finally getting an answer as to why I had been in pain for so long did just that. Now that I had the diagnoses and partial excision surgery (they weren’t able to get it all) I could work towards managing it.
Unfortunately there is no cure for endometriosis. However there are ways of managing it. For western medicine this means suppressing it with hormone therapy, excision or ablation surgery, hysterectomy, or pain medication.
Chinese medicine looks at endometriosis as “blood stagnation”. It almost always involves dysfunction of the liver along with the spleen and kidneys. All three channels run through the pelvic region, and the liver specifically is responsible for the free flow of qi and blood throughout the body. If this flow is obstructed in any way, it can lead to static blood causing painful periods. Accumulation of cold is also a common cause of blood stagnation in the uterus, depending on the pattern of the specific patient. Our main goal in treating endometriosis with acupuncture is to increase blood flow, break down any static blood, warm the uterus and relieve pain. Endometriosis is often considered an estrogen dominant condition, in which the patient either has excess estrogen or an imbalance of estrogen in relation to progesterone. By freeing the flow of liver qi, we can aid the liver in detoxing the body of this excess estrogen and promoting balance. Chinese herbal medicine can also be a helpful addition to the treatment protocol. There are specific herbs and formulas that work to improve blood flow, warm the uterus, calm inflammation, stop excess bleeding, and relieve pain.
There are also many lifestyle changes women can make to help manage their condition. Because endometriosis is a disease of stagnation, it is best to keep moving! Being a couch potato will only make things worse. Exercise keeps the blood flowing and helps ease pain. Also, certain yoga poses and stretches focused on the abdomen and pelvis can help break up stagnant tissue and prevent the growth of new adhesions. Because endometriosis is also a disease of inflammation, changes in diet prove to be very beneficial. This means avoiding inflammatory and estrogenic foods such as sugar, dairy, wheat, caffeine, alcohol, red meat and soy. You should focus your diet on lots of colorful organic vegetables, foods high in omega fatty acids such as oily fish, nuts and seeds, lean meats that are free of hormones, fiber to promote the removal of excess estrogens, and lots and lots of water.
Please don’t assume your “killer cramps” are normal. If they’re affecting your quality of life and causing you to miss work or other activities, they probably aren’t. Come in for acupuncture, work on your diet, see a doctor that specializes in pelvic pain… just don’t sit around assuming this is how you have to live your life! There are ways to make it better.
-Marcy Julius, L.Ac.