Endometriosis: Beyond Pelvic Pain |

If you are a woman, your monthly period may not be something to look forward to, but if you have endometriosis, your dread may be even greater. Debilitating pelvic pain or even chronic pain is one of the most common symptoms of endometriosis. Living life normally becomes difficult to impossible during periods or even at other times of menstrual cycles. Anywhere between 5-15 percent of women of reproductive age have endometriosis, most living with life-altering pain.

What is it?

Endometriosis is a condition where tissue similar to your uterus lining grows outside of your uterus. Most commonly, this tissue secures itself to your ovaries or fallopian tubes, but it also may attach to your bladder or intestines. This tissue mimics the tissue in your uterus, following the same growing, breaking down, and shedding cycle. Your pelvis may become inflamed if blood and tissue gets trapped in your pelvic cavity or if endometrial tissues damage the area it has attached to. The tissue usually harms whatever it has attached and grown into, sometimes leading to scarring and cysts. This damage is usually permanent. Endometriosis is non-cancerous but does increase chances of certain types of cancer.

Causes

Little is known about what causes endometriosis. For someone like Dr. Holly Lucille, ND, RN, ONC, a naturopathic doctor who is always looking for reasons behind the condition or symptoms, this makes endometriosis more challenging. Instead of being able to look at the cause, she must use what is known and the correlations between endometriosis and other factors. For example, if someone in your family has endometriosis, your chances of also developing it increase significantly. Those with endometriosis usually have a hormonal imbalance, as well. High inflammation and low body mass index (BMI) are other factors linked to endometriosis. Some believe that endometriosis happens when bleeding during periods is dysfunctional (retrograde menstruation). Instead of exiting the body through the vagina, some blood flows up into the pelvic cavity where endometriosis is usually located.

Symptoms and Diagnosis

One of the most common reasons that endometriosis is diagnosed is bad period cramps, which are so painful that they get in the way of regular life. Another way someone may find out they have endometriosis is while trying to conceive. Endometriosis is one of the main reasons for infertility, as tissue can grow into the ovaries and fallopian tubes, damaging them. Other symptoms include painful sex, pain while urinating, pain during bowel movements, and heavy period flows.

Diagnosis is not an easy process, and the most definite diagnosis involves laparoscopic surgery to remove and test tissue in the pelvic cavity. A pelvic ultrasound or MRI can also show the endometrial growths, but the growths may not show up and there is no certainty that the growths are endometriosis without surgery.

Treatments

Unfortunately, there is not a cure for endometriosis and most treatments are focused on pain management and limiting future growth of endometrial tissue. Common treatments use pain killers (typically anti-inflammatory) to manage pain and hormonal birth control to manage pain and tissue growth. Another treatment is surgery to remove growths and lesions, but regrowth is very common. In fact, none of these typical treatment options are particularly effective and many women give up on them in the long term.

Alternative Treatments

Many women with endometriosis must look for alternative treatments, especially if they are trying to get pregnant. A wide range of possible treatments have been used, especially for managing pain. “The body has an innate ability to heal itself. I’m always looking at what are obstacles to that,” says Lucille. It’s important to work with the body to address the inflammation, overgrowth of tissue, and hormonal issues. In some cases, that may mean going in laparoscopically to “clean up their tissue,” according to Lucille. It depends on the case.

Diet

It turns out that eating healthily really can make a difference for those up-in-the-middle-of-the-night cramps. Studies show that those with endometriosis usually have a history of eating fewer fruits and vegetables. Lower levels of vitamins C and B and other antioxidants are also associated with endometriosis. On the flip side, eating a balanced diet or avoiding inflammatory foods may help counteract endometriosis.

A handful of diets have been examined for benefits for endometriosis. One that Lucille stands behind is the anti-inflammatory diet. “Like anything else, I think that diet is foundational.” Addressing inflammation and calming the body’s systems is essential for managing pain, preventing future growth, and getting hormones back on track. Studies have found the anti-inflammatory diet can improve fertility and pregnancy success in those with endometriosis, as well as reduce inflammation and limit pain. Eating foods that have been shown to lower inflammation and support your body’s immune system is a must. Making sure you eat food rich in vitamins is also key. Focus on eating plenty of vegetables, especially cruciferous and leafy greens, berries, and foods with healthy fats, like salmon, walnuts, and flaxseed. Stay away from inflammatory foods such as refined sugar, conventional dairy, trans fat, caffeine, and red meat.

Other diets that have been successful in lowering symptoms from endometriosis include the following:

Low FODMAP diet

This restrictive diet, named for the short-chain carbs that can cause digestive issues in the small intestine (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), also shows promise for alleviating symptoms of endometriosis. Many women with endometriosis have symptoms similar to that of irritable bowel syndrome (IBS), so following a similar diet can help relieve pain and determine which foods are more detrimental. This diet should be supervised by a nutritionist.

Mediterranean diet

A diet that focuses on plenty of vegetables, whole grains, and healthy fat, this diet was found to reduce pain and tissue growth.

Gluten free diet

Gluten is often at least somewhat inflammatory to our digestive tracts. Taking out gluten can help reduce inflammation and relieve period pain.

Overhauling your diet and making a significant lifestyle change is not easy. Food is a central part of our lives. You may need support to take this health-changing step. When taking on new patients, Lucille always tries to determine what will be most helpful when making a change and whether or not the change will stick. Whether it takes a coach, weekly check-ins, or help from a nutritionist, Lucille believes taking on this major lifestyle change will make all the difference for endometriosis.

Supplements

For some women, significantly altering dietary routines was not necessary to improve their symptoms. Studies have found a range of supplements that can address endometriosis. Supplements also are easier to incorporate into your life, a major reason that Lucille uses these with her patients.

Vitex

Vitex, or chaste tree berry extract, has been used as a traditional medicine for many different women’s health related issues from increasing milk production to menopause. A daily dose of this berry extract can relieve and treat symptoms of endometriosis. Vitex is high in antioxidants and anti-inflammatory properties. Research shows that with vitex supplementation endometrial cysts and tissue growth shrank and diminished. According to studies, vitex has a “estrogen-like activity,” helping balance hormones. All-in-all, it makes a successful treatment for endometriosis.

B Vitamins

Another effective supplement for treating endometriosis is B vitamins. These vitamins help return order and balance to hormones. Research shows that B vitamins can also help treat retrograde menstruation, keeping further unwanted tissue growth under control. B vitamins also help reduce inflammation in the pelvic cavity. Adding these vitamins to your diet or supplements can help treat and alleviate endometriosis.

Other Anti-inflammatory supplements

Curcumin, a property of the spice turmeric, is anti-inflammatory, which is essential for treating endometriosis. Its helpful properties go beyond that, though. Curcumin can help balance hormones, discontinuing the overproduction of estrogen, and helps slow or stop the progression of growth and scarring.
Fish oil, another anti-inflammatory supplement, is another go-to supplement for Lucille when treating patients with endometriosis. Fish oil aids in lowering overall inflammation, limiting pain, and balancing hormones.

All of these anti-inflammatory supplements can aid the treatment of endometriosis.

Probiotics

Just like your gut, your reproductive systems have a microbiome with a delicate balance of bacteria, the ‘good’ keeping the ‘bad’ at bay. It turns out that your reproductive system microbiome is connected to your gut microbiome. Taking probiotics for a healthy gut can lead to a healthier reproductive system. People with endometriosis tend to have higher levels of certain strains of bad bacteria, like E. coli and Streptococcus. To counteract this, taking strains of probiotics helps with pain and slowing growth of tissue outside of the uterus. Probiotics also lower inflammation of the pelvic cavity, further helping alleviate symptoms of endometriosis.

Acupuncture

Women with endometriosis usually live with pain that affects their daily lives. Treating endometriosis takes time, even with dedicated dietary changes and hormone balancing supplements. Managing pain becomes a necessity while treating the underlying causes. Lucille recommends acupuncture as one way to do this. Acupuncture treatment designed for endometriosis can make life a lot more manageable and livable.

Endometriosis is usually a difficult diagnosis to receive. Conventional treatments are usually ineffective and don’t actually treat the condition. Endometriosis comes with pain that is difficult to live with, leading to issues with work and family and physical and mental health. There is good news, though. Alternative treatments, like those recommended by Dr. Holly Lucille, can make a difference both for your pain and for the health of your body.