Understanding and Thriving Through Endometriosis

What is Endometriosis?

Endometriosis is a painful condition in which tissue from the uterus attaches itself to other organs. The uterine tissue may appear in the fallopian tubes or the ovaries, or it may implant itself on the outer walls of the uterus itself. In rare cases, the tissue travels outside the pelvic region and appears in organs like the bladder, the lungs, and other areas.

These masses of tissue can be painful in and of themselves, but to make matters worse, they continue to behave as if they’re inside the uterus. They continue to fill up with blood over the course of the menstrual cycle, and every month, they shed blood just as the uterus does. Unlike normal menstrual blood, which leaves the body through the vagina, the blood from the abnormal growth has nowhere to go. Instead, it accumulates inside the pelvic cavity, where it often forms cysts. (3)

The Menstrual Cycle

As menstrual cycles repeat themselves and the tissue continues to bleed each month, the cysts may grow so large that they bind organs together. Sometimes a cyst may rupture and leads to agonizing pain. Two out of three women have endometrial growth on the ovaries. Pain in the pelvis and the lower back is the defining characteristic of endometriosis.

The pain usually varies with the menstrual cycle and is at its worst during ovulation, menstruation, or sexual intercourse; sometimes it is so intense as to be incapacitating.

A woman with endometriosis may experience heavy or prolonged menstrual bleeding, and this loss of blood can lead to anemia. (3) Digestive problems are common in cases of endometriosis, as are nausea and vomiting. There is a strong connection between endometriosis and infertility, although it is unknown whether the excess tissue actually prevents conception, or if infertility somehow creates conditions hospitable to endometriosis. (3)

The Cause

No one knows for sure what causes endometrial tissue to leave the uterus and travel to other parts of the body. One prevailing theory is that the disorder is caused by retrograde menstruation, in which menstrual fluid fails to exit the body properly. Instead, some of the endometrial lining that is normally shed during menstruation backs up in the fallopian tubes and enters the pelvic cavity, where the tissue deposits itself and begins to grow. It is also possible that endometrial cells travel to the pelvic cavity via the bloodstream or the lymphatic system. Others believe that endometriosis is caused when the body is still an embryo. In a normal fetus, the cells that are meant to form the uterus differentiate themselves from others and begin to travel to the appropriate site. But according to this theory, the endometrial cells of some fetuses don’t make the trip and end up in the wrong places. (3)

Environmental Causes

It is also thought that environmental estrogens may be a causative factor. These xenoestrogens are endocrine disrupters that have estrogenic effects in the body. This category of environmental estrogens includes plastics, detergents, household cleaners, pesticides, herbicides, and hormones found in meat products. (3)These substances affect the immune system, especially the phthalates - a substance that gives plastic their flexibility, transparency, and durability. Phthalates are also used coating for pharmaceutical pills, nutritional substances, and many other commonly used products. (5,7)

Immune System Involvement

In addition, studies have shown immune-system imbalance to be a factor. Specifically, women with endometriosis have higher levels of antibodies that target their own ovaries and endometrial tissue. They also tend to have lower activity of the natural killer cells that usually keep abnormal cells in check. Studies show that 90% of menstruating women without endometriosis have this backward flow that we spoke about earlier. Typically, the difference is that their immune system is able to prevent implantation and growth of the endometrial cells outsides the uterus. Women with endometriosis have typically shown alteration in the immune cells that are responsible for surveillance of the pelvis.

No matter what the cause, it does appear that all cases of endometriosis are linked to hormonal balance and that elevated estrogen levels are a problem. (3,7)

Why Liver & Gut Health is Important

It is important that liver function is optimized in women with endometriosis. Why? The liver is responsible for breaking down estrogen (and other hormones) and secreting the metabolites into the large intestine for elimination. If the liver does not metabolize estrogen and its metabolites properly, they are recycled throughout the body. While the liver is the dominant player in estrogen metabolism, the gut flora or “friendly bacteria” in the large intestine are also important in estrogen metabolism. The gut flora prevents the reactivation and the recycling of these unwanted estrogens. Conversely, “unfriendly bacteria” secrete an enzyme called beta-glucuronidase that causes estrogen to be recycled back through the body via the large intestine. A low-fiber and high-fat diet increase the activity of this enzyme.

While endometriosis is not a simple condition to treat, natural therapies often lead to significant improvement. The complementary treatments we will cover in this article will focus on regulating hormones, decreasing inflammation, and balancing the immune system and also suggest ways to provide gentle relief of pain and other symptoms.

Risk Factors

Risk factors include family history, lack of exercise from an early age, a high-fat diet, use of intrauterine devices, and increased or unbalanced estrogen levels. Women with a mother or sister with endometriosis have an increased risk. (7)

SYMPTOMS

•Pain in the abdomen and the lower back, associated with menses

•Pain with sexual intercourse

•Prolonged or excessive menstrual bleeding

•Digestive problems

•Nausea and vomiting

•Anemia

•Infertility

•Pain with urination and bowel movements

ROOT CAUSES

•Retrograde menstruation

•Endometrial cells that travel through the bloodstream or the lymphatic system

•Heredity

•Hormonal imbalance (relatively high estrogen and low progesterone) due to poor liver function, diet, xenoestrogens, or ovulatory dysfunction

•Imbalanced immune system

•Flora imbalance (dysbiosis)

How to Test for Endometriosis

The following tests help assess possible reasons for endometriosis:

Immune-system imbalance—blood Hormone testing (especially for estrogen and progesterone)—saliva, blood, or urine

Detoxification profile—urine

Digestive function (particularly, flora balance and beta-glucuronidase activity)—stool analysis

Food and environmental allergies/sensitivities—blood, electrodermal

HOW TO THRIVE THROUGH ENDOMETRIOSIS

Eating for Endometriosis

It is important to eat certified organic foods as much as possible, due to the estrogenic (estrogen promoting or increasing) effects of pesticides, herbicides, and hormone-laden meats. Research has shown that a gluten-free diet can improve pelvic pain in 75 percent of women with endometriosis. So you may find that eliminating and minimizing gluten may be helpful for you.

Eating the right type of fats is essential to endometriosis (as well as any healthy lifestyle) due to "Silent Inflammation" which leads to pain. Twelve years of prospective data from the Nurses Health Study II, which began in 1989 were analyzed for the association between dietary fat and many health problems, including endometriosis. Those women who consumed the most trans-fatty acids were 48% more likely to be diagnosed with endometriosis. In contrast, these women with the highest consumption of long-chain omega 3 fatty acids were 22% less likely to be diagnosed with Endometriosis. (3,8)

Check out the Guides on Fats, Oils, and Sugars here!

Recommended Food

• Whole grains, beans, and vegetables should form the basis of your diet. All these foods are high in fiber and will help to balance the friendly bacteria involved with estrogen metabolism. Why? Foods that are high in fiber are associated with the growth of friendly gut flora micro-organisms. Studies show that a high intake of fiber in a predominately vegetarian diet leads to a decrease of free estrogens in the blood plasma.

• Eat plenty of cold-water fish like salmon, tuna, and mackerel. These fish are good sources of essential fatty acids (EFAs), substances that reduce inflammation and pain. For additional EFAs, add 2 tablespoons of flaxseeds to your daily protocol, along with 10 ounces of water. Flaxseeds have been shown to help balance estrogen levels.

• Caffeine consumption appears to be a risk factor for endometriosis. (2,3) So if you're a coffee drinker, you want to start making changes to 1 cup a day, then half-caff, and then wean yourself off.

According to researchers at the Harvard School of Public Health, women who consume 5 to 7 grams of caffeine a month had a significantly greater incidence of endometriosis. This is equivalent to about two cups of coffee a day. (2,3)

• Eat fruits and vegetables, such as apples, cherries, broccoli, cauliflower, and brussels sprouts. They contain the phytochemical indole-3-carbinol, which supports the liver’s detoxification of estrogen.

• Regularly consume beets, carrots, artichokes, dandelion greens, onions, and garlic, as these foods stimulate liver detoxification.

• Eat organic cultured yogurt to increase the levels of friendly flora in the large intestine. If you are not sensitive to dairy.

• Once a day, drink 9 to 16 ounces of vegetable juice to support detoxification. Vegetable juice includes a fresh green smoothie or juice or celery juice. Most vegetable juice in the store is preserved and pasteurized, and processed, devaluing the veggies of their nutrients.

• Drink a glass of clean, quality water every two to three waking hours to support detoxification.

Click the PDF below to view a Meal Plan, Shopping List, and Snacks for Endometriosis

Endometriosis Meal Plan.pdf

Food to Avoid

Avoid red meat and dairy products that are not organic.

To keep pain under control, stay away from inflammatory substances like sugar, caffeine, and alcohol. Don’t eat anything that unbalances your immune system.

Processed foods, fried food, refined sugar, and alcohol all limit your body’s ability to fight your disorder.

Nutritional Supplements

*Please consult your primary physician before taking any of the supplements listed below, especially if you have multiple conditions. These supplements do not serve as a substitute for any current medications that you are currently taking.

General Supplements

*A high-potency multivitamin supplies many of the nutrients required for hormone metabolism and will contain many of the supplements/nutrients listed below. Take as directed on the container.

B-complex vitamins are involved in estrogen metabolism. Take a 50 mg complex twice daily.

Take 500 mg of D-glucarate daily. This phytochemical assists the liver in estrogen breakdown.

Melatonin has been shown to decrease pain scores for women with endometriosis. Take 10 mg at bedtime.

Vitamin C improves autoimmunity. Work up to 6 grams daily. Reduce the dosage if diarrhea occurs.

Motherwort (Leonurus cardiaca) is a good herb to use for acute uterine pain. Take 5 ml three times daily.

A plant-based, antioxidant, and flavonoid-rich formula with an ORAC (Oxygen radical absorption capacity) of 3,000 to 6,000 units per day.

Essential fatty acids -Take a daily combination of flaxseed (1 to 2 tablespoons) or fish oil (3,000 to 5,000 mg), along with gamma linoleic acid (GLA) from evening primrose oil or borage oil at a dose of 300 mg. These essential fatty acids decrease inflammation.

Red raspberry (Rubus idaeus) is an astringent herb that may help uterine inflammation and pain. Drink it as a tea, three cups daily. Women with severe endometriosis often find that the pain keeps them up at night. If you need to get to sleep, try a tea made with skullcap (Scutellaria lateriflora), passionflower (Passiflora incarnata), or valerian (Valeriana officinalis).

To see the "Endometriosis Catalog" of these Supplements and order them online, simply login to your supplement portal here.

Specialty & Botanical Supplements

Natural progesterone -This hormone balances estrogen, regulates the menses and relieves pain. Apply ¼ teaspoon (20 mg) to your skin twice daily from days six to twenty-six of your cycle (stopping during the week of your menstrual flow). It is best used under the care of a health care professional.

Vitex (chasteberry)- Vitex balances the estrogen/progesterone ratio. Take 160 to 240 mg of a 0.6 percent aucubin standardized extract or 80 drops daily. This has been traditionally used as a treatment for hormone imbalances in women. Through action on the pituitary gland, it increases progesterone production by means of an increase in luteinizing hormones, with the effect of making estrogen less available. This herb is useful for fibroids, PMS, and endometriosis. Do not use vitex if you are currently taking a birth-control pill.

Indole-3-carbinol Take 300 mg daily. It assists the liver in estrogen detoxification.

Super Prescription #4 Dandelion root (Taraxacum officinale) Take 300 to 500 mg in capsule form or 1 ml of tincture with each meal (three times daily). It improves liver detoxification.

Vitamin E Take 400 IU twice daily. It helps with estrogen metabolism and inflammation.

Bodywork Massage

Although it can’t cure endometriosis, a massage of the belly and the lower back is an effective means of easing an acute attack of pain. Find a massage therapist whom you like and trust; if flare-ups occur at a predictable point in your cycle, you may want to make a standing appointment for treatment. One study found that auricular (ear) acupuncture was as effective as hormone therapy in treating infertility due to endometriosis.

Hydrotherapy

A hot bath can help relieve digestive problems as well as pain.

Other Bodywork Recommendations

When you feel an acute episode of pain coming on, lie down and rest, with a hot compress on the affected area.

Acupuncture is highly recommended to help reduce the pain associated with endometriosis. In addition, Chinese herbal therapy from a qualified practitioner can be very helpful. (1)

General Stress-Reduction Therapies

People who suffer from chronic pain live with constant stress—more than their friends and family realize. Stress, too, can contribute to painful flare-ups. If you have endometriosis, it’s important that you devote time every day to managing the tension that accompanies a chronic illness.

Pilates offers a gentle way to stretch and reduce stress.

Moderate exercise is a natural pain reliever. Try to take a walk every morning, or find some other activity you like well enough to perform regularly.

•Use sanitary napkins instead of tampons. Tampons may encourage retrograde menstruation.

REFERENCES

1. Gerhard, I., and F. Postneek. 1992. Auricular acupuncture in the treatment of female infertility. Gynecological Endocrinology 6:171–81.

2. Grodstein, F., M. B. Goldman, L. Ryan, and D. W. Cramer. Relation of female infertility to the consumption of caffeinated beverages. 1993. American Journal of Epidemiology 137(12):1353–60.

3. Stengler, M., Balch, J., Young, R. Prescription for Natural Cures. 3rd Ed.

4. Guidace LC. Clinical Practice. Endometriosis. The New England Journal of Medicine 2010 Jun 24; 362 (25): 2389-2398

5. Weuve J, Hauser R, Calafat AM, et al. Association Exposure to phthalates with endometriosis and uterine leiomyomata: findings from NHANES, 1999-2004. Environmental Health Perspectives 2010 Jun; 118 (6): 825-832

6. Goldin BR, Adlercreutz H Dwyer JT, et al. Effect of diet on excretion of estrogens in pre and post-menopausal women. Cancer Research 1981;41;3771-3773.

7. Murray, Michael, Pizzorno, Joseph. Encyclopedia of Natural Medicine. 3rd Ed. (565-569)

8. Missmer SA, Chavarro JE, Malspeis S, et al. A Prospective study of dietary fat consumption and endometriosis risk. Human Reproduction 2010 Jun; 25(6): 1528-1535The Menstrual Cycle

As menstrual cycles repeat themselves and the tissue continues to bleed each month, the cysts may grow so large that they bind organs together. Sometimes a cyst may rupture and leads to agonizing pain. Two out of three women have endometrial growth on the ovaries. Pain in the pelvis and the lower back is the defining characteristic of endometriosis. The pain usually varies with the menstrual cycle and is at its worst during ovulation, menstruation, or sexual intercourse; sometimes it is so intense as to be incapacitating. A woman with endometriosis may experience heavy or prolonged menstrual bleeding, and this loss of blood can lead to anemia. (3) Digestive problems are common in cases of endometriosis, as are nausea and vomiting. There is a strong connection between endometriosis and infertility, although it is unknown whether the excess tissue actually prevents conception, or if infertility somehow creates conditions hospitable to endometriosis. (3) The Cause No one knows for sure what causes endometrial tissue to leave the uterus and travel to other parts of the body. One prevailing theory is that the disorder is caused by retrograde menstruation, in which menstrual fluid fails to exit the body properly. Instead, some of the endometrial lining that is normally shed during menstruation backs up in the fallopian tubes and enters the pelvic cavity, where the tissue deposits itself and begins to grow. It is also possible that endometrial cells travel to the pelvic cavity via the bloodstream or the lymphatic system. Others believe that endometriosis is caused when the body is still an embryo. In a normal fetus, the cells that are meant to form the uterus differentiate themselves from others and begin to travel to the appropriate site. But according to this theory, the endometrial cells of some fetuses don’t make the trip and end up in the wrong places. (3) Environmental Causes It is also thought that environmental estrogens may be a causative factor. These xenoestrogens are endocrine disrupters that have estrogenic effects in the body. This category of environmental estrogens includes plastics, detergents, household cleaners, pesticides, herbicides, and hormones found in meat products. (3)These substances affect the immune system, especially the phthalates - a substance that gives plastic their flexibility, transparency, and durability. Phthalates are also used coating for pharmaceutical pills, nutritional substances, and many other commonly used products. (5,7) Immune System Involvement In addition, studies have shown immune-system imbalance to be a factor. Specifically, women with endometriosis have higher levels of antibodies that target their own ovaries and endometrial tissue. They also tend to have lower activity of the natural killer cells that usually keep abnormal cells in check. Studies show that 90% of menstruating women without endometriosis have this backward flow that we spoke about earlier. Typically, the difference is that their immune system is able to prevent implantation and growth of the endometrial cells outsides the uterus. Women with endometriosis have typically shown alteration in the immune cells that are responsible for surveillance of the pelvis. No matter what the cause, it does appear that all cases of endometriosis are linked to hormonal balance and that elevated estrogen levels are a problem. (3,7) Why Liver & Gut Health is Important It is important that liver function is optimized in women with endometriosis. Why? The liver is responsible for breaking down estrogen (and other hormones) and secreting the metabolites into the large intestine for elimination. If the liver does not metabolize estrogen and its metabolites properly, they are recycled throughout the body. While the liver is the dominant player in estrogen metabolism, the gut flora or “friendly bacteria” in the large intestine are also important in estrogen metabolism. The gut flora prevents the reactivation and the recycling of these unwanted estrogens. Conversely, “unfriendly bacteria” secrete an enzyme called beta-glucuronidase that causes estrogen to be recycled back through the body via the large intestine. A low-fiber and high-fat diet increase the activity of this enzyme. While endometriosis is not a simple condition to treat, natural therapies often lead to significant improvement. The complementary treatments we will cover in this article will focus on regulating hormones, decreasing inflammation, and balancing the immune system and also suggest ways to provide gentle relief of pain and other symptoms. Risk Factors Risk factors include family history, lack of exercise from an early age, a high-fat diet, use of intrauterine devices, and increased or unbalanced estrogen levels. Women with a mother or sister with endometriosis have an increased risk. (7) SYMPTOMS

•Pain in the abdomen and the lower back, associated with menses •Pain with sexual intercourse •Prolonged or excessive menstrual bleeding •Digestive problems •Nausea and vomiting •Anemia •Infertility •Pain with urination and bowel movements ROOT CAUSES •Retrograde menstruation •Endometrial cells that travel through the bloodstream or the lymphatic system •Heredity •Hormonal imbalance (relatively high estrogen and low progesterone) due to poor liver function, diet, xenoestrogens, or ovulatory dysfunction •Imbalanced immune system •Flora imbalance (dysbiosis) How to Test for Endometriosis The following tests help assess possible reasons for endometriosis: Immune-system imbalance—blood Hormone testing (especially for estrogen and progesterone)—saliva, blood, or urine Detoxification profile—urine Digestive function (particularly, flora balance and beta-glucuronidase activity)—stool analysis Food and environmental allergies/sensitivities—blood, electrodermal HOW TO THRIVE THROUGH ENDOMETRIOSIS Eating for Endometriosis It is important to eat certified organic foods as much as possible, due to the estrogenic (estrogen promoting or increasing) effects of pesticides, herbicides, and hormone-laden meats. Research has shown that a gluten-free diet can improve pelvic pain in 75 percent of women with endometriosis. So you may find that eliminating and minimizing gluten may be helpful for you. Eating the right type of fats is essential to endometriosis (as well as any healthy lifestyle) due to "Silent Inflammation" which leads to pain. Twelve years of prospective data from the Nurses Health Study II, which began in 1989 were analyzed for the association between dietary fat and many health problems, including endometriosis. Those women who consumed the most trans-fatty acids were 48% more likely to be diagnosed with endometriosis. In contrast, these women with the highest consumption of long-chain omega 3 fatty acids were 22% less likely to be diagnosed with Endometriosis. (3,8) Check out the Guides on Fats, Oils, and Sugars here! Recommended Food Whole grains, beans, and vegetables should form the basis of your diet. All these foods are high in fiber and will help to balance the friendly bacteria involved with estrogen metabolism. Why? Foods that are high in fiber are associated with the growth of friendly gut flora micro-organisms. Studies show that a high intake of fiber in a predominately vegetarian diet leads to a decrease of free estrogens in the blood plasma. Eat plenty of cold-water fish like salmon, tuna, and mackerel. These fish are good sources of essential fatty acids (EFAs), substances that reduce inflammation and pain. For additional EFAs, add 2 tablespoons of flaxseeds to your daily protocol, along with 10 ounces of water. Flaxseeds have been shown to help balance estrogen levels. Caffeine consumption appears to be a risk factor for endometriosis. (2,3) So if you're a coffee drinker, you want to start making changes to 1 cup a day, then half-caff, and then wean yourself off. According to researchers at the Harvard School of Public Health, women who consume 5 to 7 grams of caffeine a month had a significantly greater incidence of endometriosis. This is equivalent to about two cups of coffee a day. (2,3) Eat fruits and vegetables, such as apples, cherries, broccoli, cauliflower, and brussels sprouts. They contain the phytochemical indole-3-carbinol, which supports the liver’s detoxification of estrogen. Regularly consume beets, carrots, artichokes, dandelion greens, onions, and garlic, as these foods stimulate liver detoxification. Eat organic cultured yogurt to increase the levels of friendly flora in the large intestine. If you are not sensitive to dairy. Once a day, drink 9 to 16 ounces of vegetable juice to support detoxification. Vegetable juice includes a fresh green smoothie or juice or celery juice. Most vegetable juice in the store is preserved and pasteurized, and processed, devaluing the veggies of their nutrients. Drink a glass of clean, quality water every two to three waking hours to support detoxification. Click the PDF below to view a Meal Plan, Shopping List, and Snacks for Endometriosis Endometriosis Meal Plan.pdf Food to Avoid Avoid red meat and dairy products that are not organic. To keep pain under control, stay away from inflammatory substances like sugar, caffeine, and alcohol. Don’t eat anything that unbalances your immune system. Processed foods, fried food, refined sugar, and alcohol all limit your body’s ability to fight your disorder. Nutritional Supplements *Please consult your primary physician before taking any of the supplements listed below, especially if you have multiple conditions. These supplements do not serve as a substitute for any current medications that you are currently taking. General Supplements *A high-potency multivitamin supplies many of the nutrients required for hormone metabolism and will contain many of the supplements/nutrients listed below. Take as directed on the container. B-complex vitamins are involved in estrogen metabolism. Take a 50 mg complex twice daily. Take 500 mg of D-glucarate daily. This phytochemical assists the liver in estrogen breakdown. Melatonin has been shown to decrease pain scores for women with endometriosis. Take 10 mg at bedtime. Vitamin C improves autoimmunity. Work up to 6 grams daily. Reduce the dosage if diarrhea occurs. Motherwort (Leonurus cardiaca) is a good herb to use for acute uterine pain. Take 5 ml three times daily. A plant-based, antioxidant and flavonoid rich formula with an ORAC (Oxygen radical absorption capacity) of 3,000 to 6,000 units per day. Essential fatty acids -Take a daily combination of flaxseed (1 to 2 tablespoons) or fish oil (3,000 to 5,000 mg), along with gamma linoleic acid (GLA) from evening primrose oil or borage oil at a dose of 300 mg. These essential fatty acids decrease inflammation. Red raspberry (Rubus idaeus) is an astringent herb that may help uterine inflammation and pain. Drink it as a tea, three cups daily. Women with severe endometriosis often find that the pain keeps them up at night. If you need to get to sleep, try a tea made with skullcap (Scutellaria lateriflora), passionflower (Passiflora incarnata), or valerian (Valeriana officinalis). To see the "Endometriosis Catalog" of these Supplements and order them online, simply login to your supplement portal here. Specialty & Botanical Supplements Natural progesterone -This hormone balances estrogen, regulates the menses and relieves pain. Apply ¼ teaspoon (20 mg) to your skin twice daily from days six to twenty-six of your cycle (stopping during the week of your menstrual flow). It is best used under the care of a health care professional. Vitex (chasteberry)- Vitex balances the estrogen/progesterone ratio. Take 160 to 240 mg of a 0.6 percent aucubin standardized extract or 80 drops daily. This has been traditionally used as a treatment for hormone imbalances in women. Through action on the pituitary gland, it increases progesterone production by means of an increase in luteinizing hormones, with the effect of making estrogen less available. This herb is useful for fibroids, PMS, and endometriosis. Do not use vitex if you are currently taking a birth-control pill. Indole-3-carbinol Take 300 mg daily. It assists the liver in estrogen detoxification. Super Prescription #4 Dandelion root (Taraxacum officinale) Take 300 to 500 mg in capsule form or 1 ml of tincture with each meal (three times daily). It improves liver detoxification. Vitamin E Take 400 IU twice daily. It helps with estrogen metabolism and inflammation. Bodywork Massage Although it can’t cure endometriosis, a massage of the belly and the lower back is an effective means of easing an acute attack of pain. Find a massage therapist whom you like and trust; if flare-ups occur at a predictable point in your cycle, you may want to make a standing appointment for treatment. One study found that auricular (ear) acupuncture was as effective as hormone therapy in treating infertility due to endometriosis. Hydrotherapy A hot bath can help relieve digestive problems as well as pain. Other Bodywork Recommendations When you feel an acute episode of pain coming on, lie down and rest, with a hot compress on the affected area. Acupuncture is highly recommended to help reduce the pain associated with endometriosis. In addition, Chinese herbal therapy from a qualified practitioner can be very helpful. (1) General Stress-Reduction Therapies People who suffer from chronic pain live with constant stress—more than their friends and family realize. Stress, too, can contribute to painful flare-ups. If you have endometriosis, it’s important that you devote time every day to managing the tension that accompanies a chronic illness. Pilates offers a gentle way to stretch and reduce stress. Moderate exercise is a natural pain reliever. Try to take a walk every morning, or find some other activity you like well enough to perform regularly.

•Use sanitary napkins instead of tampons. Tampons may encourage retrograde menstruation.

REFERENCES 1. Gerhard, I., and F. Postneek. 1992. Auricular acupuncture in the treatment of female infertility. Gynecological Endocrinology 6:171–81. 2. Grodstein, F., M. B. Goldman, L. Ryan, and D. W. Cramer. Relation of female infertility to the consumption of caffeinated beverages. 1993. American Journal of Epidemiology 137(12):1353–60. 3. Stengler, M., Balch, J., Young, R. Prescription for Natural Cures. 3rd Ed. 4. Guidace LC. Clinical Practice. Endometriosis. The New England Journal of Medicine 2010 Jun 24; 362 (25): 2389-2398 5. Weuve J, Hauser R, Calafat AM, et al. Association Exposure to phthalates with endometriosis and uterine leiomyomata: findings from NHANES, 1999-2004. Environmental Health Perspectives 2010 Jun; 118 (6): 825-832 6. Goldin BR, Adlercreutz H Dwyer JT, et al. Effect of diet on excretion of estrogens in pre and post-menopausal women. Cancer Research 1981;41;3771-3773. 7. Murray, Michael, Pizzorno, Joseph. Encyclopedia of Natural Medicine. 3rd Ed. (565-569) 8. Missmer SA, Chavarro JE, Malspeis S, et al. A Prospective study of dietary fat consumption and endometriosis risk. Human Reproduction 2010 Jun; 25(6): 1528-1535 Posted Aug 1, 2019 Dr. Monique Reynard, DC, CHN Tampa, Florida © Unboxed Wellness LLC