Endometriosis is when the tissues of the endometrium lining of the
uterus grow outside of the uterus. The endometrium is the inner mucosal
lining of the uterus. It has two layers. The stratum functionale
contains the excretory glands and is shed as menses during menstruation.
It is then built-up again by stimulation of the ovaries releasing
hormones. The deeper layer that resides next to the myometrium is
vascular (vessels that carry fluids) and serves to regenerate the
stratum functionale after each menstruation ends.
In women with endometriosis the displaced tissues function and are
influenced by hormones just as a normal endometrium would. This means
that these displaced tissues go through the same cycle that any
endometrium would; the tissues build up as the body approaches
ovulation, then begin to break down when ovulation does not occur and
then the displaced tissues bleed during menses. When the endometrial
lesions bleed, the blood accumulates locally and triggers inflammation
and pain. Over time this may cause development of adhesion (internal
scar tissue).
Endometriosis may attach to the ovaries, fallopian tubes, bowel,
bladder, ligaments or other areas in the abdominal cavity. Rarely the
endometrial cells will attach to other areas in the body including the
lungs and nasal cavity. If adhesions develop, this may cause internal
organs to become stuck to other internal parts of the body and may even
cause displacement of organs and other tissues.
Endometriosis can have a huge impact on fertility, being blamed for 35-50% of fertility issues in women.
Some of the symptoms are:
- Heavy menstruation with pain, large clots, long or abnormal length of cycles
- Lower abdominal pain, back pain, burning pain over the site
- Frequent or constant pain all month long
- Painful sexual intercourse
- Painful during bowel movement or urination
- Rarely bleeding after intercourse, bowel movement, or urination
- Dysmenorrhea
- Ovarian swelling
- Swollen abdomen
- Infertility
Endometriosis can have a huge impact on fertility, being blamed for
35-50% of fertility issues in women. This is two to three times the rate
of infertility in the general population.
Risk Factors
There are are a variety of risk factors for the development of endometriosis. Here are the main risk factors:
- Too much estrogen/too little progesterone
- Genetic predisposition
- Too much conventional meat
- Radiation and EMF’s
- An abnormality in the immune system
- Exposure to environmental toxins
- Benign uterine fibroids
What Causes Endometriosis?
Doctors and Scientist don’t really know for sure what causes
endometriosis. Combined theories agree that there are many different
factors in the development of this condition, which makes endometriosis a
complex condition with a many different origins. Because researchers
cannot find one direct link to the cause, it also makes it very
difficult to treat.
Genetic Predisposition
Genetic predisposition in women with a family history of mothers or
sisters that have endometriosis are at a higher risk for developing
endometriosis. Women who also have low progesterone often have a family
history of low progesterone.
Genotyping studies have associated a link between endometriosis and
individual genomic changes in certain chromosomes. This may have been
passed down genetically from a parent. Changes in the chromosomes and
gene expressions may also be caused by exposure to environmental factors
or altered metabolism.
Lymphatic Flow Theory
This theory suggests that the endometrial tissue is spread throughout the body via the lymphatic system.
Retrograde Menstrual Flow Theory
Researchers and doctors suggest that endometrial tissue flows
backward through the fallopian tubes and into the abdominal cavity
causing the displacement of endometrial cells. These cells then attach
to other areas of the abdominal cavity. This is the most widely
accepted theory. It is recognized though that other environmental,
immunological and hereditary factors may contribute to the development
of endometriosis.
Low Progesterone and Estrogen Dominance
Low progesterone disrupts hormonal imbalance overall. When progesterone becomes low, estrogen usually becomes too high. Estrogen dominance
and progesterone deficiency have been linked to the development of
endometriosis. Estrogen dominance may happen from chemical toxin
exposure from xenoestrogens (toxins that mimic estrogen), including
hormones in foods we eat, pesticides, fertilizers, and dioxin, all of
which disrupt endocrine system function.
Numerous studies have shown a correlation between
dioxin exposure
and the development of endometriosis. In a study using monkeys it was
shown that Dioxin increased the severity and growth of endometrial
tissues as well as promoted survival of endometrial tissue outside of
the uterus.
Dioxin is a group of highly toxic chemicals that are a by-product of
industrial processing using chlorine to manufacture herbicides and
pesticides, process pulp and bleached paper products (including the raw
materials for feminine care products) as well as incinerate waste.
Dioxin is considered a Persistent Organic Pollutant, POP for short,
that slowly over time accumulates in our bodies. This pollutant is
carried in the air and in our water systems as well, which affects the
entire food chain and planet. Dioxin is not only present in feminine
care products, but most paper products we use including napkins, paper
towels, tissues, make-up removal pads, toilet paper, diapers, ect.
Immunological Factors
Immunological
factors have been linked to the development of endometriosis and
endometriosis related infertility. In early endometriosis (stage 1 &
2) there are elevated levels of inflammatory mediators. Studies have
shown elevated levels of cytokines, lymphocytes, and macrophages in the
peritoneal fluid of women with early stage endometriosis.
Over time the immune system function appears to alter and may
increase the number of peritoneal macrophages, decreased T-cell activity
and natural killer cells (NK), increased antibodies and altered
cytokine network function. Overall this creates depressed immune
function and poor inflammatory response. This may allow endometriotic
tissues to implant elsewhere in the body more easily. This may also be
why women with endometriosis have more pain, inflammation and are more
susceptible to recurrent infections, especially yeast infections.
Oxidative Stress
Cell damage from free radicals has been suggested as the leading
contributing factor for development of endometriosis. This may be due
to dietary factors, exposure to chemical toxins, aging, immunological
and inflammatory response.
Free radicals
are unstable molecules that can damage cell structures, this is known
as oxidative stress. In normal everyday life free radicals are produced
from the activity in our bodies (for example free radicals are made
during energy production) but chemicals in our surrounding environment
can also create free radicals. It is said that each cell in our body is
attacked about 10,000 times a day by free radicals, accelerating the
aging process and allowing for tissue damage and the spread of disease.
How Does Endometriosis Affect Fertility?
Endometriosis is an estrogen dominant condition. When there are too
much estrogen in the system, it causes hormonal imbalance. Proper
hormonal balance is essential for healthy fertility.
Endometriosis also creates a situation of “congestion” where there
are excess tissues growing in the uterus (as well as other areas of the
body) which makes it harder for an embryo to attach and grow healthy.
Every month the excess tissues bleed which cause inflammation to
occur and scar tissue to begin adhering to uterus, fallopian tubes, the
ovaries, and other organs. This causes some serious “congestion”. If
endometrial cells attach to the ovaries or fallopian tubes this may
alter normal ovulatory function or cause the fallopian tubes to become
blocked.
As if that was not enough some researchers suggest that the woman’s
body may form antibodies against the misplaced endometrial tissue. The
same antibodies may attack the uterine lining and cause miscarriages (up
to three times the normal rate).
Medical Options for Endometriosis
If endometriosis is left untreated this condition has serious
negative impact on reproductive health. There are both medical options
and natural therapies to help heal the body from endometriosis.
Endometriosis is usually diagnosed by laparoscopic surgery.
Surgery
Doctors will often suggest laparoscopic or abdominal surgery to remove
the endometrial lesions, scar tissue damaged areas and clip away
adhesions if possible. In the case of severe endometriosis, a doctor
may suggest a full hysterectomy (removal of uterus, cervix, ovaries and
fallopian tubes).
Hormonal and Pain Medications
Doctors may prescribe hormonal medications. The purpose is to stop the
menstrual cycle to prevent further growth of the endometrial tissues.
This may also help to reduce pain. If pain is still present they may
prescribe pain medications. Hormonal medications alter the natural
menstrual cycle and may prevent pregnancy. They all come with a variety
of side effects. Medications are not always effective and once
medications are stopped the endometriosis may come back or spread
further. Your doctor can help you to determine which options may be
best for your particular situation. Most times surgical options may be
combined with natural therapies.
Natural Therapies for Endometriosis Infertility
Lifestyle changes are some of the most effective ways to help with
endometriosis. These would be changing your diet, clearing out old
tissues and congestion, balancing your hormones, and avoiding certain
pollutants. The overall goal is to support proper function and health
of the endometrium, endocrine and immune systems.
Step 1: Eat a nutrient dense fertility diet
To begin you will want to build a healthy foundation for your
fertility by creating a baby-friendly-body. Diet changes specific to
endometriosis are important. There are several types of food you may
want to avoid because they have been linked to making endometriosis
worse. Certain foods may trigger flare-ups, promote inflammation, or
are “congesting” to the body, feeding the congestive nature of
endometriosis, while other foods may increase hormonal imbalance.
Foods to Limit or Avoid
The following foods have been linked to making endometriosis worse:
Gluten, specifically wheat
Wheat has a direct link to making pain worse in women with
endometriosis. Researchers are not sure why, but nutritionist Dian
Mills says, “Wheat has been genetically modified…There is also problems
with gluten sensitivity, and more people are becoming gluten sensitive
and I find that when I’ve taken wheat out of the diet, in 80% of the
women with endometriosis, their pain subsides.”At study performed in 2009 of 120 women with endometriosis tested
positive for markers that signal the possibility of celiac disease. Of
those 9 women, 4 agreed to intestinal biopsy to confirm celiac disease,
all 4 tested positive. Researchers concluded that celiac disease
appears to be common in women with endometriosis which may warrant
further studies on the topic.
When you have Celiac disease, every time you eat something with
gluten in it, your immune system goes into overdrive which results in
the production toxins throughout the body. These toxins ultimately
damage the villi found in the stomach. This destruction restricts the
bodies ability to absorb the right nutrients which can actually starve
the body of the vitamins and minerals it needs to work properly,
eventually affecting every system in the body – including the
reproductive system.
It is suggested to remove gluten or at least wheat from the diet for a
minimum of 2 months to see if pain is reduced or eliminated.
Dairy products
Dairy products are “congesting” to the body. Consumption of dairy
products should be limited to about 2 times a week at most. Choose
organic raw dairy products when possible. Homogenized and pasteurized
cow milk is the most congesting and hard to digest of all dairy
products. Choose dairy milk alternatives, such as hemp, almond or brown
rice milk instead. Organic raw unsweetened yogurt or kefir are the
best choices for dairy products. Be sure that all dairy you do consume
is organic or says it does not contain any added hormones.
Red meat, especially commercially raised beef
A study performed in 2004 compared 504 women under the age of 65 who had
endometriosis to 504 women under the age of 65 who had no known
fertility problems. They found that women who ate beef or other red
meat seven times a week or more were 100 percent more likely to have
endometriosis than women who ate red meat three times a week or less.
The study did not mention what the connection between red meat
consumption and endometriosis is, but that it does exist. It may very
well be that most red meat contains a variety of xenohormones and
antibiotics which are known to be toxic the the human body. See
Non-organic foods below for more information on how non-organic meats
affect fertility.
Pork
The same study from above showed that women who ate ham three or more
times per week were 80 percent more likely to have endometriosis than
those who ate it less than once a week. Pork is one of the fattiest
meats a person could consume, which means pigs store more toxins than
other animals.
Soy
Soy foods are highly processed and contain concentrated amounts of
isoflavones. The isoflavones are known to be phytoestrogenic. In fact
soy contains more concentrations of isoflavones than any other
phytoestrogen, which may contribute to estrogen dominance. Most soy is
genetically modified and not organic, both of which have been linked to
numerous infertility cases.
Non-organic foods
We have learned that exposure and consumption of pesticides, herbicides,
synthetic fertilizers and GMO foods can create hormonal imbalance
through endocrine disruption and suppressed immune function.
Conventional fruits and vegetables are regularly sprayed with these
chemicals and then not only do we eat them daily, but so do animals that
are raised for meat.
If you eat non-organic meats, you are being doubly exposed to these
toxins. This is because xenohormones become more concentrated as they
move up the food chain. Xenohormones are often stored in the fat cells
of animals. The more fatty the meats you are consuming the more
xenohormones you are consuming. For example if you are eating 80%
lean/20% fat beef, you may be consuming 20% toxins that cow has stored
in its fat. What was that non-organic cow eating? Well, conventional
beef is raised in feedlots. They are fed corn and soy feed. This is GMO
corn and soy, sprayed with pesticides, fertilizers and possibly
herbicides. The cows eat this everyday. Then on top of that the
animals live in horrible living conditions and are given antibiotics to
stave off the spread of disease.
Foods to Focus On
Fresh Vegetables and Fruits
These foods should make up most of your diet. The study from 2004 that
linked red meat consumption to endometriosis also Studies showed that
women who eat green vegetables 13 times or more per week (roughly twice a
day) were 70 percent less likely to have endometriosis than those who
green vegetables less than six times per week.
Women who ate fresh fruit 14 times or more per week (at least twice a
day) were 40 percent less likely to have endometriosis than those who
ate fruit and vegetables less than six times per week.
This study suggests that there may be link between eating a healthy
diet, low in red meat and high in fruit and vegetables and a reduced
risk of developing endometriosis.
The current advice is to eat at least five 80g portions of fruit and vegetables every day.
The Importance of Fiber
Your main focus and one of the first things you should do right now is
eating more fiber. Fiber helps the body to get rid of excess estrogens.
Some good sources of fiber are:
- Dark leafy greens
- Broccoli
- Swiss chard
- Quinoa
- Chia seeds
- Beans
Essential Fatty Acids
In addition make sure to eat a diet high in essential fatty acids.
EFA’s, specifically omega 3′s, reduce inflammation in the body which
will help to lessen the pain that endometriosis can cause. Omegas also
support hormonal balance. A diet high in Omega EFA’s and lower in trans
fatty acids protects cellular integrity, which protects the cells in
the body from oxidative stress.
Good sources of omegas are:
- Omega 3: Flax seeds (ground or oil), cage free organic eggs, wild Alaskan salmon
- Omega 6: Borage Oil, Evening Primrose Oil
- Omega 9: fresh seeds and nuts, avocado and sunflower oil
If you are not getting enough essential fatty acids from the foods you eat, you may want to consider taking a complete omega supplement or at least one high in omega 3.
Endometriosis Smoothie
- The pineapple and papaya in this smoothie are anti-inflammatory and
the naturally occuring protein digesting enzymes may help the body to
dissolve abnormal tissues. You can usually find the pineapple, papaya,
and mango frozen if you can’t get it fresh.
- The chia seeds and coconut flakes serve as extra fiber to help
remove excess estrogens from the body as well as providing essential
fatty acids.
- Bee Propolis – In a recent study, women with endometriosis have a
60% greater chance of getting pregnant than the women who take nothing.
Suggested usage is 500 mg twice a day of bee propolis.
1/4 C. Pineapple
1/4 C. Papaya
1/4 C. Mango
2 scoops Fertilica Whey protein powder
1 T. chia seeds
1/4 tsp. Bee Propolis (equivalent to 500mg)
1 T. Coconut flakes (dried)
1.4 C. -3/4 C. water or juice of choice (I love the pineapple coconut
juice from Knudsen’s) fresh squeezed orange juice goes great!
Blend and enjoy!
Step 2: Avoid Exposure to Environmental Toxins
We have learned that exposure to certain environmental toxins may
contribute to the development of endometriosis or make it worse. Some
toxins are known to be endocrine disruptors. Endocrine disruptors, also
known as xenohormones, are human-made chemicals. These chemicals have
the ability to interfere with the natural functions and development of
our bodies. The main function of the endocrine system is to serve as our
body’s message center. Hormones deliver messages, the endocrine system
coordinates hormones.
Ways to support healthy endocrine function and avoid xenohormones:
- Eat organic foods
- Avoid exposure to pesticides, herbicides and synthetic fertilizers
- Use natural feminine care products
- Use organic, natural body care products, including makeup
- Avoid food preservatives and dyes
- Use low VOC paints
- Use recycled unbleached paper products
- Use non-chlorinated oxygen based bleach in the laundry
- Avoid plastics
Step 3: Prepare your body with a cleanse
Cleansing specifically for fertility
is an important first step if you are experiencing endometriosis.
Cleansing using specific herbs helps the body to clear out old tissue,
increase circulation to the reproductive system, support hormonal
balance, reduce inflammation and pain caused from endometriosis. There
is a correlation between the body’s inability to remove excess toxins
and waste products in women with endometriosis.
A fertility cleanse also aids the liver in removing excess estrogens
from your system. Again, supporting proper hormonal balance is vital to
reducing the spread of endometriosis. We find doing a Fertility
Cleanse 2 times a year is important for supporting a healthy endometrium
and hormonal balance.
Step 4: Fertility Enzyme Therapy
Fertility Enzyme Therapy is one of the best and most effective
natural therapies for helping the body to deal with endometriosis.
Specific systemic enzymes can help support the body to reduce the
“stagnation”, scar tissue and breakdown the excess tissues left from
endometriosis.
Certain systemic enzymes also have the ability to reducing the
inflammation caused from the scar tissue irritating the surrounding
organs and may help with the pain that sometimes comes from having
endometriosis.
The blood cleansing actions of this therapy help to bring proper
circulation to the reproductive system and get the “stagnant blood”
cleared out, bringing fresh oxygenated blood to your uterus and ovaries.
It is best to start the Fertility Enzyme Therapy
in conjunction with fertility cleansing. For endometriosis you will
want to stay on a systemic enzyme for many months so all of the stagnant
tissues and scar tissues can be cleared. This should only be done in
the months prior to trying to conceive.
Step 5: Supportive Herbs and Supplements for Hormonal Balance and Creating a Healthy Endometrium
Herbs and supplements can be very helpful for women with
endometriosis. Many of these natural therapies support the body in
eliminating excess hormones, endometrial tissues, inflammation, while
promoting the reduction in endometrial growth.
Progesterone
If you have endometriosis, Dr. John Lee recommends using progesterone cream
from days 8 to 26 of your cycle, to reduce the effects of estrogen on
the body (estrogen stimulates endometrial growth). Take a short week off
to refresh your receptor sites. He has had success with this
controlling symptoms within six months. Once the outbreaks of
endometriosis are tolerable reduce the usage to days 12 till menstrual
cycle.
DIM
DIM
helps to balance the hormones by breaking down excess estrogen and
removing it from the body. Endometriosis is an estrogen dominant
condition. Cleansing the body of excess estrogen should help the body to
reduce the growth of excess endometrial tissues.
Women’s Best Friend
Women’s Best Friend takes down pain and swelling caused from
endometriosis so you start feeling better right away. Women’s Best
Friend goes to the source of the problem, helping to reduce excess
estrogen that fuels abnormal growths, and stimulating liver activity for
improved estrogen metabolism. It works with your body’s natural
detoxification processes to clear congested endometrial tissues while
reducing symptoms like abnormal bleeding.
Key herbs in Women’s Best Friend that make this product so effective:
Goldenseal Root(Hydrastis canadensis)-
This herb is extremely antibiotic, antimicrobial and anti-inflammatory.
It works to heal any infection in the reproductive system, while also
reducing pain and inflammation from foreign tissue growth. Reduction in
inflammation may help to prevent scar tissue and adhesion.Jamaican Dogwood(Piscidia erythrina)- This
herb is extremely antispasmodic and analgesic. It reduces muscular
cramps and spasm. This is an herb that is often relied on by herbalists
for women who have unrelenting pain disturbing daily life activities;
debilitating pain.
Wild Yam(Dioscorea villosa)- Helps to
promote normal hormone levels and overall balance within the
reproductive system. Wild Yam may also help the uterus to work more
efficiently during menses.
Cramp Bark(Viburnum opulus)- This is one
of the most effective herbs for reducing uterine spasm and cramping.
Cramp Bark brings relief of pain and muscle spasm for smooth muscle,
especially the uterus.
Peony Root(Paeonia officinalis)- Peony has
been found to aid in increasing progesterone levels, lower testosterone
and balance estrogen. Overall this herb has excellent hormone balancing
support.
Additional Supplements that are helpful for endometriosis…
Whole Food Prenatal Multivitamin
A major part of increasing egg health and preparing the uterine lining is to take a prenatal multivitamin.
Making sure your body has all of the nutrients necessary is a lot
easier when you are taking a multivitamin. My favorite is the 100% whole
food Baby and Me from Mega Food. Synthetic multivitamins don’t have the
same effect. If you decide to change your diet to reduce
endometriosis, you will need to make sure your body is supported
nutritionally as your body adjusts to the diet changes. For women that
have gluten or wheat intolerance, the digestive system may be damaged,
which make absorption of nutrients from the diet difficult, it is vital
you supplement with a multivitamin to ensure make up for lost nutrients
in foods.
Pycnogenol: Pycnogenol is a powerful antioxidant that comes from the bark of the pine tree
Pinus maritima.
It has been shown to help women with endometriosis, improve egg
health, and increase sperm health. Antioxidants are important in
restoring and protecting cellular health and DNA. Pycnogenol is a
therapeutic alternative to Gn-RHa in the treatment of endometriosis.
Bee propolis
Bee Propolis
is a resinous mixture of tree sap, tree buds, tree leaves and other
botanical sources that the bees make to seal small openings in their
hives.
A study published in Fertility and Sterility
(2003;80:S32) showed that 60% of women with endometriosis related
infertility who took 500mg of bee propolis twice a day for 9 months
became pregnant as opposed to 20% in the placebo group.
Endometriosis pain, scar tissue and adhesion formation is thought to be
triggered by inflammation response. Bee propolis has been shown to be
extremely anti-inflammatory which may reduce endometriosis. Bee propolis
may also contain immunomodulating properties. This may be beneficial
for autoimmune related fertility issues. Some doctors theorize that
endometriosis may be an autoimmune disorder.
Maca
Maca is an incredible fertility super food. It helps to
balance the hormones, but does not contain any hormones itself. Maca
is able to do this through nourishing and balancing the endocrine
system. This is essential in preparing for women with endometriosis
because healthy hormonal balance contributes to healthy fertility.
Summary
Endometriosis is a complex fertility issue that has been shown to
have multiple causes. Because of this there are a variety of steps that
need to be taken to heal and reduce the effects it can have on
fertility. The following 5 steps can help you to support a healthy
endometrium!
1. Diet is your foundation. There are many foods that contribute to
the spread and pain of endometriosis, limit those. Choose foods that
support estrogen metabolism and reduce inflammation.
2. Avoid exposure to environmental toxins. Exposure to certain toxins may make endometriosis worse.
3. Fertility Cleansing is vital to supporting hormonal balance and uterine health.
4. Fertility Enzyme Therapy supports both proper inflammatory
response and immune function. It also aids in the breakdown of scar
tissue and adhesion.
5. Use supportive herbs and supplements for hormonal balance and to create a healthy endometrium.
Red Raspberry (Rubus idaeus, spp)
is one of the most well known and most loved fruits in the world, but
in the herbal and midwifery world it’s leaves are also a dearly
treasured herbal remedy for women of childbearing age. Raspberry Leaf
is most popular as a tonic for pregnancy and labor, but is it also
excellent as a nutritive and tonic in preparation for pregnancy. It is
also one of the main herbs that is considered safe in most cases to use
during pregnancy in preparation for labor. But, why wait until you are
pregnant to reap the benefits of this wonderful leaf?
This
herb is best taken as an infusion (herbal tea). Drink 1 cup, 1-3 times
a day. Pour ¼ cup of dried red raspberry leaf into a quart mason jar,
fill with freshly boiled water, cover and let steep for at least 15-30
minutes. For a stronger infusion, steep for 3-4 hours.
Egg
health is one of the cornerstones of healthy fertility. The health of
your eggs (ovum) can affect whether or not fertilization and
implantation will occur as well as the viability of a pregnancy. In the
past is has been thought that we are born with all of the eggs cells we
will have for the rest of our lives, hence the reason age can have such
an impact on egg health. Egg cells are some of the only cells in the
body that do not regenerate… or at least that has been the belief up
until now. Recent research has brought up some promising new views on
egg production – women may actually produce eggs throughout the
reproductive years. Scientists have found stem cells within the ovaries
that produce new egg cells (Nature, 2004). 
We
live in a fast paced world, and being a woman today has many blessings,
one of them being a professional life. But are we constantly trying to
hurry up and rush things in order to meet all of our commitments?
Last edited 13/04/2011