Endometriosis Natural Medicine Support

Originally published in Innerself Magazine www.innerself.com.au

Endometriosis, or growth of the endometrial lining outside of the uterus, affects approximately 10% of women of childbearing age.  The condition is associated with painful periods, heavy periods and infertility.  The degree of symptoms varies greatly from severe, debilitating symptoms to mild or none at all.  Although the cause of endometriosis remains unclear, several of the proposed causative factors are amenable to natural medicine support including oxidative stress, immune dysfunction, lymphatic flow dysfunction and hormonal imbalance (particularly relative estrogen to progesterone excess). Lifestyle and other factors that are associated include high caffeine and alcohol intake, chemical exposure particularly to Dioxin, using the IUD for more than 2 years, high stress, high intake of fried foods/trans-fat, essential fatty acid deficiency and magnesium deficiency.  A natural medicine support program can help minimise or slow the disease by addressing the factors mentioned above as well as help symptom control. However, it is important to note that endometriosis may require medical intervention such as laser laparoscopy to remove the visible endometrial deposits which can then be complemented with the natural approach to prevent or minimise further disease progression.

 Herbal Approaches

 The mainstay of the natural medicine approach to  endometriosis is herbal medicine and there are a wide variety of herbal medicines that are very  useful for treating its probable causes and symptoms.  These herbs have antioxidant, anti-inflammatory, anti-spasmodic, immune modulating, lymphatic and blood flow balancing and hormone balancing properties. Traditional herbs for endometriosis include Dong Quai, Licorice, Peony, Rehmannia and St John’s Wort.  Additional herbs may be prescribed such as herbs for pain: Corydalis, Jamaica Dogwood and California Poppy; herbs for stress: Withania, Rhodiola, and Siberian Ginseng; herbs for sex hormone balance: Chaste Tree, Vervain, and Wild Yam; and herbs for lymphatic drainage: Blue Flag, Calendula, Clivers.  Immune modulation approaches include Reishi mushrooms.

 Estrogen Management

 In addition to prescribing sex hormone balancing herbs, it is important to address the clearance of estrogen as a relative excess of estrogen is likely a contributing factor to endometriosis.  Estrogen is conjugated for removal from the body in the liver and then passes into the bile and the faeces for excretion.  Support of the liver and healthy bowel motions are therefore of paramount importance in estrogen management.  The primary herb for liver support is St Mary’s Thistle which helps maintain liver health and optimal function.  If there is a sluggish bowel problem this should be addressed via diet, water intake and if necessary herbal bowel tonics.  It is possible to check the liver metabolism of estrogens with a urinary estrogen metabolite test.  If the result of this test is not optimal it is best to take Indole 3 Carbinol, an extract of the cabbage family, to shift estrogen metabolism to a more optimal pathway.  Of course including broccoli, cabbages, kale and Brussels sprouts in the diet is very helpful as well (steamed or stir-fried, not raw in large amounts).

 In addition to our own endogenous estrogen production we must be wary of exogenous or external sources of estrogens from our environment.  These are widespread as estrogen like substances or hormone disruptors are found in many plastics, herbicides, pesticides and other chemicals.  It is important to avoid these whenever possible another reason to opt for organic or biodynamic food whenever possible.  Do not use plastics whenever they can be avoided and seek a source of clean filtered water to drink.  Obviously it is best to avoid prescription estrogen whenever possible including the so-called “bio-identical” forms. Taking B Vitamins, Vitamin E and Zinc may also help as they are utilised in estrogen metabolism.

 Diet and Lifestyle

 A diet of whole foods rich in antioxidants and natural anti-inflammatories is recommended such as green tea, berries, pomegranate and turmeric as is the avoidance of foods that are associated with oxidation, inflammation and immune dysfunction such as red meat, fried foods, alcohol, caffeine and refined carbohydrates.  Increasing Omega 3 essential fatty acids found in deep sea fatty fish has direct anti-inflammatory and immuno-modulatory actions.  Supplement sources include high quality fish oils, Evening primrose oil and Flax seed oil.  As mentioned, supplementing B vitamins, Vitamin E and zinc may also be useful as they help with estrogen metabolism and supplementing magnesium can reduce cramping and pain.

 Exercise and stress management are both important for endometriosis support. Regular, gentle exercise helps alleviate pelvic congestion and normalise many body functions.  Specific yoga postures are particularly useful as they can help alleviate pelvic congestion and promote deep relaxation and stress release.