What is Endometriosis?

One of the most common causes of infertility is a mysterious medical condition called “endometriosis”. Amongst the millions of women who are affected, forty percent don’t experience any symptoms other than the inability to fall pregnant, while some of the remaining sufferers complain of experiencing excruciating pain.

The endometrium is the outer lining of the uterus. In the early stage of a woman’s monthly menstrual cycle, a surge of estrogen hormones cause that lining to expand to allow implantation of the egg if a pregnancy occurs. When it doesn’t, enzymes in the body break down and liquefy that superficial lining, which becomes the menstrual bloodshed during the menses.

In endometriosis, small sections of that layer are retained in the body. These endometrial cells gradually migrate outside the uterus to implant themselves in a wide range of areas, inside, and outside the reproductive organs, including: in the cervix, the fallopian tubes, the large intestine, the bladder, the thorax and the lungs. Once implanted in these foreign sites, the endometrial tissue continues to respond to the hormonal fluctuation of the menstrual cycle, getting thicker prior to ovulation, and turning into blood during menstruation.

Being in an enclosed space, these abnormal secretions can’t be expelled from the body, so they accumulate and get inflamed, causing scarring and adhesions to the surrounding tissues. If the ovaries are involved, the blood stagnation can result in the production of fibrous cysts in the fallopian tubes which stop the egg being fertilized.

Why does endometriosis occur is still a matter of controversy. One common theory is that this condition is the consequence of “retrograde menstruation” when some of the menstrual blood seeps backward into the fallopian tubes and travels up the abdominal cavity during the monthly menses, but many women who experience retrograde menstruation don’t get affected by endometriosis.

Another theory is that these endometrial implants secrete the hormone prostaglandin causing spasms in the reproductive organs, and impairing their capacity to function.

In fact, no one really knows!

The main symptoms of endometriosis, apart from infertility, include severe menstrual pain, and cramping, pain during sexual intercourse, fatigue, pain during urination and bowel movements, diarrhea, constipation or nausea.

Endometriosis is classified according to the extent of pelvic adhesions and implanted foreign tissue and the amount of blockage of the fallopian tubes. These different stages don’t always reflect the level of pain experienced, the risk of infertility, or the symptoms present. For example, a woman in the first stage could be in tremendous pain, while a woman in stage four might be asymptomatic. Nevertheless, being treated during the early stages of the disease is the best chance of regaining fertility.

The current Western medical approach is to prescribe painkillers, and then to use surgery, or hormone controlling drugs to remove the foreign endometrial tissue. These include taking the birth control pill, or menopause inducing medication to stop menstruation and ovulation. Unfortunately, the increased level of testosterone hormones in the body can result in severe side effects. Even when surgery occurs, it is very difficult to totally remove all the endometrial cells, so there is a constant risk of further contamination of the fallopian tubes.

There seem to be increased incidence of endometriosis if a member of the family already has the condition. Lifestyle factors such as, drinking more than two coffees daily put women at a greater risk. Ironically, cigarette smoking, which impairs the production of estrogen, appears to have the opposite effect. Also, having sex, or undertaking intense exercise during menstruation can increase the risks of retrograde menstrual flow which promotes the implantation of endometrial tissue outside the uterus. In contrast, regular moderate exercise seems to be beneficial.

In Oriental medicine, endometriosis is considered to be caused by blood stagnation, or lack of circulation of blood in the deeper layers of the meridians. That blood stagnation in the implanted foreign endometrial tissues is detected as a toxic substance by the immune system which then reacts by attacking all the endometrial cells in the body and creating inflammation and pain.

The Oriental medicine’s approach to treatment is to prescribe blood moving herbs, and ancient resins type substances such as frankincense, or myrrh which are used to break the blood stagnation at a deep level. A Japanese medical study conducted at the University of Osaka a few years ago showed that the group of women who received a classic herbal with cinnamon twigs had their IgM antibody and inflammation levels decreased to such an extent that they remained pain-free for months after the study was concluded. Also changing the diet, avoiding dairy and wheat products, reducing meat consumption, and taking flaxseed, evening primrose, or fish oil supplements will restore the immune system, and eliminate the built up of fluid stagnation in the organs.

With the right diagnosis, lifestyle modifications, and appropriate treatments, the results can be very effective. Many women, who had previously been told that they had no chance of achieving a normal birth, often get delighted when they are able to regain their health and have a successful pregnancy after a few months of regular herbal and acupuncture treatments.

Olivier Lejus MHSc BHSc. is a Sydney based registered acupuncturist and herbalist with a special interest in infertility.