Endometriosis

What is it?

Endometriosis is the presence and proliferation of endometrial tissue outside of the uterine cavity.

Who gets it

It is believed to occur in

0.5 to 10% of fertile women

25 to 40% of infertile women

Why does it happen?

Possible theories

• Retrograde flow
• Biochemically abnormal endometrial tissue characteristics
• Immune dysfunction higher levels of macrophages in the early stages help suppress the early growth of endometriosis but may also engulf sperm and ova, contributing to infertility. These levels decrease over time allowing greater invasiveness of endometrial growths
• Hormonal imbalance of oestradiol and cytokines stimulate a vascular endothelial growth factor allowing the tissue to adhere inside the peritoneum and other locations in the body. This would be encouraged by a relative oestrogen excess. Risk factors for this are shorter cycles, early menarche and delayed pregnancy. It is common to have luteal phase defects, which reduce the production of progesterone to oppose the oestrogen.
• Genetic factors which may effect the expression of genes allowing the development of ectopic implants such as interleukins and steroidogenic acute regulatory protein. Having a  family member with endometriosis increases the risk.
• Environmental pollution such as dioxin which acts as a xeno-oestrogen promoting the development of endometriosis

What are the signs and symptoms of endometriosis?

Severe dysmenorrhoea

Infertility

Dyspareunia (painful intercourse)

Increased severity of pain towards the end of menstruation

Pain before menstruation and at ovulation

One sided pelvic pain

A mother or sister with endometriosis

How can you treat endometriosis?

The aim is to reduce or eliminate deposits to relieve pain or improve fertility.

Medical options include

• Surgery to remove growths or uterus
• Drugs to induce an anovulatory state,
• IVF
• Anti inflammatory drugs
• Hormones to induce a pseudo-pregnant state
• Continuous oral contraceptive pill (the Oral Contraceptive Pill) to reduce flow and pain

Naturopathically we can offer

• pain relief
• improvement of condition for enhanced fertility

Treatment aims to:

• improve relative oestrogen excess
• ensure normal uterine function and menstrual flow
• regulate prostaglandins
• address immune irregularities
• improve fertility where appropriate
• address depression, fatigue, emotional issues around sexuality