Pelvic pain and achiness are a dreaded but common part of the monthly menstrual cycle. Most menstrual cramps can be alleviated fairly easily with dietary changes and anti-inflammatory supplements or OTC medications. However, for women with endometriosis, pelvic pain can be constant and debilitating, and treatment is not that simple.

What is endometriosis?

Endometriosis is a condition where cells from the uterine lining (the endometrium) are located in places outside of the uterus. These rogue endometrial cells can occur anywhere in the body, but the most common places to find them are the ovaries, fallopian tubes, and in the pelvis around the uterus. They also commonly implant in the bowels, bladder, or rectum. Just like normal endometrial cells, endometrial lesions respond to estrogen and progesterone. Estrogen helps them grow, and progesterone will stabilize them. They will also bleed when hormones drop, just like the bleeding of the menstrual cycle. When these lesions bleed, they cause localized inflammation and scar tissue formation. All of this leads to the pain and other symptoms associated with endometriosis.

The cause of endometriosis is still unknown. There is a definite genetic component, as having a female relative with the condition greatly increases the chances of also having endometriosis. It has also been related to dioxin (a highly toxic chemical) exposure while in utero. Although inflammation does not cause endometriosis, it does contribute to severity of symptoms and progression of the disease.

What are the symptoms of endometriosis?

The most common symptom of endometriosis is severe pelvic pain, usually at the time of menstrual bleeding, but it can also be constant or occur throughout the menstrual cycle. Pain often also occurs with sexual intercourse. Unlike regular menstrual cramps, the pain of endometriosis will rarely resolve with anti-inflammatory medications like ibuprofen. Other common symptoms include: digestive disturbance with abdominal pain, bloating, nausea and vomiting, and diarrhea or constipation, severe back pain, pain in legs, fatigue, low grade fever, pain with urination, and pain with bowel movements. Endometriosis is a common cause of infertility and recurrent miscarriage. Women with endometriosis are at higher risk of ovarian cancer and possibly breast cancer than the general population. They are also at higher risk of autoimmune conditions.

How is endometriosis diagnosed?

Although endometriosis is a common condition, getting a diagnosis is difficult. According to the American College of Obstetricians and Gynecologists, endometriosis occurs in 10% of women and at least 75% of women who complain of chronic pelvic pain. Currently the only way to diagnosis endometriosis is with laparoscopic surgery. Unfortunately, ultrasound most often can not visual endometriosis lesions and there currently is not a blood test to diagnosis the disease. Due to the invasiveness of the diagnostic procedure and because many women associate their pelvic pain with a normal aspect of having a period, it can take on average 6 to 10 years to get a formal diagnosis of endometriosis.

How is endometriosis treated?

Due to the severity of symptoms of endometriosis, quality of life can be greatly impacted by this condition. Unfortunately, there is no cure with either conventional or naturopathic medicine. However, we do have treatments that can greatly reduce pain and other symptoms. Conventional treatment utilizes medications to suppress estrogen, thereby slowing growth of the endometrial lesions. Progesterone-like drugs, called progestins, are also used to stabilize lesions. For severe cases, surgery performed by a doctor well versed in endometriosis can be one of the best ways to alleviate pain and also support fertility. Natural treatments can also be quite effective in helping to control symptoms. These include dietary changes to decrease inflammation. A1 casein from cow’s dairy is particularly inflammatory and aggravating in endometriosis. Herbal and dietary supplements, such as turmeric, zinc, berberine, and NAC, can also help decrease inflammation and pain. Bio-identical progesterone therapy is often chosen over progestins to help stabilize endometrial lesions.

Although the cause of endometriosis is still unknown, awareness and knowledge of this medical condition is much more widespread in the medical community now than it ever has been. There are numerous treatment options that can help minimize the pain and other symptoms of endometriosis. The practitioners at 2BWell are well versed in this condition and can help get patients the support they need. If you experience any of the symptoms mentioned above, please come see us!