Endometriosis

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Finding a good herbalist

Much of what's written here is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

Symptom relief

This article is focused on understanding and treating the main causes for endometriosis, however working on causes is a gradual process and firstly there are two recommendations that have been seen to offer much help right away for the two most common symptoms of endometriosis

Cramping

For cramping pelvic pain, with or around the period, one of the best of all herbal medicines to help is the aptly named Cramp Bark. As a sample formula of how Cramp Bark could be used in practice:

Cramp Bark 25 mls
Ginger root 12 mls
Lobelia herb 3 mls

To make 50mls of tinctures or extracts. A larger amount can be made in the same proportions. Take from 10 drops up to 40 drops per dose.

One must not think that 'more is better' with herbal medicines. The best dose is the one that you can clearly feel with a generalised relaxation response and an easing of the cramps happening within a few minutes of taking the herbs. For most women, an effective dose will be somewhere between 10 and 20 drops but it is ok if you need to take more to feel anything, especially at first.

Start low and gradually work the dose up until you get a certain reaction. Feeling how they work will definitely get easier with practice, these herbs are not at all mind-altering but they do bring about a characteristic physiological response that releases pain and spasm and goes much further and deeper than the initial heat response from the Ginger.

As well as working out the optimal amount to take, you need to experiment with how often to repeat the dose to get the best effects. When the cramping is bad, use the herbs freely and frequently, up to once every 40 minutes when needed. As things settle down and you get more comfortable you will naturally slow down and stop using them. If the cramps return, start back up again.

It will be valuable to learn more about these herbs if they will become your close allies in times of need, perhaps starting with the page on Cramp bark here

Heavy bleeding

Two herbal medicines that can be of great help to a woman with a heavy, flooding period are Shepherd's purse and Lady's mantle. As a sample formula of how they could be used:

Shepherd's purse 50mls
Lady's mantle 50 mls

To make 100mls of tinctures or extracts. Take from 2-4 mls, again, less or more according to how well you feel their effects, dilute with just a little water and then hold in the mouth for up to one minute before swallowing.

They will taste very 'astringent', like a cup of tea that has been brewed too strong, but getting this effect in the mouth first will help your body to respond more rapidly to their action, which in effect helps to bind tissues and blood vessels that have become too loose.

Again, use as frequently as needed to get a good result, you could safely take a dose of these two herbs up to 5 or 6 times a day with absolutely no worry of any kind of side-effects or toxicity. More about Shepherd's purse here, and Lady's Mantle here


Viburnum opulus (Cramp bark)

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Conventional vs. Holistic Medicine for Endometriosis

It is assumed that nearly anyone who is reading this, for themselves or for someone they care for, will already know a lot about the approach of conventional medicine towards endometriosis, including how it is diagnosed and 'staged' as well as some of the drug, IUD and surgical options that are commonly recommended.

Endometriosis can cause much pain and suffering and great care is required to find the best way to get well. As a herbalist's approach to working with endometriosis is shared below, it must be made clear from the outset that we can expect zero problems with using the holistic herbal approach alongside any of the conventional medicine treatment options, so long as that is what the woman wants to do.

It is an unfortunate fact that there are still practitioners in the mainstream system who look askance at what we do in traditional herbal medicine, but if you scratch the surface of these attitudes, it always comes from a simple lack of understanding and an absence of communication.

If you, or the person you care for, wish to use herbal medicines alongside any conventional drugs or other treatments, it is warmly recommended that you openly communicate what you are doing with any practitioners who are involved.

You must not be afraid of being treated any differently because you choose to work holistically, if they did so then they would be breaking their code of ethics! Old traditional medicine and new pharmaceutical medicine are not inherently in conflict with each other and hardly ever interact badly. All that matters is that whatever treatments you use actually work and that you get well, nothing else is important!


Alchemilla vulgaris (Lady's mantle)

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Potential causes & their treatments

It is because endometriosis is such a complex and multi-factorial health problem that it is so vital to bring a holistic, open-minded approach to its treatment. We can be certain that it is happening for one or more reasons and we can be equally sure that however much we effectively treat the cause of a problem then we can cure that problem, or at least help it to improve in a meaningful and lasting way.

After getting an appreciation of the woman's history and her symptoms, the next step is to try to get a sense of what has been driving things along to get to where they are today.

In nearly every case, we will find evidence for one or more of the following problems...

Hormonal imbalances

Hormonal imbalance can obviously be a critical factor in endometriosis and many women will have already tried to manage their endometriosis symptoms with drugs or an IUD to increase their progesterone or decrease their oestrogen.

This may have been of help but there are also many for whom this hasn't seem to have made a positive difference or they have even gotten worse with these approaches so it is very important to know that drugs are not the only options to help hormonal imbalance.

Traditional herbalists around the world have worked extensively in this area and have consistently found certain herbs to have pronounced actions on hormonal health. Hormonally active herbs include:

Note that it is normal practice to combine several herbs together to be taken at the same time.

Vitex

One of the most important of all herbs for women's hormonal health is the potent Vitex, or Chaste tree. It is not for everyone but if it is the right herb for the right woman, and used in the right way, it has been seen to make a tremendous difference, more here.

Black Cohosh

Black Cohosh is equally as powerful as Vitex to affect hormonal change and is potentially a far more useful remedy for things like endometriosis or infertility, than its now popular reputation as a menopause herb would suggest.

However, like Vitex, Black Cohosh is not for everyone, and it is with these kinds of herbs that getting the help of an experienced practitioner can be especially valuable. Nevertheless, if that is just not possible, then it shouldn't be excluded as an option, herbs are the medicines for the people, everyone should have access to them. The next best step, if needed, is to learn more about it, more here.

Dong Quai

Dong Quai has been seen to be quite fantastic for some women with endometriosis, and you can have much less concern about it being the 'right herb' as with the Vitex or Black Cohosh.

Dong Quai moves 'stuck blood', it must be used in quite reasonable doses, again unlike the Vitex and Black Cohosh which are better in much smaller amounts, but if used generously you will often see a major shift in the amount of pain and disturbed bleeding around the period in a gratifyingly short amount of time; more here.

Feverfew

There are other hormonally active herbs that could potentially help, but just one more to mention here is Feverfew, which has been somewhat typecast as a migraine medicine but has an action which is, at least in part, to beneficially influence the prostaglandins, which are hormone-like chemicals, that we know play a key role in the inflammation happening with endometriosis.

Feverfew is a low-dose/high-strength herb that is best taken over several months to see its true benefits; more here.


Vitex agnus-castus (Chaste tree)

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Gastro-intestinal disturbance

Some years ago, the American Endometriosis association put out a comprehensive book that went into great detail on the many conventional and complementary approaches available to treat endometriosis including a frank discussion of their relative strengths and weaknesses.

This book was put together by professional women who themselves had all had endometriosis, it was refreshingly candid and free from bias. One chapter described the results of a major survey of thousands of their members on exactly what they had found had made the biggest difference to their health.

Interestingly, the treatment strategy that was described as the best by the largest number of women involved the 'anti-candida diet' which was a diet very low in refined sugars and carbohydrates. The survey contained some real gold but the conclusions drawn from it may have been a little misdirected.

Firstly, many of those women with endometriosis may have had the 'metabolic syndrome' and were improving because of a low-carbohydrate diet, this is discussed a little further on.

Secondly, Candida itself was actually unlikely to be the core issue but rather a general overgrowth of unhealthy yeast, fungi, bacteria or other parasites may have been a key driver towards the inflammatory imbalance of endometriosis; this kind of overgrowth is called 'dysbiosis'.

Dysbiosis

How you might suspect that 'dysbiosis', an overgrowth of unhealthy micro-organisms, is a core issue needing attention could be the primary symptom of marked abdominal bloating that always comes along with it. However, there are of course other conditions, including the inflammation of endometriosis itself, that can cause similar bloating so this can only be a pointer rather than a proof.

Dysbiosis can be difficult to diagnose with certainty and sometimes the best way to proceed, if there is reason to suspect it is playing a role, is to take a treatment that is both safe and strong enough to fix it. If the related health problems improve, you were on the right track, if they don't, then at least you've ruled it out. The practicalities of how to do this, along with other information, are written about in more depth here.

Irritable Bowel Syndrome

If you have had a history of upset digestion or bowel function that goes back well before any of your endometriosis symptoms, then you may need to particularly focus on this area in your journey back to health.

For example, if you have been diagnosed with, or think you have symptoms of, the irritable bowel syndrome that precede your endometriosis then one or more of the strategies in the comprehensive article on IBS may do more to help than anything, more here

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Liver trouble

Many writers and practitioners who work with endometriosis believe that its 'apparent' increase is due to increased toxicity in the environment, especially from xeno-oestrogens and dioxins.

The word 'apparent' there is because it should be noted that endometriosis has been with us for a long time, the ancient Greeks wrote about it extensively albeit by a different name, and also that an accurate diagnosis of endometriosis is typically badly delayed in most women's cases, taking an average of 6 years from when they first present to a doctor with their symptoms! It may be that we are seeing an increase in reporting rather than actual cases.

In any instance, it is the liver that takes the brunt of the body's toxic load and it is also the liver that plays a vital role in determining how much oestrogen recirculates around the body.

When a person needs liver support and detoxification they will typically show signs of fluid retention, poor bowel health, bad skin, and a distinctive kind of grumpy tiredness. The tongue is another aid to knowing when cleansing is required in the way it gets a distinctive off-colour coating that gets worse when the symptoms are worse.

If cleansing is required, then you will need to use a cleansing diet, such as written up here, plus herbs for it all to work with certainty. Celandine is perhaps the strongest of the liver herbs, more about it here, for some women a gentler liver herb such as Dandelion root will be better, more here, or to help clear the liver and bowel, Yellow Dock, more here. In any case, if you think this may be key area for you to explore further, then start with reading the article 'what is detoxification' found here


Chelidonium majus (Celandine)

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Immune problems

Immune health can play a major role in whether a women's endometriosis gets better or worse. For instance, we know for a fact that it is specialised white blood cells whose job it is to clear away the endometrial debris that accumulates outside of the uterus.

How we might suspect that a weakened immune system could be a primary cause for endometriosis are such signs as recurrent infections, allergies, or slow healing from wounds or injuries.

If immune support is needed, then two of the most reliable herbal medicines to make a significant difference are Echinacea root, more here, and Astragalus, more here. Further to that, a comprehensive write-up on this vital subject is found here

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The Metabolic Syndrome

The polycystic ovarian syndrome is directly caused by the metabolic syndrome. Many people who work in this area strongly believe that for some women the metabolic syndrome is a key driver for endometriosis as well.

How you might suspect the metabolic syndrome is the presence of other tell-tale signs such as weight problems and an 'apple-shaped' figure, cravings for carbohydrates and mildly elevated cholesterol &/or blood-pressure levels.

The metabolic syndrome effects a great many people, its successful treatment requires sustaining a low-carbohydrate diet for a sustained period of time, but when it is a core issue the results from making such a change can be outstanding, more here

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Putting it together

Having read the above notes it is entirely possible that you will have identified with more than one of the potential causes and so will wonder, 'where do I start

Endometriosis is a complex condition, it is entirely normal and appropriate to work on more than one area at a time. The approach of holistic medicine is simply to do whatever is needed to get a great result, whatever it takes! By way of example a typical treatment program could look something like the following

Vitex or Black Cohosh 25-50mls

1-2 mls or 20-40 drops each morning on rising for up to 3 full menstrual cycles before taking a break
Or 1-2mls Black Cohosh for the 1st two weeks of the cycle
Then 1-2 mls of Vitex each morning until bleeding starts

Liver, Hormonal & Immune formula

Dandelion root 80mls
Celandine 40mls
Dong Quai 140mls
Raspberry leaf 60mls
Echinacea 80mls
Astragalus 80mls
Licorice root 60mls

To make 540mls of tinctures or extracts. Between 8-10mls 2 times daily until significant improvement have been achieved whereupon continue with 10mls once a day for at least a few months.

Other immune or liver tonic herbs could be used in addition if one of those areas seemed particularly bad, there are further ideas on the pages linked in those sections. Treatment plans for dysbiosis or IBS are quite comprehensive and are discussed in detail in their pages as linked. Likewise, the diet to cure the metabolic syndrome needs dedicated study to understand and follow.

It probably all looks like hard work, and it is, but when you do the necessary work and you start making meaningful and lasting improvements, it will all seem more than worthwhile.


Angelica sinensis (Dong Quai)

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Constitutional Health Note:

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general.

Constitutional health is an old and fascinating way of understanding our differences. There's a brief introduction here and a more detailed section on working out which constitution you are here

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!

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© 2011 R.J.Whelan Ltd