Endometriosis

I meet many women with endometriosis in my work and it seems to be affecting younger and younger women. This article is entirely based on my experience with actual patients and it is to share some strategies to help with those things that most commonly underly this difficult condition.

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Finding a good herbalist

Much of what's written in this article 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

Conventional vs. Holistic Medicine for Endometriosis

Most people who are reading this will have already been on a journey of understanding endometriosis either for themselves or for someone they care for and it is likely they already know quite a lot about the approach of conventional medicine including how it is diagnosed and 'staged' as well as some of the drug, IUD and surgical options that are commonly recommended.

There is no doubt that endometriosis can cause much pain and suffering and great care is required to find the best way to get well. As I describe my own approach to working with endometriosis below I want to make it clear from the outset that I have found there to be absolutely zero problems with using the holistic herbal approach alongside any of the conventional medicine treatment options if that is what my patient wants to do.

It is an unfortunate fact that there are many in the conventional system who look askance at what we do in traditional herbal medicine but I think this comes from a simple lack of understanding of our practices that have been long-established to be truly safe as well as effective. When it comes to wanting to relieve suffering and help people to regain their health then, even if our approaches are very different, there are many instances where working together will be in the patient's best interests.

Whatever it legitimately takes to get well is welcome, wherever it comes from. No-one who is truly interested in healing will take a side against anything that does good so long as it doesn't do harm.

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A holistic approach to endometriosis: 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.

The first thing I will do in my practice, after getting an appreciation of the woman's history and symptoms, is to try to get a sense of what kind of primary causes may have been driving things to get to where they are today and, in nearly every case, I find evidence for one or more of the five following problems...

Holistic approach to endometriosis: potential causes & their treatments

1) Hormonal imbalances

Hormonal imbalance can obviously be a critical factor in endometriosis. Many women will have already tried to manage their endometriosis symptoms with drugs or an IUD to increase their progesterone or decrease their oestrogen and this may have been of help but I also meet many for whom this hasn't seem to have made a positive difference or they have even gotten worse with these approaches! It is very important to know that these are not the only options to help and that there are in fact legitimate herbal approaches to helping hormonal imbalances. I can assure you that these herbs do not lack in the power to be able to change things - in many instances rather dramatically!

Vitex

One of the stand-out herbs for women's hormonal health is the potent little berry Vitex (also popularly called Chasteberry). Used in the right way for the right woman I have seen Vitex make a huge difference to endometriosis but if there was ever a herb to understand and use well it is this one! Just as with hormonal drugs, or any other approach to endometriosis for that matter, there is no one thing that works for everyone and to make things even more complex it can be seen that for some women the use of Vitex will see an initial worsening of symptoms in the first period after using it but then things can rapidly improve after that...

Black Cohosh

To make things even more complex it can be seen that some women do best with a small daily dose of Vitex each morning whilst others will do much better with using a small dose of Black Cohosh for the first two weeks from the first day of the cycle beginning with their period and then switching to the use of a similarly small dose of Vitex each day in the morning from day 14 until their period begins whereupon they switch back to the Black Cohosh. You must surely by now be seeing why I am giving the advice above to find a good herbalist to guide you in these areas if it is at all possible!

I have a detailed write up on Vitex here and on Black Cohosh here. If you read the Vitex article you will see in my personal experiences how I typically 'pulse-test' women before using it; this account will give the astute reader a frank appreciation of just how non-standardised my approach to using these kinds of herbs is - every case is truly different!

Dong Quai

Another herb that I have found to be fantastic for some women with their endometriosis is the famous Chinese remedy Dong Quai. Again this is by no means going to be the right herb for everyone but there are some for whom its consistent use has literally transformed their lives. Dong Quai is a herb that moves 'stuck blood' and, so long as it is used in quite reasonable doses (unlike Vitex and Black Cohosh which are better in much smaller amounts), you will often see a major shift in the amount of pain around the period in a gratifyingly short amount of time; more info on it here.

Feverfew

There are other herbs that could potentially help but just one further stand-out herb I want to talk about in this section 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 (hormone-like chemicals) that we also know to play a key role in the inflammation happening with endometriosis. Feverfew is also a low-dose/high-strength herb that is best taken over a time frame of a few months to see its true benefits; more info here.


Vitex agnus-castus (Chaste tree)

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2) Gut health & endometriosis

Some years ago I read an excellent book put out by the American Endometriosis association 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 and I found it to be refreshingly candid and free from the usual bias towards one approach over another.

One particularly interesting chapter described the results of a major survey of thousands of their members on exactly what women had found had made the biggest difference to their health. Surprisingly, the treatment strategy that was described as by far the best by the largest number of women involved the 'anti-candida diet' (a diet very low in refined sugars and carbohydrates) and it was speculated that an overgrowth of bad bugs in the gut might somehow be driving endometriosis into a more inflammatory condition.

The survey contained some real gold but I believe that the conclusions drawn from it were a little misdirected because since then we now know a great deal more about the human 'microbiome; the micro-organisms that live in the entire digestive tract and on all the surfaces of the body. Candida itself is actually unlikely to be the core issue but rather a general overgrowth of unhealthy yeast, fungi, bacteria or other parasites may be a key driver towards the inflammatory imbalance of endometriosis and, in taking actions that were effective against that general overgrowth, those women clearly experienced a great deal of benefit.

Dysbiosis

In my own practice I have found this to be a central issue with some women with endometriosis but not at all an issue with others. How you might suspect that 'dysbiosis', an overgrowth of unhealthy micro-organisms, is a key issue needing attention will be the symptom of marked abdominal bloating that comes with it. There are of course other conditions (including the inflammation of endometriosis itself) that can cause similar bloating so it can only be a pointer rather than a proof.

Sometimes you can only suspect something and the only way to prove it right or wrong is to take a treatment that you are confident is strong enough to make a difference and see whether the person gets better or not to tell you if you were on the right track. The complexities in human health rarely reduce down to an exact science and this kind of 'empirical' approach of 'try and see' continues to be a mainstay across all health disciplines to this day. In my own practice this approach usually consists of large doses of Wormwood and/or Garlic at night and then equally robust doses of pre and probiotics in the morning. I have written this important subject up in much more detail here.

Irritable Bowel Syndrome

Herbalists and holistic practitioners from all the old traditions of medicine give the greatest importance to a healthy gut in general for all kinds of chronic problems. If you know yourself that you have had a history of upset digestion or bowel function that goes back even further than your first endometriosis symptoms, then I encourage you 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 article written up here may do more to help the causes of your gynaecological health problems than anything.

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3) Liver health & toxicity

Many writers and practitioners who work extensively with endometriosis believe that its apparent increase is due to increased toxicity in the environment, especially from xeno-oestrogens and dioxins. I say 'apparent' increase because it should be noted that a) endometriosis has been with us for a long time - the ancient Greeks wrote about it extensively albeit by a different name and b) an accurate diagnosis of endometriosis has typically been badly delayed in most women's cases (taking an average of 6 years from when they first present to a doctor with their symptoms!) and it may be that we are seeing an increase in reporting rather than actual cases.

Liver herbs

In any instance it is the liver that will take 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 and I urge anyone wanting to improve their liver health to look at those herbs that have stood the test of time and practice for many thousands of years. Celandine is, in my view, the strongest of them (a detailed article on it here) but for some women the gentler liver herbs such as Dandelion root (info here) or Yellow Dock (more here) may be more appropriate.

How you would even know that this was the area that a woman with endometriosis needed to focus really depends on being able to see the bigger picture of the overall health and the specific picture of the tongue! When a person needs detoxification and liver support they characteristically show signs of fluid retention, poor bowel health, bad skin (which can include break-outs) and a distinctive kind of grumpy tiredness. The tongue is also a great aid at knowing when cleansing is required in the way it gets a distinctive off-colour coating that gets worse when the symptoms are worse but much 'cleaner' looking when the symptoms improve.

What is detoxification?

If you think this might be key area for you then read the article 'what is detoxification' here along with a page that describes how to do a cleansing diet here. You really need herbs to make this work so, if you are not able to consult with a good herbalist, one economical but potent approach is the Juniper & Celandine cleanse as written up in practical detail here.


Chelidonium majus (Celandine)

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4) Immune health

Immune health can play a huge role in whether a women's endometriosis gets better or worse. Aside from anything else we know for a fact that it is specialised white blood cells that, if they are able to, will 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 telling signs as the woman suffers from recurrent infections, delayed healing from small wounds or slow healing from minor injuries.

Echinacea & Astragalus

Nature has some tremendous allies for us in this area and the two herbs I rely on the most to significantly increase immune health are Echinacea (more on it here) and Astragalus (more here). I use a high-powered microscope to analyse the blood of my patients and the rapid and visible effect of these herbs on improving the health of the white blood cells is quite remarkable. There are other areas in immune health that can be equally important to address and, if you think this may be an area that needs attention then I recommend you read my detailed article on immune health in general here.

Effects of stress

Does endometriosis cause stress? Most definitely yes, it very clearly does. Women with endometriosis can suffer from a terrible amount of pain on a regular basis, their fertility may be under threat and their hormones are almost certainly cycling in a way that greatly disturbs their inner equilibrium; all of which can have profound effects on mental health.

Does stress cause endometriosis? No, I personally don't think it causes it, but I am sure it can make it very much worse and I am sure that the actual physical way in which this happens is a direct, negative effect on to the immune system. If you personally feel yourself that stress is one of the key things that is driving your own condition to be worse then I encourage you to read an article that, whilst it was primarily written from my experience with people suffering intense tension and anxiety, has many broader applications as it comprises the best approach I have worked with to legitimately help people to relax and heal their nervous systems; it's here.

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5) Metabolic Syndrome

The hormone insulin has powerful effects on stimulating excess growth in the body and people who have the metabolic syndrome commonly have too-high levels of insulin cascading through their bloodstreams. There is now certain evidence that the polycystic ovarian syndrome is directly caused and worsened by the metabolic syndrome and many people who work in this area, including me, strongly suspect that for some women the metabolic syndrome is a key driver for endometriosis as well.

How you might know that this was the key issue would be the presence of other tell-tale signs of the metabolic syndrome such as an 'apple-shaped' figure, great difficulty losing weight, cravings for carbohydrates and mildly elevated cholesterol &/or blood-pressure levels. If this is something that needs attention then you have to take a wholehearted approach to its treatment as a fairly radical change in eating is required for its cure but it is doable and, when it is what is required, it makes a massive difference to every aspect of the woman's health, including her endometriosis.

As I also work extensively with people who have the metabolic syndrome I have written a detailed article that goes into much practical detail about what it is and how to fix it - you can find it here.

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Symptom relief: cramps &/or excess bleeding

So far we have focused on how to identify and approach the main drivers for endometriosis because, as I said at the beginning, however much we effectively treat the cause of a problem is how much we can cure that problem, or at least help it to improve in a meaningful and lasting way.

However, working on causes is a gradual process and I want to make a couple of recommendations that I have seen to help a great deal at a symptomatic level to relieve some of the most common symptoms of endometriosis; especially for women who do not want or cannot take a lot of drugs.

Cramping

For cramping pelvic pain either with or around the period then I urge you to get hold of some high quality Cramp Bark and then carefully experiment with how to best use it to give the maximum benefits of this truly great herb; detailed information on it here.

Heavy bleeding

For a heavy, flooding period where you need to ease the intensity and/or reduce some of the blood loss then carefully working with the great pair of Shepherd's purse (more info here) and Lady's Mantle (more here) has been seen to be rapidly effective even in some rather extreme cases, but they do have to be used correctly to get the right results...


Viburnum opulus (Cramp bark)

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Constitutional Health Note:

You might want to learn about your constitution to help better understand how endometriosis has become an issue in your health as well as what kinds of herbs may best help. Constitutional health is an old and fascinating way of understanding our differences and to demonstrate how it works I can say that the number one constitution my endometriosis patients have is of the cool & damp natured 'Bears' and that many of these women have needed to work on several fronts at the same time to get truly well, e.g. their digestive, immune and metabolic health. The hot and damp constitutions, the Tigers, are the second most common group to get endometriosis and in their cases we often have to do some liver cleansing plus have a hard look at the metabolic syndrome diet to see a true turn-around. Less common than those two but when a person from the cool & dry constitution (the Elephant/Butterfly) gets endometriosis it can be seen that hormonal imbalance is usually the key issue whereas when it is one of the hot & dry constitutions (Eagles) then it is most commonly their immune health that needs the primary focus. There is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

I do hope you are able to find a good, experienced and holistic practitioner to help you or the person you care for with this condition and again the link to how I suggest you might go about that is here. I can tell you from a great deal of experience of my own in this area that it is not a short journey to get truly well but that there will be a tremendous amount of healing on all kinds of unexpected levels along the way. Good luck!

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