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ABOUT CONSTITUTIONAL MEDICINE
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The general recommendations further on in this article are 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 Used wisely, a holistic approach that includes herbal medicines can be extremely helpful for endometriosis. Herbs have been humankind's only medicine for virtually our entire evolution so, of course, we found allies in the natural world to help us with such a problem that can cause so much deep distress. Even though the name 'endometriosis' is relatively new, the same condition has been described in early medical texts with different terminology. It has clearly been with us for a long time and we long ago needed to find ways that could reliably help. I've been in full-time practice since 1989 and, like everywhere in the world, there are many women who are struggling with endometriosis in Christchurch, New Zealand, the city where I have worked all this time. I've worked extensively with a number of those women and, whilst each case is different, there is also much common ground between people and there are some general suggestions given further on that may potentially be of benefit to anyone. Firstly however, from the clinic files, I am sharing two case histories to illustrate some individual approaches to this complex condition.
I first met Vicky when she was 26 years old. She had been diagnosed with endometriosis through laparoscopy 4 years earlier and, from the surgery that accompanied the procedure, had experienced significant relief from her primary symptom of extremely painful, heavy and long-drawn out periods for nearly a year before her symptoms began to return. Vicky said they were now as bad or worse than they had ever been, and she hoped that there was something that we might be able to do to help. I must also mention that the main reason Vicky came in was not, in fact, for her painful periods but because of the severe anxiety she had been experiencing for some time and had grown to the point of causing her to experience panic attacks. I'll say something more about this a little further on. Vicky was from the Bear constitution, cooler and damper, and signs in her body, including her tongue and pulse, showed that she especially needed help with the cleansing and relaxing phases of her cycle of healing. The subject of 'constitutions and the healing cycle' are introduced further later on, what I want to share right now is that in Vicky's case, especially because I wanted to use hormonally active herbs, and also because I perceived her as being as person who would likely be very sensitive to whatever I gave her, that I used the ancient process of pulse-testing with a number of her remedies to help determine what might best help her right now. Anyone interested to learn more about this process can read here. The point I want to convey is that this isn't an 'endometriosis formula; but that it was specific to her individual case. Liver & Hormonal Formula Dong Quai 160mls We make our own tinctures from organic dried herbs, so it might be important that you understand that the optimal dose range will vary with different preparations made by different companies or practitioners, The above formula made 560mls, which will just fit into a 500ml amber pharm round and will give 4 weeks, or 28 days, if taken at the maximum dose of 10mls, twice a day, which is what we used. St Mary's thistle capsules Two capsules twice a day. St Mary's has some extraordinary liver-healing and protective properties. As with all our encapsulated herbs, we get organic concentrates with one or more active ingredients standardised to a high level, and then send them to a local factory to be put into capsules. Relaxing tea & formula The Relaxing tea was for her to use freely, as much or as little as she wanted. The recipe and instructions for this tea are written up here The relaxing formula is a very special little bottle of herbs that have been seen to be of speedy benefit to a great many people suffering from anxiety. The recipe and the method of using it are written up in detail in the article on anxiety found here The first step in healing is the one in which Nature can help us back to health. Herbal medicines are ancient allies that can support and help us to get well, so the first step for Vicky was simply to let Nature in and to take the prescription twice a day, and the relaxing herbs as freely and frequently as she needed them. The next step is what I call the 'work'. It is what the patient does to help themselves. Underlying all the old ways of healing is an understanding that all living organisms have the innate ability to self-regulate and self-repair. The 'work' is usually about doing something that helps to remove the obstacles that are getting in the way of that natural, healing intelligence. In Vicky's case, her primary 'work' was to go back to something she used to love as a younger person, namely reading novels! Particularly as a 'Bear', Vicky had done something that many Bears do, which is to internalise their stress into their body. Rather than 'trying' to relax, apart from when she took her drops of the relaxing herbs and did the three deep breaths that go with that, her 'work' was to stop stressing about her life and her body and to engage her brain in something completely different. This might sound like an odd prescription but, if it's done right, with books that they love and get absorbed in, it works and that's all that matters. Even though I am a man, and will never experience it for myself, I have a high level of appreciation for how challenging endometriosis can be, as well as how hard it can be to treat! When I was thinking of some cases to share, and plenty of tough ones came to mind, as you will see in the next case history, I also remembered Vicky's experience as one of those marvellous instances where everything goes great from the beginning. I don't know, and never will know, whether it was helping her liver to work better, or the hormonal herbs, or all the 'work' she did on destressing and getting into a much better mental state, or whether it was a combination of everything (which is usually what I say to people if they bring that question up) but Vicky came back on her 2nd visit a very happy young woman. Not only was her mood greatly improved but she had experienced a virtually painless period for the first time in years. I saw Vicky a third time, two months later. She hadn't needed to use so much of the relaxing herbs but had kept the liver and hormonal herbs going for a total of 3 months by this stage, and things had continued to go very well. I then put her in charge of her treatment, encouraged her to try halving the dose of her herbs whenever she was ready and likewise, to completely stop and see if she still needed them whenever she felt ready to stop and see. Vicky continued to come back and get repeats of her herbal formula on and off, over the next few years and then got pregnant and began her own family. All is well, and it's wonderful when things improve so quickly... There have been other cases, like Vicky, where the right combination of things hits the right spot and there are big improvements right away. We all want that but, with endometriosis, there are going to be times when it's two steps forwards and one step back and the going is much harder no matter what we do, as the next case demonstrates.
I first met Tracey when she was 29 years old. She had already had multiple surgeries for endometriosis as well as to repair the adhesions created by previous surgeries. Tracey had terrible periods, but she also frequently experienced a painfully distended and bloated abdomen at other times of the month and more or less constantly had a great deal of bowel disturbance in the form of looseness and excess frequency. She had also been on numerous combinations of oral drugs and had tried the Mirena but felt that everything just made her worse and was at that point where I meet many of my patients, when they are in a state of despair and desperation. In my own practice, the most women I have met who have had endometriosis have been from the cooler and damper Bear constitution, and then the second most common constitution that gets it appears to be the hotter and damper Tigers, which is what Tracey was. From pulse-testing along with analysing her blood and her tongue, we set out with the following herbs Immune & Hormonal Formula Echinacea 120mls To make 560mls and to take at 10mls, twice a day for a 4-week course. Anyone interested to learn more about any of these herbs can be read up on them in the herbal A-Z here 4 capsules, twice a day. This is a very high dose of two herbs that are already highly concentrated (50% curcuminoids and a 4:1 extract of Willow) but her system was so riddled with 'damp heat' an old way of describing inflammation, that I felt it was warranted.
These were used later in the treatment program as described below. 4 capsules of Wormwood at night, plus 1 tsp of 'Barbiotic' in the morning slurried into water. We make this in our clinic from powdered organic Barberry and 14 different beneficial probiotics. It's terribly bitter to drink but it helps. Given her history and symptoms, plus what she ate most during the day, plus some tell-tale signs in her blood, I felt it was probable that Tracey might have one or more food intolerances driving some of the excess inflammation in her body, so I asked her to completely avoid gluten for up to 2 weeks, see how she felt when off it, and then to feel free to challenge her system with some gluten-containing foods if she was in any doubt about whether she really needed to be avoiding it. Her other 'work' was to get more rest. She had been driving herself hard for a long time to keep working and be a normal functioning adult despite what was often crippling levels of pain and bloating. I admired her courage and her determination to not let her condition beat her but there was room in her after-work schedule to get more rest, and she could definitely allow herself to get more sleep. When I saw Tracey a month later, she had a mixed set of responses to report. Initially she had felt a little worse for the first few days and then had a striking improvement in her bloating and general well-being that had lasted for nearly 3 weeks. She was, of course, then celebrating what she thought was something of a miracle when everything came crashing down again just 5 days before her appointment. She had taken all her herbs, remained completely gluten-free for the entire time, been good about going to bed early etc. so she was dismayed that everything had become worse again although she said that she understood that it was likely just her period being due any day and that it was hormonal shifts that had bought about her relapse. Given how well she had initially responded and given that any kind of treatment that involves the hormones of the monthly cycle takes time to work and time to assess, I suggested that we didn't change anything in the treatment program but rather allow it all another month to see how things went. When we met a month later, although she said that things were a little better overall, that she had really had a very bad month. For reasons that are spelled out in more depth in the section below under general recommendations called 'Dysbiosis' we began the 2nd stage of her treatment with including a dose of Wormwood and Barbiotic as described above in 'the prescription'. In a nutshell, this was to kill any bad bugs in her gut that might be contributing to the problem and to seed in a healthier bowel micro-flora to try to help her hormonal and inflammatory balance. Tracey responded moderately well to this phase of the treatment, she felt it made some positive difference to her bowel health and general level of bloating, but she was still experiencing high levels of discomfort overall and her periods were still extremely painful. Wormwood is mostly only used for a single course, but we agreed to do a 2nd course of the Barbiotic, especially as she had not found it at all too hard to take. By this time, Tracey had re-introduced gluten a number of times back into her diet with no obvious worsening of her symptoms, though as she said, she felt so bloated so often that it was really hard to tell if things were making her worse or they were just bad already. On our next visit, there was a palpable sense of doom and gloom in the air. She had been working hard, the treatment was expensive, she had been doing everything she was supposed to, but she was still in a lot of pain and discomfort and was feeling very discouraged. At this point, partly because she was a Tiger constitution, who are especially prone to the metabolic syndrome, and partly because I wondered if the real reason she had initially improved so much on a gluten-free diet was actually because she had restricted her carbohydrates so much (no bread, pasta, flour etc.) I suggested to Tracey that we might try one further full-on treatment option, which was to go on to a ketogenic diet to see what difference it made. This is even harder than going gluten free so, to start with, this is something that you just talk over with people, explain what it means and what it involves, then give them plenty of information to read and think over. Anyone that wants to read what I sent to Tracey now can click here I met with Tracey a further three times. She found the keto diet incredibly challenging at first, as people do, and it is a great credit to her determination to do whatever it took that she stuck, especially because, as she reported, her condition if anything, felt worse when she started on it! But she persevered and, very slowly and gradually, her bloating and inflammation got less and less as the weeks went by. On our final visit, which was a whole 10 months since we first met, she was finally well enough to be discharged from coming back for regular appointments and could be put in charge of how much she kept using any of her herbs or when she came back for them. There were some adjustments to her herbal program over the course of this time. I haven't recorded them here for the sake of brevity, but they were similar to some of what you will read below about symptom relief. It is an observable phenomenon for a sub-section of our population that any amount of excess sugar sets in motion a train pf events that causes hormonal disruption and, at least in some cases, the conditions that allow for endometrial tissue to grow outside the womb. I wanted to write about Tracey's case because it was representative of how very difficult it can be to treat endometriosis and also because it was one of those memorable ones where, when you finally hit upon the strategy that brings about a deep and lasting benefit, it is just such a great relief to all concerned!
I've mentioned above about the damper constitutions (Bears and Tigers) being more prone to endometriosis, at least in my own experience. I do not want that comment to seem prohibitive though because, as I delve into my memory, I am 100% certain that I have met both Eagle and EB constitutions who have had some heinous troubles with endometriosis as well. What can be said for sure is that this ancient way of understanding our differences, according to how we are naturally either hotter or cooler, and at the same time dryer or damper, underpins much of the approach to what kinds of foods, herbs etc, will best help a person and that if you, or someone you care for, are having troubles in this area, you may get much benefit from learning more about the general subject of the constitutions starting here, and then by working out which constitution you or they are by going here
After getting a sense of whether a person is naturally cooler or hotter, dryer or damper, the next level of knowledge to take the kind of personal approach that can be essential to a great result is to look into the healing cycle. This is a fascinating subject in itself and understanding it can give great insight into what needs to be done to treat the cause and help healing happen naturally. There are four stages in the cycle; cleansing, activation, nourishment and rest. However, before I put the link for anyone who wants to learn more, I want to say that I fully recognise that many people are not ready to take the kinds of steps you see being talked about in the case histories above or in the general recommendations below. They would rather use drugs, IUDs or surgeries and get on with their lives with as little disturbance as possible. Yes, probably, if there are underlying issues that aren't being dealt with, there will be further trouble to come, but none of us are getting out of this alive no matter what we do, and I deeply believe that people should choose their own paths as much as they possibly can. That said, people can get better from just about anything if they let Nature in and work on the cause of their problems and that is what understanding the Cycle of Healing can help us to see; more here
I trust that you will understand that the holistic treatment of endometriosis requires an individualised approach that works alongside the person wherever they are at and, as mentioned at the beginning, if your condition is very bad or you know you need some guidance in person, then I hope you will be able to find a good herbalist who will get involved and guide you to getting and doing whatever you need to get well. However, it also may be that the condition is not so severe, or even that it is but you just don't have the option of working with a holistic practitioner. In these instances, it is my hope that the following will be of much practical benefit to you. Along with trying to understand and treat the cause or causes for endometriosis, and especially given how all that can take a lot of time, firstly there are two general recommendations that have been seen to offer some women much immediate much help for the two most commonly disturbing symptoms
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
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 at least a few seconds and up to as much as half a 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 concern about any kind of side-effects or toxicity. More about Shepherd's purse here, and Lady's Mantle here
Presumably, nearly anyone who is reading this, whether for themselves or someone they care for, will already know a lot about how conventional medicine approaches 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 I've shared my approach in the case studies above and the general recommendations below, it must be made abundantly clear that we can expect zero problems with using the holistic herbal approach alongside any conventional medicine treatments that the women choose 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 simply comes from a lack of understanding and communication. If you, or the person you care for, wish to use herbal medicines alongside any conventional drugs or other treatments that you have been prescribed, 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 discriminated against by your doctor because you choose to work holistically. That would be breaking their code of ethics and, at least in New Zealand, it would be breaking the law of the health and disability act! Old-school traditional medicine and new-world pharmaceutical medicine are not inherently in conflict with each other and, despite much fear-mongering, they hardly ever interact badly with each other. Truly, all that matters is, whatever treatments you use, in whatever combination, that they help and that you get well, nothing else is important!
As you no doubt already know from your own experience, and was demonstrated in the case-histories above, endometriosis is a complex and multi-factorial health problem. This is why it is so vital to bring a holistic, open-minded approach to its treatment. It is, of course, happening for one or more reasons, nothing happens without good reason. Equally, we can be sure that, however much we effectively treat the cause or causes, the more we can cure it, or at least help it to improve in a meaningful and lasting way. The main causes we need to be aware of, and to carefully look for are:
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, particularly including:
I should note that it is quite normal to combine more than one herb to be taken at the same time. I also want to again put the same link I shared in Vicky's case history where I talked about doing 'pulse-testing' to help ask that living, feeling innate intelligence which herbs to use. It needs an open mind to understand and use it but, where there's a will there's a way... that page is here
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, like the case of Tracey above, 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 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
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 much to help, more here
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. I say 'apparent' is because it should be noted that endometriosis has been with us for a long time. As s mentioned earlier, the ancient Greeks wrote about it extensively, albeit by a different name. Another point to make clear is that an accurate diagnosis of endometriosis is usually very delayed in most cases, taking an average of 6 years from when they first present to a doctor. 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. 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
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 More on immune health here
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
Having read the above notes it is entirely possible that you will have identified with more than one of the potential causes and so might wonder, 'where do I start?' Start with the first step and go from there. If you can, tackle whatever it is that seems the hardest but, if that's not possible, just start somewhere! It's also entirely ok, and normal, to do more than one thing at a time. Believe me, if you get better, you will not care if you don't know what helped the most, that is what we call a happy problem! None of this is easy and, like I said earlier, this kind of work is definitely not for everyone, but when the person is ready to do whatever it takes, and they get focused on at least one of the areas in their health that need attention, the results always make any amount of effort feel worthwhile.
Please understand that I cannot personally advise you without seeing you in my clinic. |
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