Endometriosis

Understanding Endometriosis and How It Affects Fertility

It is estimated that 5.5 million women in North America alone have endometriosis, and 30 to 40 percent of these women are infertile as a result of the condition. Endometriosis is a disease in which endometrial tissue (normally only found in the endometrial lining inside the uterus) grows outside the uterus and implants most commonly on adjacent pelvic organs such as the ovaries, fallopian tubes, vagina, sigmoid colon, pelvic ligaments, uterus, rectum, bladder, and less commonly on the liver and lungs. This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Normal menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from abnormal endometrial growths has no way of leaving the body. The result is internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation, which can all cause pain, scar tissue formation, adhesions, bowel problems, and infertility.

It is thought that scar tissue and adhesions may obstruct or distort the shape of the fallopian tubes and prevent the ovaries from releasing eggs. Endometriosis may also affect fertility by causing hormonal irregularities, a higher rate of early miscarriage, and immune system malfunctions. The immune system can react to the pain and inflammation of endometrial adhesions by attempting to keep the body safe from this perceived threatening tissue by preventing any foreign tissue (including embryos) to implant into the endometrium until the reaction is calmed down. While the cause of endometriosis is still unknown, many theories exist including retrograde menstruation, genetic predisposition, abnormal tissue development, or malfunction of the immune system. Common symptoms include:

• Severe menstrual cramps
• Pelvic pain apart from menses
• Backache
• Painful intercourse
• Painful bowel movements
• Fatigue
• Heavy, dark, or clotted menstrual flow
• Bloating
• Constipation
• Menstrual diarrhea
• Pain with exercise
• Painful pelvic exams
• Painful and frequent urination

How Chinese Medicine and Acupuncture Treat Endometriosis

Chinese medicine views endometriosis as a problem of blood stasis, or blood not moving. Stagnant blood coagulates and cannot be moved through blood vessels due to blocked or insufficient energy in the pathways of the body. Blocked or insufficient energy may be due to emotional trauma, severe stress, constitutional weakness, surgical history, and/or exposure to cold, either cold temperatures or regular consumption of cold foods, especially during menstruation. Signs of blood stasis include stabbing pain that is fixed in one place, frequent or heavy bleeding, dark (brownish) menstrual blood, and bleeding with dark clots. Endometriosis, fibroids, and ovarian cysts are all examples of blood stasis in women.

Fortunately, this condition can be successfully treated with the help of acupuncture, Chinese herbs, reproductive organ massage, and nutritional guidelines. More and more women are experiencing the benefits of these therapies which can completely cure or significantly improve endometriosis, as well as improve the ability to conceive and carry a healthy baby to full term.

Acupuncture alleviates pain by increasing circulation in the pelvic organs and warming the uterus. It enhances the immune and endocrine systems by stimulating the autonomic nervous system to help eliminate stray endometrial cells. Acupuncture also relieves stress and corrects disruptions in the flow of the body’s energy, returning the body to good health. It also restores renal and adrenal function to correct irregular cycles and helps clear liver stagnation needed to metabolize excess estrogen that feeds endometriosis. Overall, acupuncture calms the endometrial tissue to accept an embryo and support a pregnancy.

Chinese herbs help reduce pain and control and shrink endometriosis. They are targeted to the pelvic region to increase circulation and to eliminate the growth and recurrence of endometriosis by breaking down congealed blood and clots and by dissolving masses.

Reproductive organ massage (ROM) is a highly specialized form of therapeutic massage that manipulates the fascia of the pelvic cavity to unblock any obstructions or reduce any adhesions in the reproductive organs and improve the blood flow to these organs. The result is a balance of hormonal production, improved ovarian production and ovulation, regular menstrual cycles, lower FSH levels, better egg quality, and stronger embryos.

Nutritional guidance is customized for each patient based on the health of her kidney, liver, and spleen functions, which control our reproductive health and underlie our metabolic processes. For endometriosis, most patients will be put on a diet of warm foods as well as organic food to reduce the amount of exogenous estrogens which lead to endometrial growth. Our guidelines also recommend less dairy and wheat which contribute to the inflammatory process and can increase pain.

How Western Medicine Treats Endometriosis

Western Medicine focuses on providing temporary relief from symptoms with drug therapy, but this does not cure endometriosis.

• Oral contraceptives offer a regulated, low-dose combination of estrogen and progesterone to prevent ovulation.
• Progesterone is usually given in a long-acting form via injection (depo-provera). Progesterone can also prevent ovulation and reduce circulating estrogen levels.
• GNRH analogs (Synarel, Lupron, Zoladex and Danocrine) are drugs that stop hormone production and ovulation. Pain medications are used to control pain associated with endometriosis.
• Surgical treatment is often necessary for endometriosis patients. The type of surgery is dependent on the extensiveness of the implants.

Research and Related Articles on Endometriosis

Clinical observation on treatment of endometriosis by tonifying qi and promoting blood circulation to remove stasis and purgation principle
Gynecological Department of Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai (200032)
PMID: 11783186 [PubMed – indexed for MEDLINE]

Clinical study of the treatment of endometriosis with promoting blood circulation and stasis removing method
Affiliated Ruijin Hospital, Shanghai 2nd Medical University
PMID: 8499728 [PubMed – indexed for MEDLINE]