The endometrium is the outer lining of the uterus. In the early stage of a woman's monthly menstrual cycle, a surge of oestrogen hormones cause that lining to expand to allow implantation of the egg if a pregnancy occurs. When it doesn't, enzymes in the body break down and liquefy that superficial lining, which becomes the menstrual blood shed during the menses.
In endometriosis, small sections of that layer are retained in the body. These endometrial cells gradually migrate outside the uterus to implant themselves in a wide range of areas inside and outside the reproductive organs including the cervix, the fallopian tubes, the large intestine, the bladder, the thorax and the lungs. Once implanted in these foreign sites, the endometrial tissue continues to respond to the hormonal fluctuation of the menstrual cycle, getting thicker prior to ovulation, and turning into blood during menstruation.
Being in an enclosed space, these abnormal secretions can't be expelled from the body, so they accumulate and become inflamed, causing scarring and adhesions to the surrounding tissues. If the ovaries are involved, the blood stagnation can result in the production of fibrous cysts in the fallopian tubes, which stops the egg being fertilised.
Why endometriosis occurs is still a matter of controversy.
One common theory is that this condition is the consequence of "retrograde menstruation", when some of the menstrual blood seeps backwards into the fallopian tubes and travels up the abdominal cavity during the monthly menses. But many women who experience retrograde menstruation don't get affected by endometriosis.
Another theory is that these endometrial implants secrete the hormone prostaglandin causing spasms in the reproductive organs and impairing their capacity to function.
In fact, no one really knows!
The main symptoms of endometriosis, apart from infertility, include severe menstrual pain and cramping, pain during sexual intercourse, fatigue, pain during urination and bowel movements, diarrhoea, constipation and nausea.
Endometriosis is classified according to the extent of pelvic adhesions and implanted foreign tissue, and the degree of blockage of the fallopian tubes. These different stages don't always reflect the level of pain experienced, risk of infertility, or the symptoms present. For example, a woman in the first stage could be in tremendous pain, while a woman in stage four might be asymptomatic. Nevertheless, being treated during the early stages of the disease is the best chance of regaining fertility.
Being treated during the early stages of the disease is the best chance of regaining fertility.
The current Western medical approach is to prescribe painkillers and then to use surgery or hormone controlling drugs to remove the foreign endometrial tissue. These drugs include the birth control pill, or menopause-inducing medication to stop menstruation and ovulation. Unfortunately, the increased level of testosterone hormones in the body can result in severe side effects. Even when surgery occurs, it is very difficult to totally remove all the endometrial cells, so there is a constant risk of further contamination of the fallopian tubes.
There seems to be increased incidence of endometriosis if a family member already has the condition.
Lifestyle factors such as drinking more than two coffees daily put women at a greater risk. Ironically, cigarette smoking, which impairs the production of oestrogen, appears to have the opposite effect. Also, having sex, or undertaking intense exercise during menstruation can increase the risks of retrograde menstrual flow, which promotes the implantation of endometrial tissue outside the uterus. In contrast, regular moderate exercise seems to be beneficial.
In Oriental medicine, endometriosis is considered to be caused by blood stagnation, or lack of circulation of blood in the deeper layers of the meridians. The immune system detects the blood stagnation in the implanted foreign endometrial tissues as toxic and reacts by attacking all the endometrial cells in the body, leading to inflammation and pain.
The Oriental practitioner's approach to treatment is to prescribe blood moving herbs, and ancient resinous substances such as frankincense or myrrh, which are used to break the blood stagnation at a deep level.
A Japanese medical study conducted at the University of Osaka a few years ago, showed that a group of women who received a classic herbal with cinnamon twigs had their IgM antibody and inflammation levels reduced to such an extent that they remained pain-free for months after the study ended. Also changing the diet, avoiding dairy and wheat products, reducing meat consumption, and taking flaxseed, evening primrose, or fish oil supplements will restore the immune system, and eliminate the build up of fluid stagnation in the organs.
The Oriental practitioner's approach to treatment is to prescribe blood moving herbs, and ancient resinous substances such as frankincense or myrrh...
With the right diagnosis, lifestyle modifications, and appropriate treatments, the results can be very effective. Women who had previously been told they had no chance of achieving a normal birth are delighted when they are able to regain their health, and experience a successful pregnancy after a few months of regular herbal and acupuncture treatments.
Olivier Lejus MHSc, BHSc is a registered acupuncturist practising in Sydney. www.olejusacupuncture.com
Read Olivier's earlier column on Chinese Medicine for Infertility (NOVA October 2015 Issue No 253) - http://novamagazine.com.au/article_archive/2015/2015-10-chinese-medicine-and-infertility.html
Olivier Lejus BHSc.MHSc. is a registered acupuncturist and Chinese herbalist practising in Sydney. A former casual university lecturer and tutor in Oriental medicine with over 15 years experience in clinical practice, Olivier specialises in Japanese- style acupuncture for the treatment of male and female infertility, migraine, pain, and insomnia.www.olejusacupuncture.com