Endometriosis is an extremely troublesome, and usually very painful disorder, in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. The condition most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis, but not limited to just those areas. Over time these endometrial lesions can cause internal scarring that may affect organ function inside and outside of the reproductive system. Digestive problems can occur as endometriomas cause organs to stick together and to scar. Patients report pain with intercourse, pain urinating and passing bowel movements, and extreme pain in different areas of the abdomen. The inflammation associated with endometriosis can cause constant fatigue, abdominal bloating, and depression.
One in 10 women suffer from endometriosis. Infertility can result from the internal scarring, and managing the symptoms can be a full time job. Even worse, it generally takes about a decade for women to get a definitive diagnosis. With new methods of testing, this is changing, but the only sure fire way to diagnose it is laproscopic surgery. No other test is as accurate, though tests to measure CA125 markers and Inflammation in the uterine lining can indicate a high likelihood of endometriosis.
Many women encounter issues with their caregivers not being fully educated about endometriosis, and not taking their pain and other symptoms seriously, especially women of color. Most are directed to birth control (which may or may not suppress symptoms). Many have been advised in past decades to get pregnant in the hopes that this will change or eliminate the disease course - spoiler alert, some do, but symptoms usually recur after menses resumes or breastfeeding stops. Many women’s suffering from endometriosis is not treated seriously if the woman is not trying to conceive.
In the past several years, endometriosis has begun to be taken much more seriously and caregivers are quicker to consider it as a cause of menstrual pain and infertility. But treatments are still fairly limited. Hormone therapy, excision surgery for lesions, and hysterectomy are still the only conventional medical treatments for endometriosis.
Luckily, there are several natural treatments that can lessen pain and help you function better.
Let's go through a few👇🏼:
1️⃣ Hands On Relief (in a few forms):
-Electrostimulation in the form of a portable TENS unit. More portable than heat and very effective at reducing pain. These small TENS units are inexpensive and can be worn invisibly under the clothes. Attached to the unit are usually 2-4 leads with a sticky electrode pad at the end of each. They can be placed in painful areas as pairs that move gentle current through the tissue, and are very effective at giving pain relief. (Personally, as an endometriosis sufferer, e-stim was as effective as NSAIDS on pain, while less hard on my liver. -K.H.)
-Mayan abdominal massage can reduce pain, regulate cycles and provide more mobility in the abdomen (the opposite of what the endo lesions are doing). It can also help treat fertility complications of endometriosis.
-Heat can majorly reduce acute pain in the form of a heating pad or hot water bottle.
2️⃣ Movement. Getting your body moving with gentle exercise or yoga helps with blood flow, which has been shown to greatly reduce the pain associated with endometriosis. On difficult days when movement feels like too much, dry skin brushing and epsom salt baths can create passive movement in the blood and lymph that will still be helpful.
3️⃣ Anti-inflammatory Foods and Blood Sugar Management. Our patients have seen excellent results in treating their endometriosis by simply decreasing and in some cases eliminating foods like refined sugar, carbs, dairy, & gluten. Concentrating on eating a more plant based diet with healthy proteins and fats can reduce flare ups and diminish the intensity of endo pain. NOTE: It’s important to eventually try adding back in, one at a time, foods that have been eliminated. You will have a better idea of what foods may trigger flares, but not unnecessarily restrict yourself from foods you love. And as a general rule, pay attention to your blood sugar. Spikes in blood sugar can precipitate inflammation that causes flares, regardless of the particular food.
4️⃣ Ginger. Studies have shown that supplementing with Zingiber Officinale, aka ginger root, has an anti-inflammatory and pain relieving effect by inhibiting prostaglandins. It’s often used in Chinese herbal remedies in a synergistic effect with other herbs that are considered “warming” in Chinese medicine, which is thought to help move blood stagnation in the abdomen in the form of endometriomas. (I’ve found Chinese herbs including ginger, ginseng, cinnamon and mugwort to have the most profound effect on severe pain. -K.H.)
5️⃣ Acupuncture. Several studies show that acupuncture can help not only help relieve the symptoms of Endometriosis, one particular showed that acupuncture helped to reduce pelvic masses, and also lowered CA125 levels, a biomarker for several types of cancer and benign conditions including endometriosis. Acupuncture is an excellent fertility support in addition to helping manage endometriosis itself. We routinely treat concurrent conditions in patients, it’s all a part of the picture of your overall health.
A wonderful resource is Jessica Murnane, whose book “Know Your Endo” is an excellent source for more knowledge and supportive lifestyle changes. Check out @knowyourendo on Instagram for more info.
Resources:
Mira TAA, Buen MM, Borges MG, Yela DA, Benetti-Pinto CL. Systematic review and meta-analysis of complementary treatments for women with symptomatic endometriosis. Int J Gynaecol Obstet. 2018 Oct;143(1):2-9. doi: 10.1002/ijgo.12576. Epub 2018 Jul 9. PMID: 29944729.
Wasserman JB, Copeland M, Upp M, Abraham K. Effect of soft tissue mobilization techniques on adhesion-related pain and function in the abdomen: A systematic review. J Bodyw Mov Ther. 2019 Apr;23(2):262-269. doi: 10.1016/j.jbmt.2018.06.004. Epub 2018 Jun 28. PMID: 31103106.
Marziali M, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir. 2012 Dec;67(6):499-504. PMID: 23334113.
Kiyama R. Nutritional implications of ginger: chemistry, biological activities and signaling pathways. J Nutr Biochem. 2020 Dec;86:108486. doi: 10.1016/j.jnutbio.2020.108486. Epub 2020 Aug 19. PMID: 32827666.
Zheng W, Wu J, Gu J, Weng H, Wang J, Wang T, Liang X, Cao L. Modular Characteristics and Mechanism of Action of Herbs for Endometriosis Treatment in Chinese Medicine: A Data Mining and Network Pharmacology-Based Identification. Front Pharmacol. 2020 Mar 6;11:147. doi: 10.3389/fphar.2020.00147. PMID: 32210799; PMCID: PMC7069061.
Daily JW, Zhang X, Kim DS, Park S. Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Pain Med. 2015 Dec;16(12):2243-55. doi: 10.1111/pme.12853. Epub 2015 Jul 14. PMID: 26177393.
Lund I, Lundeberg T. Is acupuncture effective in the treatment of pain in endometriosis? J Pain Res. 2016 Mar 24;9:157-65. doi: 10.2147/JPR.S55580. PMID: 27069371; PMCID: PMC4818044.