Endometriosis - is there a role for naturopaths?

Endometrosis is a chronic female health condition affecting approximately 10% of reproductive aged women.  It's a painful condition, characterised by the presence of endometrial tissue outside of the uterus, commonly within the pelvic region but can also be found in far away places like the spinal cord, lungs, diaphragm, gallbladder and even the nasal cavity.  Although it's associated with pelvic pain and infertility, it can also be fertile and asymptomatic women

 Common sites for endometriosis include the ovaries, fallopian tubes, vagina, cervix and Pouch of Douglas

Common sites for endometriosis include the ovaries, fallopian tubes, vagina, cervix and Pouch of Douglas

Endometriosis Drivers

Critical to our understanding of endometriosis is the role of oestrogen. To summarise, in endometriosis there is a dominant, highly proliferative form of oestrogen being produced by the body, localising itself into various tissue sites where it shouldn't normally be growing.  There is also immune dysregulation and chronic inflammation driving this process, with insulin resistance also implicated.  The pain of endometriosis comes about from recurrent, cyclic micro-bleeding of the tissue sites, which can then lead to the formation of lesions and blood filled cysts. If these cysts rupture, it can cause severe pain.

Treatment Options for Endometriosis

Standard conventional treatments for endometriosis involve NSAID's for pain relief, oral contraceptives and other drugs to alter hormone balance and also surgical intervention to remove cysts and lesions.  However there is no known "cure" at this time, with even high recurrence rates of endometrial cysts after surgery.  And some women dislike the adverse effects of the hormonal drugs.  So, with this in mind, is there a role here for naturopathic medicine?

Inflammation

Endometriosis is an inflammatory condition, and central to a naturopath's kit bag are herbal and nutritional anti-inflammatories.  Herbs such as tumeric, boswellia and rosemary have been supported by traditional and clincial research evidence to effectively reduce inflammation.  Unlike some medications, these herbs can also benefit healthy liver detoxification, which is critical in helping to convert the proliferative oestrogen common in endometriosis to a weaker anti-proliferative version. Fish Oil is also a common nutritional anti-inflammatory, with one animal study showing that fish oil supplementation can reduce endometrial adhesion/lesion size, (Herington et al, 2013).  

 

Insulin Resistance

Our modern diets, full of sugar and refined carbohydrates, are responsible for many of the modern chronic health diseases prevalent today.  Endometriosis fits into that equation also.  Naturopathic dietary plans are ideally placed to tackle this.  With a focus on carbohydrate restriction, adequate protein and anti-inflammatory fat intake, the nautropath is able to prescribe a diet to help reverse insulin resistance, burn excess fat stores and control this endrometriosis driver.

 

Oestrogen Detoxification

Indole-3-Carbinol (I3C) is an compound found in many cruciferous vegetables, such as broccoli, cauliflower, and brussel sprouts. I3C works by helping to modulate the detoxification of oestrogen by the digestive system, (chiefly the liver).  As previously mentioned, this process is often skewed in endometriosis patients, and the addition of this nutrient as part of a supervised nutritional program, can help to rebalance the oestrogen ratios, and provide relief to those suffering symptoms.

Other  nutrients/foods commonly utilised by naturopaths to assist oestrogen detoxification include Calcium D-Glucarate, Glycine, N-Acteyl Cysteine, Tumeric, St Mary's thistle, Broccoli Sprouts, Green Tea, Dandelion Tea, Pomegrante, Folate, Zinc and Selenium.

Important Information

It's important to remember when using any of the nutrients listed above, that even though they are found in nature, when taken in an extract form they have the ability to be toxic.  That is why it is vital to get health professional guidance from an integrative GP, or qualified nutritional medicine/naturopathic practitioner before considering the treatment options above.