How to Cure Chronic Pelvic Pain
Common form of vitamin E in American diets, decreases TNF-alpha, which is elevated in women with endometriosis.39 Studies also indicate that vitamin E succinate and vitamin A protect tissues against damage from dioxin exposure.40,41 It is important to keep in mind, however, that high-dose vitamin E therapy may have antiplatelet aggregating effect, which thins the blood and increases the likelihood of hemorrhage, independently or in conjunction with anticoagulant and antithrombotic pharmaceutical drugs.41
Conventional medical treatment focuses on reducing estrogen stimulation, managing pain, and preserving fertility. At the time of laparoscopic diagnosis, treatment often begins as visible lesions are removed or destroyed. Hormone therapy is commonly utilized because endometrial tissue responds to hormone stimulation. Estrogen has been shown to increase aberrant endometrial lesions, while progesterone and androgens may decrease implant size. Hormone modulation does not cure endometriosis and the disease often returns upon discontinuation of pharmaceutical therapy.2
A well-nurtured body is a more resilient one. A healthy diet and stress reduction can help alleviate not only the symptoms but also the imbalances that underlie endometriosis. Diets high in fruits and vegetables provide the vitamins and flavonoids required to decrease inflammation and oxidation. Nutritional status affects the immune response, inflammation, and hormone regulation. Studies have demonstrated that dietary vitamins and minerals protect patients against immune suppression caused by dioxin exposure and that dietary fiber promotes fecal excretion of dioxin.59 The phytochemical indole-3-carbinol found in cruciferous vegetables, such as kale, turnips, broccoli, cauliflower, cabbage, collard greens, and mustard greens, may prove to be clinically useful for treating endometriosis because this phytochemical modulates estrogen levels. Liver function can be improved by increasing intake of artichokes, burdock root, beets, dandelion greens, lemons, carrots, onions, and garlic. Diets...
Researchers have found a genetic correlation in endometriosis development. Women who have first-degree relatives with the disease have 10 times the risk of developing endometriosis.3 In addition, women with family histories of endometriosis are statistically more likely to experience an earlier onset and increased severity of the disease.4 Recent studies suggest oxidative stress, environmental toxin exposure, and immune dysfunction as possible factors in the onset and progression of endometriosis. Chlorinated hydrocarbons such as dioxin and polychlo-rinated biphenyls (PCBs), which have adverse clinical effects on the immune and endocrine systems, have been associated with endometriosis. For example, several studies on monkeys have demonstrated a direct correlation between dioxin exposure and endometriosis. In these studies, the amount of dioxin exposure was correlated with severity of disease. The monkeys showed immune system dysfunction similar to the immune abnormalities seen in...
Classically, patients with endometriosis present with chronic or cyclic pelvic pain and infertility. Pain often begins 1 to 2 days prior to onset of menstruation and may last several days or throughout the menstrual period. Additional symptoms may include dyspareunia, abnormal uterine bleeding, cyclic pain with defecation or urination, blood in urine or stool, constipation, diarrhea, nausea, vomiting, and fainting. However, one-third of women diagnosed with endometriosis are asymptomatic. The severity of pelvic pain does not correlate with the extent of the disease though it may correlate with the proximity of adhesions to nerve endings (see the box below entitled Symptoms of Endometriosis'').17
Endometriomas are commonly found on the ovaries fallopian tubes peritoneal lining cervix colon appendix vagina and uterosacral, broad, and round ligaments. In severe cases, adhesions are also found on the bladder, kidney, vulva, arms, legs, lungs, nasal mucosa, spinal column, and sites of previous surgical incisions.2 Two-thirds of women with endometriosis have their ovaries affected in 30 of women, local lymph nodes are involved and in 10 -15 of women, the sigmoid colon is affected.2 The immune system is implicated in the development, progression, and symptoms of endometriosis. Both humoral and cell-mediated acquired immune responses are abnormal in women who have this disease. Humoral immune responses are mediated by immunoglobulins or antibodies such as immunoglobulin E (IgE), IgG, IgD, IgA, and IgM. T-lymphocytes mediate the cellular immune responses and have receptors on their membranes, which respond to antigens. Antigens binding to these receptors activate the cells to release...
Diagnosis of endometriosis is often difficult because the disease has various presentations. Physical examination of a patient may reveal a fixed retroverted uterus, enlarged ovaries, and nodules on the uterosacral ligaments. Transvaginal sonography is often utilized to access large ovarian, intestinal, or bladder endometriomas. It is less accurate for rectovaginal, vaginal, or uterosacral lesions. CA-125 is a blood test that can indicate the presence of endometriosis, although the test is not utilized often for diagnostic purposes because of its low sensitivity. Laparoscopy with biopsy provides a definitive diagnosis (see the box above entitled Procedures for Diagnosing Endometriosis'').
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage pelvic pain. Prostaglandins are responsible for much of the pain associated with endometriosis because NSAIDs inhibit prostaglandin synthesis, they often reduce pain. Hormones typically used in treatment are danazol, a weak androgen that decreases follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secreted from the pituitary gland, thereby inhibiting ovulation and menstruation oral contraceptives progestins and gona-dotropin-releasing hormone agonists (GnRH agonists) thatsuppress FSH and LH and inhibitovulation. Studies have demonstrated reduction of symptoms in 67 or more individuals on oral contraceptive treatment (see the box on page 149 entitled Pharmacologic Interventions for Treating Endometriosis'').30
Vitamin C increases T-lymphocyte activity, phagocyte function, leukocyte mobility, and interferon production. Studies have shown abnormal phagocytes, antibodies, and cytokines in women with endometriosis, so vitamin C may be therapeutically useful. Because it is an antioxidant, vitamin C can protect cells from reactive oxygen species known to cause tissue damage and disease. This protective effect may also prevent tissue damage from dioxin and PCBs. Women with high estrogen levels, oral contraceptive users, and nicotine users will have increased vitamin C excretion and measurably lower plasma levels, and these women might require higher levels of supplementation.42,43
Progesterone is commonly prescribed to treat menopausal symptoms, abnormal uterine bleeding, premenstrual syndrome, endometrial hyperplasia, and infertility. Progesterone causes uterine smooth-muscle relaxation.57 Low levels of progesterone can cause a relative estrogen excess excessive estrogen is implicated in endometriosis. Thus, a clinical trial of progesterone therapy in conjunction with immunologic and inflammatory modulation of the internal biochemical milieu appears to be a rational approach to treating endometriosis.
Chaste tree (Vitex agnus castus) may provide some benefit in women with endometriosis, although direct evidence is lacking. Studies show that it alleviates many symptoms associated Table 12-1. Natural Interventions for Endometriosis Table 12-1. Natural Interventions for Endometriosis
Caffeine, while not the most detrimental of dietary incursions, does apparently have a rather negative effect on fertility. In fact, there is strong evidence that avoidance of caffeine is important for women who are trying to conceive. One study indicated that consumption of more than two cups of coffee per day may lead to adverse effects on fertility, especially among women with fallopian-tube disease and endometriosis.9 Other studies have shown evidence associating caffeine consumption with delayed conception. Women who consumed greater than 300 mg of caffeine per day had a 27 lower chance of achieving conception while woman who consumed less than 300 mg per day of caffeine had a 10 lower chance of conception compared to women who consumed no caffeine.10 Studies have also shown a decreased incidence of miscarriage in women who avoid caffeine during pregnancy. Sources of caffeine other than coffee include green and black tea, soft drinks, cocoa, chocolate, and some over-the-counter...
Estrogens play a role in the control of body temperature. Soybean contains phytochemicals such as genistein, daidzein, and other phytoestrogens. These are the botanical equivalents of the human female hormone, but their effect is milder than that of estrogen and progesterone. However, they may ease menopausal symptoms such as hot flashes, night sweats and vaginal dryness and perhaps alleviate premenstrual difficulties such as cramping and irritability. Isoflavones in soybean may also offer some relief from the pain, swelling, nausea and bleeding of endometriosis (Lock, 1991 Cassidy et al., 1995).
51 Tips for Dealing with Endometriosis
Do you have Endometriosis? Do you think you do, but aren’t sure? Are you having a hard time learning to cope? 51 Tips for Dealing with Endometriosis can help.