Endometriosis – Part 1

Many people think endometriosis cannot be treated but there are complementary treatments that work successfully to reduce the pain and other symptoms dramatically.

Endometriosis occurs when the cells that line the uterus (the endometrium) move to other parts of the pelvic cavity like the ovaries, bladder and GI tract. After the cells transplant themselves they continue to respond to the body’s monthly hormonal cycle as though they had never left the uterus. The tissue fills up with blood and is released at menstruation. Because of the swelling and because the blood has nowhere to go the tissue may become the site of pain and inflammation.

These sites of transplanted cells are called implants. Although they are often no larger than the size of a pinhead they can create debilitating pelvic pain.

We don’t know what causes endometriosis but we do know that many women have it and don’t have symptoms and we know that several factors are implicated including environmental pollutants. In a study with monkeys, 79 per cent developed endometriosis after exposure to dioxins compared to 33 per cent in a non-exposed group.

Radiation could be another culprit. In that 1960’s the U.S. Space Program did a study with monkeys in which 53 per cent of the animals developed endometriosis after exposure to radiation compared with 26 per cent who were not exposed.

A German study done in 1995 linked PCB’s to endometriosis. PCB’s are common in our environment specifically in the liquid in our refrigerators.

During the last century the number of cases of endometriosis has risen steadily as has the intensity of the patients’ pain. It is now a major source of pain and disability and may also be linked to infertility.

Signs that you may have endometriosis usually start with menstrual cramps that worsen over time. There can be pain at ovulation or severe pelvic pain a few days before or after ovulation. The type and timing of the pain can vary from woman to woman. If you keep a pain journal, it can help determine where the endometrial spots are located. Painful bowel movements during menstruation could suggest the spots are in the large intestine. Painful urination during menstruation might implicate the bladder. When ovaries are the site, there may be excessive menstrual bleeding or spotting between periods. Symptoms tend to increase as the endometrial tissue grows.

When symptoms are mild no treatment is necessary. For severe pain conventional medicine uses drugs and surgery. The symptoms of endometriosis can decrease during pregnancy and at menopause so the drugs prescribed try to mimic these bodily states. Birth control pills, progesterone pills or menopause inducing drugs are the common choices. Surgery involves a laproscope to clear away the implants thus reducing pain or relieving a blockage that is causing infertility. Unfortunately this surgery does not always work and can create the painful effect of adhesions (scar tissue).

If you decide to go the surgical route find a surgeon who is committed to removing all the endometrial implants no matter how small. A thorough operation can take up to four hours.

Stay tuned for my next column when I will discuss the complementary treatments that have been successful.

Dr. Paulette Roscoe is a naturopathic physician who practices in Nanaimo. She welcomes your calls at 754-1733.