Endometriosis Awareness Month
March is Endometriosis Awareness Month and the perfect time to open up a conversation and to promote awareness about the condition.
What is Endometriosis?
Endometriosis is a chronic inflammatory condition in which endometrial tissue grows outside the uterus (Zondervan et al. 2020). This rogue endometrial tissue can be found throughout other organs such as bowel, bladder, muscle joints, lungs and brain (endomarchaustralia 2019). Endometriosis development occurs via interactions between endocrine (hormones), immunologic, pro-inflammatory and pro-angiogenic (formation of new blood vessels) processes (Zondervan et al. 2020).
Symptoms are variable and include painful periods, pain during intercourse, chronic abdominal or pelvic pain, painful bowel motions, heavy bleeding and digestive disturbances. This results in chronic inflammation, varying pain levels and fatigue. In 25-40% of women it can cause subfertility or infertility (Ozkan 2008).
The actual cause of Endometriosis is still yet to be determined. However, the hallmarks of Endometriosis include:
Genetic predisposition – accounts or approximately 26% endometriosis risk (Zondervan et al. 2020 p. 1250)
Hormones - estrogen dominance and progesterone resistance (Burney & Giudice 2013 p. 3, 4-5)
Chronic inflammatory responses (Burney & Giudice 2013 p.3)
Retrograde menstruation (back flow of menstrual bleed into fallopian tubes to the peritoneal cavity) (Zondervan et al. 2020 p. 1247)
Gut microbiome (Zondervan et al. 2020 p. 1253)
Environmental exposures
Stress
Who does it affect?
The condition often begins in teenage years and affects 10% of women of reproductive age. However, unfortunately it can take years of enduring these disturbing symptoms before a definitive diagnosis is made. During these years negative effects on mood, wellbeing and quality of life are significant and systemic coexisting conditions can accumulate (Zondervan et al. 2020).
How is endometriosis diagnosed?
The only real way to get a definitive diagnosis of endometriosis is by undergoing a laparoscopy (surgical visualisation) (Zondervan et al. 2020 p. 1244).
How is the condition managed?
Surgical removal of lesions and hormonal medications resulting in certain side effects and variable efficacy. However, lesions may return following surgical removal (Zondervan et al. 2020 p. 1244). There is no cure for endometriosis. It must be managed across the lifespan.
Clients with endometriosis usually require a collaborative practitioner approach including GP, gynaecologist, naturopath, psychologist and pelvic floor physiotherapist.
Naturopathic Considerations:
Pain reduction
Reducing inflammation
Supporting hormonal health via modulation of oestrogen dominance with liver support and detoxification
Improve digestive health, leaky gut and gut microbiome
Support the nervous system and mood
Exercise such as Pilates, yoga or walking – start with low intensity and build up
For some, referral for pelvic floor exercises with a physiotherapist
Remove environmental exposures of endocrine disruptors such as plastics, pesticide exposure and chemicals in beauty products.
Use organic pads www.thetomco.com.au available at most supermarkets or a menstrual cup, however, this may need to be emptied more regularly.
Diet considerations:
Increase cruciferous vegetable intake and flaxseed consumption to improve oestrogen metabolism
Increase intake of omega-3 fatty acids for anti-inflammatory action
Increase fibre (gradually)
Increase prebiotic and probiotic foods to support the gut microbiome
Avoid/limit pro-inflammatory foods such as processed foods, saturated and trans fats, refined carbohydrates, alcohol, red meat, deli meats and dairy.
What you can do to support someone with endometriosis?
It is important for us to understand what women are going through so that we can provide support and have compassion for an incredibly debilitating condition.
Educate yourself about the condition. Just taking the time to understand can really support sufferers and help them feel they are not alone.
It’s a challenge experiencing so much pain and uncertainty. So, support these ladies by making them laugh, spoil them with love and affection during hard times and pick up the slack for them during times of inflammation and pain.
Yellow is the colour associated with Endometriosis Awareness Month. So, wear yellow where possible to reinforce your support for these extraordinary ladies.
Send these women to a naturopath!
Links & Resources:
Endometriosis Australia
https://www.endometriosisaustralia.org/
Endometriosis March Australia
https://www.endomarchaustralia.org.au/
QUENDO.org.au
Cochrane
Endometriosis Books
How to Endo: a guide to surviving and thriving with endometriosis by Bridget Hustwaite
Endometriosis 101: For the Significant Other by Dr. Graham Tronc
Period Repair Manual: Natural treatment for better hormones and better periods by Lara Briden ND.
Living with Endometriosis: The Complete Guide to Risk Factors, Prevention, Symptoms and Treatment Options by Samantha Bowick
References:
Endomarchaustralia (2019).
https://www.endomarchaustralia.org.au/
Burney, R.O. Giudice, L.C. (2013). Pathogenesis & Pathophysiology of Endometriosis. Fertil Steril. 98(3). Doi: 10.1016/j.fertnstert.2012.06.029.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836682/pdf/nihms395589.pdf
Ozkan, S. Murk, W. Arici, A (2008). Endometriosis & Infertility. Annals of the New York Academy of Sciences. 1127(1): 92-100. Doi: 1196/annals.1434.007
https://sci-hub.se/10.1196/annals.1434.007
Zondervan, K.T. Becker, P.C.M. Missmer, S.A. (2020). Endometriosis. The New England Journal of Medicine. 382:1244-1256. Doi: 10.1056/NEJMra1810764. https://sci-hub.se/10.1056/NEJMra1810764