ENDOMETRIOSIS

AMONG THE HEALTH PROBLEMS that affect women, endometriosis is the most mysterious. It occurs when uterine tissue migrates outside the uterus to the ovaries, fallopian tubes, cervix, bowel or bladder. Sometimes this tissue even grows outside the pelvic region - in the lungs, for example.

The problem is not where the tissue ends up, but what it does. It swells and bleeds monthly, directed by hormones that cause the same changes in normal uterine tissue.

The symptoms of endometriosis vary greatly from one woman to another. Sometimes they're severe; other times they're virtually non­

THE DIFFERENCE DIET CAN MAKE

Fats and dairy products can stimulate oestrogen production, aggravating symptoms of endometriosis. Stick to low-fat, high-fibre foods, including abundant amounts of vegetables and fruits. Avoid partially hydrogenated oils, including margarine, and increase your intake of essential fatty acids from salmon, nuts and seeds.

Phytoestrogens found in soya-based foods and other beans can help prevent natural or synthetic oestrogens from overstimulating body tissues. Eat these foods regularly, daily if you can.

And cut down on those lattes, colas and chocolate binges - caffeine can dramatically worsen symptoms of endometriosis.

existent. In fact, some women don't even realise they have the condition until their doctors diagnose it while looking for the cause of some other disorder - infertility, for example.

Perhaps the most common symptoms of endometriosis are abdominal pain, severe menstrual cramps, excessive bleeding, irregular periods or painful sexual intercourse. These same symptoms can also indicate pelvic inflammatory disease, irritable bowel syndrome or a growth on the ovaries. That's why diagnosing endometriosis is difficult.

Women usually learn they have endometriosis between the ages of 25 and 35, yet the problem is thought to start near the time menstruation begins. While theories abound as to the cause, the condition is known to be stimulated, in part, by oestrogen and other menstrual-cycle hormones. When these hormones are kept in balance, endometriosis symptoms often disappear, thus rendering the disease inactive.

There are surgical options for treating endometriosis. One such procedure is called laparoscopy. Using a small, flexible viewing instrument called a laparoscope, doctors first locate the afflicting spots. Sometimes surgical tools or lasers are attached to the laparo scope for removing the endometrial tissue and any surrounding scar tissue. After such surgery, however, endometrial tissue can regrow in the same spot.

DRUG TREATMENT

Oral Contraceptives

Ethinylestradiol, norethisterone acetate (Loestrin, others). Function: prevent ovulation in women with mild endometriosis. Side effects: dizziness, headache, stomach upset, bloating, nausea.

Synthetic Progesterone (Progestogen)

Oral: norethisterone (Micronor, Noriday), levonorgestrel (Microval, Norgeston); injection: medroxyprogesterone acetate (Depo-Provera). Function: stop ovulation and control oestrogen levels. Side effects: nausea, vomiting, headache, dizziness, depression, sleeplessness, irritability, weight gain, others.

Natural Progesterone

Creams, capsules, vaginal or rectal suppositories. Function: stop ovulation and control oestrogen levels. Side effects: rare to-none. Note: natural progesterone is synthesised from wild yam (Dioscorea villosa), but creams containing only wild yam extract - though helpful for some women - are not the same as those containing adequate amounts of natural progesterone. Ask your chemist or doctor to recommend a product if you find this distinction confusing.

SUPPLEMENTS FOR ENDOMETRIOSIS

Antioxidants can help prevent tissue damage and reduce inflammation and scarring. Try the following daily regimen:

1. Vitamin E: 400 to 800 I U

2. Vitamin C: 2,000 milligrams

3. Grapeseed or green tea extract: 200 to 400 milligrams

4. Magnesium: 500 milligrams

 

Testosterone Derivatives

Danazol (Danol). Function: reduces the size of endometrial areas and decreases pain. Side effects: weight gain, unwanted hair growth, hot flushes, vaginal dryness, deepening of the voice, acne, fatigue, water retention, decreased sexual drive.

Gonadorelin Analogues

Nafarelin (Synarel), leuprorelin acetate. Function: relieve pelvic pain and shrink extensive areas of abnormal tissue before surgery. Side effects: cessation of normal periods accompanied by menopause-like symptoms.

HERBAL REMEDIES

Valerian (Valerians officinalis)

This herb has been used for centuries to treat conditions associated with pain, including menstrual difficulties. Experimental studies have shown it acts as a mild sedative and relieves cramping. Typical dosage: 300 to 400 milligrams in capsules standardised to 0.5 per cent essential oil per day; or 20 to 60 drops of tincture per day.

Camomile (Matricaria recutita)

A popular calming herb with antispasmodic properties, camomile may help quell cramps. It also soothes a mildly upset stomach, a symptom some women experience along with abdominal cramps. Typical dosage: up to six 300- to 400-milligram capsules per day; or 3 to 4 cups of tea per day (steep 1/2 to 1 teaspoon of dried flowers in 1/4 litre of hot water for 10 to 15 minutes); or 10 to 40 drops of tincture three times per day. Caution: some people experience allergic reactions to camomile.

Guelder Rose (Viburnum opulus)

Native Americans regarded guelder rose, also known as cramp bark, as a uterine sedative and tonic. By relaxing uterine muscles, the herb has been beneficial in treating menstrual cramps, discomfort during pregnancy, and in the prevention of miscarriage. Typical dosage: up to 3 cups of tea per day (steep 1 teaspoon of bark in 1/4 litre of water for 10 to 15 minutes). Caution: do not use if you have kidney stones.

Wild Yam (Dioscorea villosa)
Various yams are used in Ayurvedic and traditional Chinese medicine. The root of this particular species of wild yam has anti-inflammatory properties that may be helpful in relaxing uterine spasms. Typical dosage: up to two 400-milligram capsules per day; or 20 to 40 drops of tincture up to five times per day.

Motherwort (Leonurus cardiaca)
Chinese researchers have found that motherwort increases the volume of blood circulation and stimulates uterine activity. It can help with such endometrial symptoms as late periods and sluggish menstrual flow. Typical dosage: 3 cups of tea per day (steep % to
1 teaspoon of dried herb in % litre of hot water for 10 to 15 minutes); or 20 to 50 drops of tincture up to five times per day. Caution: do not use if you are pregnant or trying to become pregnant.

Feverfew (Chrysanthemum parthenium)
A proven remedy for migraines, feverfew also has a 2,000-year history as a folk medicine for regulating women's menstrual cycles. How it works isn't known, but it may be worth a try. Typical dosage: up to 400 milligrams in standardised capsules per day; or two average-sized fresh leaves per day; or 15 to 30 drops of tincture per day. Caution: do not use if you are pregnant.

Yarrow (Achillea millefolium)
More than 40 active ingredients have been isolated in yarrow. It can reduce inflammation, relax cramps and arrest excessive bleeding. Typical dosage: 3/ teaspoon of tincture in a little water three times per day, starting 10 days before menstruation; discontinue for two weeks after your period ends. Caution: do not use if you are pregnant.

 

Agnus Castus (Vitex agnus-castus)

Agnus castus normalises and stimulates the pituitary gland functions, particularly those regulating female sex hormones. Typical dosage: up to three 650-milligram capsules per day; or 15 to 40 drops of tincture per day; or 1 cup of tea per day (steep I scant teaspoon of dried ground berries in litre of hot water for 10 to 15 minutes). Caution: do not use if you are pregnant or with hormone replacement therapy.

Black Cohosh (Actaea racemosa)
Another hormone balancer, black cohosh is approved in Germany for several conditions associated with female hormonal irregularities. Because hormonal imbalances are thought to be the cause of endometriosis, this herb is worth a try. Typical dosage: three 500- to 600-milligram capsules per day; or 10 to 25 drops of tincture as often as every four hours. Caution: do not use if you are pregnant or attempting to become pregnant.

Dang Gui (Angelica sinensis)

One of the more frequently prescribed herbs in traditional Chinese medicine, dang gui is used to tone and regulate the female reproductive system. Typical dosage: up to six 500- to 600-milligram capsules per day; or 5 to 20 drops of tincture up to three times per day. Caution: do not use if you are pregnant.

Raspberry (Rubes idaeus)

This herb is recommended by many modern-day herbalists for toning the uterus when you are pregnant and for facilitating childbirth. Some women swear by this herb's ability to relieve heavy periods. Typical dosage: up to six 430-milligram capsules per day; or up to 10 cups of tea per day (steep 1 teaspoon of dried leaves in % litre of hot water for 10 to 15 minutes). Caution: if you're pregnant, use raspberry only under the supervision of a health practitioner.

Dandelion (Taraxacum officinale)

Widely used, dandelion helps the liver break down excess hormones that may encourage endometrial growth. Typical dosage: 120 grams of young leaves eaten raw or lightly cooked; or 3 to 9 teaspoons of dried herb three times per day; or 30 to 60 drops of liquid extract three times per day; or 2 cups of tea per day (steep % teaspoon of sifted dry root in litre of hot water for 10 to 15 minutes).

Burdock (Arctium lappa, A. minus)

Burdock is another herb that helps the liver break down excess hormones such as oestrogen. Typical dosage: up to six 400- or 500-milligram capsules per day; or 3 cups of tea per day (steep 1 teaspoon of dried root in ; litre of hot water for 10 to 15 minutes); or 25 to 40 drops of tincture three times per day.

Yellow Dock (Rumex crispus)

Traditionally used to treat long-term skin ailments, jaundice and constipation, yellow dock is also considered a cleansing herb, though solid research confirming its use is lacking. Typical dosage: up to four 500-milligram capsules per day; or 20 to 40 drops of tincture up to two times per day. Caution: avoid if you are pregnant.

 

ENDOMETRIOSIS TEA
Drink 2 cups of this tea per day for 2 weeks for a single course of treatment.
1 teaspoon agnus castus berries
1 teaspoon red clover blossoms
1 teaspoon wild yam root
1 teaspoon guelder rose
1/2 teaspoon horsetail
1/2 teaspoon red raspberry leaves
1/2 teaspoon motherwort
900 millilitres water
In a medium saucepan, combine the herbs and water and bring to the boil.
Turn down the heat and simmer for about 5 minutes. Remove from the heat, cover, and let steep an additional 15 minutes. Strain and discard the herbs.

 

TWO TREATMENTS WORTH A TRY

Many herbalists use castor-oil packs for any kind of pelvic pain. Preliminary studies suggest that they improve immune system functioning. To make a castor oil pack, saturate a piece of flannel or wool folded in four thicknesses with cold-pressed castor oil at room temperature. Put the flannel directly on your lower abdomen. Cover it with a plastic bag, and then place a hot-water bottle or a heating pad on top of the plastic. Try using the pack for an hour at a time, three times a week, for at least three months. If you find that it relieves symptoms of endometriosis, scale back to once a week.

Acupuncture has been shown to reduce greatly and sometimes eliminate menstrual pain. One preliminary study indicates it may also be effective in treating infertile women who have endometriosis.