Endometriosis refers to a condition in which endometrial tissue, which normally lines the uterus, implants and grows outside the uterus. It is a common gynaecological disease, and is believed to affect approximately 10% of women at some stage during their menstruating years. 30-50% of cases of infertility are believed to be caused by endometriosis.
In endometriosis, the migrant endometrial cells may settle in many various areas. They can stick to the ovaries or the ligaments that support the uterus, or settle in the pouch of Douglas (the area between the uterus and the rectum). The cells can also become attached to the fallopian tubes, the vagina, the vulva, the bladder and the bowel. In some rare cases, they may be found in the eyes, the brain, the lungs, or in old surgical scars on the abdomen.
The displaced endometrial patches act like the normal endometrial tissue lining inside the uterus, growing with estrogen stimulation and bleeding during menstruation, but without any outlet of leaving the body. This may causes inflammation, adhesions (fibrous scar tissue) and leads to pain, swelling and sometimes damage to the fallopian tubes or ovaries, causing fertility problems.
What causes endometriosis?
The causes of endometriosis are not fully known, but there are several theories:
- Retrograde menstruation – the most common theory is that endometriosis is caused by a back-flow of blood through the fallopian tubes during a woman’s period instead of through the cervix. The endometrial cells embed themselves onto the tissues or organs of the pelvis.
- Genetics – endometriosis is sometimes believed to be hereditary, being passed down through the genes of family members.
- Spreading through the bloodstream or lymphatic system – endometrial cells are sometimes believed to enter the bloodstream or lymphatic system, although it is not known how. This theory could explain how, in very rare cases, the cells are found in remote places such as the eyes or lungs.
- Metaplasia – the process of one type of cell changing into another to adapt to its new environment. It is this development that allows the human body to grow in the uterus before birth. It has been suggested that some adult cells retain the ability they had as an embryo to change into endometrial cells.
- Immune dysfunction – the body’s immune system attacks the endometrium that is growing outside the uterus and causes inflammation. The body cannot distinguish between endometrium growing inside or outside the uterus and so a hostile environment occurs in the entire pelvic cavity.
Symptoms of endometriosis
Endometriosis is a chronic condition that causes painful or heavy periods. It often causes pain in the pelvis, lower abdomen or lower back. It may also lead to lack of energy, depression and infertility.
The symptoms of endometriosis vary from person to person. Some women suffer from pain all the time, while others only have pain during their periods, when they have sex or when they go to the toilet. How severe the symptoms are depends mostly on where in your body the endometriosis is, rather than the amount of endometriosis you have. A small amount of tissue in a certain area can be as painful as, or more painful than, a large amount in another. Some women may have few symptoms or no symptoms at all.
The most common symptoms include:
- Intense or persistent period pain
- Pain in the pelvis, lower abdomen or lower back that worsens during periods
- Pain during sexual intercourse
- Heavy or irregular menstrual bleeding or clotting
There is a strong association between endometriosis and infertility. It is thought that scar tissue and adhesions may obstruct or distort the shape of the fallopian tubes and prevent the ovaries from releasing eggs. Endometriosis may also affect fertility by causing hormonal irregularities, and can also increase the chance of early miscarriage.
Pregnancy sometimes reduces the symptoms of endometriosis, although symptoms often return once the menstrual cycle returns to normal.
Other symptoms may include:
- Discomfort when urinating
- Rectal bleeding and pain during bowel movements (if the endometrial tissue is in the intestines)
- Coughing blood (if the endometrial tissue is in the lung)
- Stress and anxiety as a result of knowing of their upcoming period will bring pain and discomfort
Endometriosis can only be diagnosed with an examination called a laparoscopy, which is carried out by a gynaecologist to check for any endometrial implants, adhesions or cysts in your abdomen.
Treatment of endometriosis
From the perspective of western medicine, there is no known cure for endometriosis (aside from hysterectomy), and it can be difficult to treat. The aim of treatment is to ease the symptoms so that the condition does not interfere with one’s daily life.
Treatment options include:
- Pain management – the use of anti-inflammatory or painkilling medications.
- Hormonal medications – to limit or stop the production of estrogen by putting you in either an artificial state of pregnancy or an artificial state of menopause, which stops your periods. Different types of hormonal medications include: (1) the combined (estrogen and progesterone) oral contraceptive pill; (2) progestogens (bring on an artificial state of pregnancy by stopping ovulation, which can help to shrink endometriosis tissue); (3) antiprogestogens (bring on an artificial menopause by decreasing the production of estrogen and progesterone); (4) medications that inhibit the body’s release of gonadotrophin releasing hormone (which stimulates estrogen production) or medications that interfere with the way gonadotrophin releasing hormone works.
- Surgery to remove implants, adhesions and cysts, and to repair any damage the disease has done. In extreme cases a hysterectomy is performed.
Treatment with synthetic hormones will suppress the symptoms of endometriosis, but they have side effects and do not cure the disease itself. In addition, symptoms will often return after discontinuing the hormone therapy. Surgery is often only a temporary measure, because endometriosis recurs in most women.
TCM perspective of endometriosis
From the perspective of TCM, endometriosis is the result of the slowdown and stasis of blood flow in the pelvis, brought about either by blocked energy in the pathways of the body or by insufficient energy to push the blood through the vessels. This sluggishness in blood flow can be caused by a number of factors such as poor digestion, weakness in certain parts of the body, especially the kidneys (which in Chinese medicine thought support the whole reproductive system), stress and tension, the habitual consumption of cold foods or overwork especially during menstruation, genital infections and surgical history.
Five common patterns of endometriosis include:
- Qi stagnation and blood stasis
- Kidney deficiency and blood stasis
- Cold retention and blood stasis
- Qi deficiency and blood stasis
- Heat obstruction and blood stasis.
Signs of blood stasis include stabbing pain that is fixed in one place, frequent or heavy bleeding, and bleeding with dark purple clots. Chronic stagnation causes clots, which can have a tendency to manifest themselves as masses or lumps.
How TCM can help treat endometriosis
Endometriosis can be successfully treated with the help of acupuncture and Chinese herbal medicine. More and more women are experiencing the benefits from TCM treatment which not only efficiently relieve the symptoms of, and/or significantly clear endometriosis, but can also bring about the ability to conceive and carry a healthy baby to full term.
Acupuncture can improve the function of the immune system and increase the flow of energy through the meridians in the body. It has been found that acupuncture treatment promotes the release of endorphins and other ‘healing’ chemicals in the body. These chemicals assist in healing and pain management.
Both acupuncture and herbs can work to reduce the pain, breakup the old stagnated blood, encourage blood flow and promote hormonal balance. TCM treatment also helps re-establish proper estrogen/progesterone ratios, which is essential in healing this condition. A woman with mild or moderate endometrial symptoms may be able to use TCM treatment alone to heal naturally. More severe cases may need to employ the use of both western medicine and Chinese medicine to have the best prognosis for long-term cessation of the effects of this condition.
For example, a laparoscopy can precisely tell the location and severity of the endometriosis lesions. It can also clear away extensive or severe lesions or adhesions more rapidly than herbs. This can greatly reduce the time needed for treatment, and therefore the strain severe endometriosis may place on the body. Chinese herbs can then be used to reduce any remaining lesions in difficult-to-reach places, such as the Pouch of Douglas, and also to restore normal circulation and functioning within the pelvis and throughout the rest of the body. Chinese medicine is designed to take all of the symptoms into consideration, and treats the patient as an individual and as a whole, not just the condition.
Patients who find western drug treatments onerous often opt for herbs as a substitute. Others may choose to use the herbs with the drugs. The herbs can be designed to reduce the side effects of the drugs, while enhancing the endometriosis clearing effect.
Using Chinese medicine and acupuncture to treat endometriosis has many advantages, including better curative effect, no side effect, and less chance of recurrence. At our clinic, Dr. Xing has successfully treated quite a number of endometriosis patients. If you suffer from endometriosis, please feel free to contact us for further information, or to arrange an appointment.
Helped at the centre:
TCM has proven to be highly effective in treating endometriosis, and helping many who suffer from the condition feel healthy again. Dr. Xing of our clinic has successfully treated a large number of patients who had been suffering from this condition, including many who had tried western drugs and surgical treatments, but without success.
One lady, 38 years of age, had been suffering from endometriosis and infertility for over 8 years. During this time, she had undergone several surgical procedures in an effort to treat the condition, but to no avail. The first time she visited the centre, she was in pain, very tired and rundown. Dr. Xing treated her using acupuncture, and prescribed some Chinese herbal medicine. After a few weeks of treatment, the patient found herself to be much healthier and happier. By the 11th week, she had, to her pleasant surprise, found herself to be pregnant.
Another 32 year old woman had been suffering from period pain since she was 16 years of age. When she was 25, she was diagnosed with endometriosis affecting the left ovary, bladder and bowels. She had undergone two operations in an effort to treat her condition, however these were unsuccessful in helping treat her period pain. In addition, she had also been suffering from infertility, and had tried to get pregnant for many months, without success. After a recommendation made by a friend, the patient decided to visit Dr. Xing, who treated her with acupuncture and herbs. By the 5th month of treatment, her symptoms of period pain had started to improve significantly, and within a year from her first visit, her menstrual cycle had returned to normal, she had become free of pain, and had fallen pregnant.