Affecting an estimated 4-10% of women worldwide, endometriosis is an all too common disease in which cells from the uterus lining begin to grow outside the uterine cavity, usually in the abdominal area. Symptoms vary depending on a number of different factors, but severe pelvic pain is reported by many women suffering from this disease. It is called an “Invisible Illness” since often women are misdiagnosed for a number of years, and may not “look sick”.
What are the Symptoms of Endometriosis?
The cells in endometriosis form tissue in the abdomen (or sometimes elsewhere in the body) that responds to the menstrual cycle in the same way that the normal tissue lining the uterus does: each month the tissue builds up, breaks down and sheds. However, this blood and tissue from endometriosis has no way of leaving the body, as it does not shed and exit the body the same way as does regular menstrual blood and tissue.
The result can be painful inflammation, sometimes compounded by cysts and scarring from adhesions. It can affect ovaries, bowel and other areas within the pelvis. Women with very mild levels of endometriosis may sometimes still have very painful symptoms, while others with high levels of the growth may experience only mild discomfort. There are no fixed rules for this chronic and sometimes debilitating condition.
It may include symptoms such as:
- painful periods (cramping, feelings of heaviness, bloating)
- very heavy periods, often with heavy clotting
- pain at other times of the menstrual cycle
- painful intercourse
- nausea, vomiting
- constipation and/or diarrhea
- frequent and/or urgent urination
- lower back ache
- it is often associated with fertility challenges
Because women’s symptoms vary greatly, this complex condition is often misdiagnosed by doctors and may be treated as a simple “painful period” or even as a bad case of IBS. To officially diagnose endometriosis, evidence must be seen during a laparascopy. However, doctors who are familiar with the signs will often suspect endometriosis is present based on symptoms, lab results and ultrasounds.
What causes Endometriosis?
Currently there is no confirmed cause for endometriosis, although there are a number of theories that suspect it is linked to:
- Retrograde menstruation. In this theory, menstrual fluid is thought to flow backward into the fallopian tubes and into the reproductive organs instead of exiting the body. This is a long-standing theory that is sometimes still discussed, although more recent advances tend to look at other possible factors as more likely.
- Embryonic cell transformation. In this theory, it is thought that the body’s cells are affected by irregular hormonal activity during the earliest stages of development. This in turn, may turn them into endometrial type implants later in a woman’s life.
- Scar implantation. After a surgery, such as cesarean section or other pelvic surgery, endometrial type cells may attach and grow on or near scar tissue – forming adhesions.
- An auto immune response. One of the most recent theories looks at potential issues with the immune system being unable to recognize and destroy irregular endometrial tissue (appearing in places other than the uterine lining).
How does TCM see Endometriosis?
To better understand how TCM views and treats endometriosis, it is important to see how this medicine understands the body. The body’s vital energy force, known as ‘Qi’, constantly flows in a healthy cycle between our organs and the pathways of the body known as meridiens. When Qi flow is blocked or slowed down, stagnation occurs and it stops the organs from being nourished and functioning optimally. This increases the risk of pain, illness and disease.
In Traditional Chinese Medicine, Endometriosis is considered a disease of “stagnation” or “stasis”. Energy flow is hampered or restricted, not allowing blood and other body fluids (such as lymph fluid) to circulate freely in the pelvic area.
Because there is stagnation in the body, this often results in a cycle of pain on multiple levels (both physical and emotional). Multiple organ systems may be affected, including digestion and elimination as well as the reproductive system. With reduced circulation, congestion increases, causing further obstruction as potential cysts and adhesions form and add to the stasis.
Although this may appear to be a very simplified view, it is an effective treatment approach that has been developed over thousands of years.
What are the treatment options for Endometriosis?
There is currently no known cure for endometriosis. Most women assume conventional therapies (ie. prescription pain killers, anti-inflammatory drugs, surgery, hormone therapy, oral contraceptives) are the first and best course of action. Not every option works well for every woman however, and its important to become familiar with possible side effects.
Surgery is usually suggested for more serious cases of endometriosis, although now most specialists will leave this as a last option. Surgical excision can remove painful adhesions and endometriomas, but may also be a factor in future endometrial growth in any areas of scarring. Other options such as hormonal therapy (ie. Luperon) are meant to “dry up” the endometrial growth by essentially causing a temporary state of menopause. Although this works well for many women, others will find the potential side effects to be unacceptable.
Even oral contraceptives, which are readily prescribed as the least invasive method of conventional treatment, act more to mask the problem than treat the underlying cause. These are also not an option when a woman with endometriosis is trying to get pregnant.
Natural Treatments for Endometriosis
While each woman should discuss the pros and cons of a particular treatment approach with her physician, there are a number of natural therapies that work well alongside more conventional options. For some women, finding the right combination of natural methods may help them avoid more invasive treatments. These include:
- nutrition and diet changes – such as reducing inflammatory foods and potential triggers (ie. the EndoDiet)
- introducing lifestyle changes to reduce stress
- supplementation of key nutrients and minerals with herbal remedies and/or supplements
- gentle yoga and mindful movement practices such as Qi Gong
- Acupuncture and Chinese Medicine
- specialized therapies such as the Arvigo Techniques of Maya Abdominal Therapy®
How can Acupuncture help?
Traditional Chinese Medicine offers a “whole person” approach to treating endometriosis. Therapy may include the use of acupuncture, abdominal massage, herbal remedies, essential oils, lifestyle changes and diet suggestions. As endometriosis is a complex condition several of these may be combined as part of the holistic approach to restore the body and mind back to a healthy state.
The good news is that you can restore the healthy, regular flow of Qi (vital energy) and stop the cycle of pain. The general approach is to bring the body back into homeostasis by focusing on restoring and regulating the smooth flow of Qi. When Qi flow is balanced this also means blood and lymph fluid can circulate smoothly in body.
Acupuncture works to:
- increase circulation of energy and blood in the body (overall, and in the abdominal and pelvic regions)
- reduce inflammation in the body, reducing pain
- encourage the body’s natural “rest and heal” state, during which tissues heal and recover
- reduce stress and anxiety around pain
For women with mild to moderate symptoms, acupuncture can be very effective in managing pain, bloating and inflammation in the body. It may be possible to reduce pain medications and avoid more invasive treatments. For women who choose hormone therapies or surgery, it is an excellent supportive therapy that can help with side effects and hasten recovery.
A holistic approach also considers overall emotional health, and can help to reduce pain and stress that is associated with endometriosis, or even possible subfertility. Whether used on its own, or combined with conventional treatment, Acupuncture and other components of Traditional Chinese Medicine are a safe, effective way to treat endometriosis symptoms while improving the body’s overall health in the long run.
Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659600/
Mayo Clinic, Endometrios Overview/Causes/Diagnostic/Treatments https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661