Do you experience severe cramping, heavy bleeding and clots during your cycle? This may be a sign of endometriosis. Endometriosis is a condition where the endometrium, or the lining of the inside of the uterus, grows outside of the uterus. It can be located in the fallopian tubes, ovaries, pelvic wall, and in some rare cases, the digestive tract. It is estimated that almost 10% of menstruating women suffer from this condition, which can lead to infertility, painful intercourse, chronic pelvic pain in addition to very painful and heavy cycles. While the origin or cause of endometriosis is still unknown which can make it difficult to treat, an integrated health and hormone clinic can help diagnose and discuss a customized treatment plan unique to your body’s needs.

Traditional Approach

Endometriosis is considered to be a chronic condition, and medical management is aimed at reducing symptoms. It is traditionally recommended for women with endometriosis to take nonsteroidal anti-inflammatory drugs (NSAIDS) for pain, as well as continuous birth control pills to avoid having a cycle.

There are also newer medications, known as Gonadotropin-hormone releasing antagonists, which suppress the pituitary gonadotropin hormone production, in turn suppressing estrogen production. These medications can be effective but come with risks and side effects that should be discussed with your integrative family doctor. If medications are not successful in treating endometriosis, surgical removal of the endometrial tissue is often recommended. Discussing these different options with an integrated health and hormone clinic is the best way to determine the proper course of treatment.

Integrated Health and Hormone Clinic Approach

Integrative medicine focuses on the root cause of a condition or disease. In endometriosis, it is thought that supporting the possible root causes, including inflammatory and immune response, as well as balancing hormones (specifically estrogen detoxification), can help improve symptoms and reduce the severity of the condition.

Inflammation and Immune:

Did you know that about 70% of your immune response comes from your gut? So, foods and your diet play a critical role in supporting immunity. Endometriosis, although not considered an autoimmune disease itself, is known to disrupt the inflammatory and immune systems, putting you at higher risk of autoimmune diseases. This means, to help mitigate symptoms of endometriosis, you need to act, and in particular, EAT like you have autoimmune disease.

  • This means cutting out foods that are known to contribute to inflammation like gluten, sugar and dairy.
  • You should also consider working with your health care provider to complete food allergy and food sensitivity testing to ensure other foods are not contributing to your inflammation.
  • Eat a balanced anti-inflammatory diet full of mostly veggies and fruits (7-10 servings daily) as well as healthy proteins and fats.
  • Increase omega 3 rich foods like cold water fish, chia and flax seeds, walnut or take an omega 3 supplement (aim for 2-3 grams daily).
  • Specific to endometriosis, red meats have known to be a trigger, so eat plant-based proteins when possible and limit red meat.
  • Consider cutting out caffeine which has been shown to increase symptoms in women with endometriosis

Supplements to consider: Omega 3, Turmeric or Curcumin, Probiotics

Hormonal Balance/ Estrogen Dominance:

Endometriosis tends to run consistently with “estrogen dominance” in patients.  Estrogen dominance is having normal to high estrogen levels without sufficient progesterone to balance out. Estrogen is a growth hormone and stimulates growth in the endometrial lining whereas progesterone helps to control that growth. Estrogen plays a key role as it stimulates growth in the endometrial tissue which is a trigger for pain and inflammation in patients with endometriosis. Estrogen and progesterone balance each other in many ways throughout the body and are both important in different ways- but their balance is key. By helping your body detoxify estrogen you are improving this balance.

  • Avoid added hormones and toxins; Aim to eat organic with no hormones added when possible.
  • Increase foods to support detox: cilantro, parsley, cruciferous veggies and dandelion and milk thistle tea.
  • Ensure you are getting enough fiber daily which helps detox estrogen through your bowel movements.
  • Avoid estrogen containing birth control pills or hormonal replacement.
  • Maintaining proper body weight and supporting insulin sensitivity has been shown beneficial for balancing these hormones and reducing risk of endometriosis.

Make sure to work with your healthcare provider to test your levels as you might need progesterone support either in herbal (such as Vitex) or bioidentical form to help balance your estrogen levels.

Supplements to consider: NAC, I-3-C, DIM, Vitex 

Antioxidant Support:

Antioxidants have shown promise in reducing the changes in endometrial cells and the scarring that can occur with endometriosis. Studies have shown that taking supplemental N-Acetylcysteine, a compound commonly found in the body and used to help boost antioxidants in the body, has shown benefits. When taken consistently for 6-8 weeks it improved pain severity, reduced endometrial tissue and showed improvements in fertility. Pine Bark, an herbal antioxidant, was shown to help reduce pain caused by endometriosis

Supplements: NAC 600 mg three times daily, Pine Bark 30 mg twice a day

As you can see, although endometriosis is thought to be a lifelong condition, by taking an integrated health and hormone approach, you can see resolution in symptoms and potentially avoid complications! Each person should be treated individually so be sure to work with your health care provider to develop a plan that is right for you. At CentreSpringMD we would be happy to help lead you on your journey to wellness if you need any health and hormone support at our integrative medical center.

To Optimal Health,

Christina Grace FNP-C

References:

Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007;52(8):703‐708.

Parazzini F, Chiaffarino F, Surace M, et al. Selected food intake and risk of endometriosis. Hum Reprod. 2004;19(8):1755‐1759.

Czyzyk A, Podfigurna A, Szeliga A, Meczekalski B. Update on endometriosis pathogenesis. Minerva Ginecol. 2017;69(5):447‐461.

Porpora, M. G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E. K., Lundeberg, T., Nofroni, I., Piccioni, M. G., Pittaluga, E., Ticino, A., & Parasassi, T. (2013). A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Evidence-based complementary and alternative medicine : eCAM, 2013, 240702.


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