Endometriosis is a condition that affectsup to 20% of cycling women, is pro-inflammatory, but not yet classified as an autoimmune disease. Pelvic pain, pain with sex, irritable bowel syndrome, pain with urination, and painful periods are all aspects of endometriosis, along with anxiety due to inflammation and pain and depression from loss of quality of life!
Endometrial cells are those thatform the lining of the uterus. This lining thickens after ovulation in mammals, forming the layer that is ripe for implanting a fertilized egg. After ovulation, progesterone rises and this normally triggers cell death for endometrium. This
cell layer is then released or sloughed off during menstruation.
At the beginning of a new mooncycle (I like this name better than ‘menstruation’) the cell lining starts to be rebuilt all over again (with some birth control methods, this lining becomes
dormant). Estrogen stimulates the rapid increase in the number of cells to produce the uterine lining. When these epithelial/endometrial cells are found outside of the uterine environment, a chronic inflammatory disease associated with pain during menstruation and chronic pelvic pain during the rest of the cycle can ensue: endometriosis. The response of the cells to hormones triggers nerve pain in the abdomen and pelvic cavity. Infertility is often associated with endometriosis, but the debilitating pain for many women is a major life disrupter and destroyer of quality of life. Why do these cells not stay put inthe uterus in the first place and wreak havoc on the body?
One theory is thought to be due to what is known as ‘retrograde menstruation’, where the
cells migrate through the fallopian tubes and then here to the wall of the lining of the abdomen (peritoneum) and there they multiply. Another theory is that a sex-hormone-dependentmechanism transforms cells that are already in the abdominal cavity into an epithelial type. It has also been considered that endometriosis may be an autoimmune disease because of association of the disease with presence of autoantibodies.
Normally our immune system woulduse natural killer (NK) cells to scavenge these out-of-context cells and so and a decrease of NK cell/immune function may also be involved in the process. Left untreated, this disease can be associated with the development of reproductive
cancers, such as uterine cancer. Balancing hormones estrogen and progesterone
is an important part of helping to treat endometriosis, in addition to treating
Pain benefit may be found with ibuprofen(reducing prostaglandin production), but this drug should only be used temporarily due to risk of damage to the lining of the gut. Curcumin is a natural product with similar benefit, along with ginger omega-3 fatty acids (fish oil).
Cannabis is one of the most potent botanicalpain relievers, and it does not take high THC-potency cannabis to help. Cannabis is a traditional women’s herbal ally, said to be used by Queen Victoria for treating her pelvic pain- but with history as an analgesic dating back to 3000 BCE in China . You don’t necessarily have to feel stoned or dysfunctional to use it. Cannabis can be a helpful tool for chronic pelvic pain and adds a layer of anti-inflammatory protection. A suppository form of cannabis, placed in the vagina can be non-intoxicating and deliver the cannabinoids right where they are needed! Women have reported benefit from cannabis in modern times as well!
There is some evidence that cannabinoids may contribute to the taming of B-cells, to slow antibody production, or help to switch their activity in a beneficial manner.
PEA is a member of the endogenouscannabinoid family that is available as an over-the-counter supplement. It is also anti-inflammatory and has been used to calm mast cells, which are
inflammatory and pain mediators in endometriosis tissue. N-acetylcysteine (NAC)
is a natural amino acid that can help calm mast cells.
Targeting the CB2 receptor tomodulate the pro-inflammatory response of the immune system is a rational approach. Dietary and herbal cannabinoids are at your service. Eat cinnamon, black pepper, cloves and vegetable sin the brassicacea (broccole) family in your diet every day. This activity of taming inflammation through the endocannabinoid system has been shown preclinically to help slow the migration of the cells and to limit their ability to multiply.
You can try these approaches on your own, but seeking an integrative medicine practitioner skilled in these arts can help you make a customized plan, specific to your health needs.
In addition, a skilled pelvicphysical therapist can work with you to help break up adhesions, and using enzymes to break down scar tissue is a great addition to pelvic PT! Don’t give up hope that you can get betterand recover from this debilitating condition with some effort to clean up your diet, your environmental exposures and hormone balancing!
You can schedule a consult with Dr.Sexton to ask your questions about a protocol specific for you! Use the QR code below to see the supplements often used in the support of endometriosis!