Integrative Approach to Endometriosis
November 15, 2001—Endometriosis is a progressive and chronic disease of the female reproductive tissues that affects as many as 10% of all women in the United States and is the third leading cause of gynecologic hospitalization, including hysterectomy.1 The most common symptoms are pain during menses, painful intercourse, pain with urination or bowel movements, general pelvic pain, and infertility. While no cure for endometriosis exists, a review article in Alternative Therapies suggests that using multiple therapies, including diet, exercise, herbal medicine, and acupuncture, may reduce the symptoms associated with endometriosis.2
Foods rich in omega-3 fatty acids, including cold water fish, nuts, and seeds, may help decrease the inflammation caused by endometriosis. Animal research suggests that fish oils may reduce the severity of endometriosis,3 4 and fish oils have been shown to improve symptoms of painful menstruation,5 which may be caused by endometriosis. Although there is no research that investigates omega-3 fatty acids as a treatment for endometriosis in humans, reasonable intake is approximately 2 grams of fish oil per day.
While botanical medicines have not been specifically studied in women with endometriosis, certain herbs may be of benefit. The fruit of the chaste tree (Vitex agnus castus) has been found to increase progesterone levels in women with short menstrual periods.6 The author of the Alternative Therapies article believes that since estrogen is known to exacerbate endometriosis, increasing levels of progesterone (which is an estrogen antagonist) may help reduce symptoms. Dong quai (Angelica sinensis) and black haw (Viburnum prunifolium) have anti-inflammatory activity and may reduce painful spasms of the uterus during menses.7 8 Extract of kava kava (Piper methysticum) induces a tranquilizing effect in the brain and reduces muscle spasms.9 Because of the potential interaction with substances that act on the brain, such as alcohol or psychiatric drugs, it is recommended to avoid taking kava kava simultaneously with these substances. The author discusses using Turska’s Formula, a combination of four potentially toxic herbs (Aconite, Bryonia, Phytolacca and Gelsemium) for endometriosis. Due to the toxic nature of this preparation, this formula should only be taken under the close supervision of a physician specially trained in the use of these herbs. In addition, more research is needed to determine whether these herbs are effective against endometriosis.
Other interventions may provide additional help for women suffering from endometriosis. One preliminary report found that participating in regular meetings with other endometriosis sufferers helped women cope better with the many psychological and emotional issues associated with this condition.10 Acupuncture has been reported anecdotally to help control the pain associated with some cases of endometriosis,11 but no controlled studies have confirmed this claim.
Conventional treatment for endometriosis involves surgery, hormone suppression, or both. Neither option is without risk and side effects. Using an integrative approach may provide for relatively safe, effective relief for women who endure this devastating disease. Nevertheless, some of the treatment approaches discussed in this article remain theoretical, and need to be subjected to formal study.
1. Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997;24:235–58 [review].
2. Low Dog T. Conventional and alternative treatments for endometriosis. Alternative Therapies 2001;7:50–6[review].
3. Yano Y. Effect of dietary supplementation with eicosapentaenoic acid on surgically induced endometriosis in the rabbit. Nippon Sanka Fujinka Gakkai Zasshi 1992;44:282–8 [in Japanese].
4. Covens AL, Christopher P, Casper RF. The effect of dietary supplementation with fish oil fatty acids on surgically induced endometriosis in the rabbit. Fertil Steril 1988;49:698–703.
5. Harel Z, Biro FM, Kottenhahn RK, Rosenthal SL. Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents. Am J Obstet Gynecol 1996;174:1335–8.
6. Milewicz A, Gejdel E, Sworen H, et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993;43:752–6 [in German].
7. Jarboe CH, Zirvi KA, Schmidt CM, et al. 1-methyl 2,3-dibutyl hemimellitate. A novel component of Viburnum prunifolium. J Org Chem 1969;34:4202–3.
8. Ozaki Y. Anti-inflammatory effect of tetramethylpyrazinc and ferulic acid. Chem Pharm Bull (Tokyo) 1992;40:954–6.
9. Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians Guide to Herbal Medicine. New York: Springer-Verlag, 1998.
10. Whitney ML. Importance of lay organizations for coping with endometriosis. J Reprod Med 1998;43(3 Suppl):331–4.
11. Maciocia, G. Obstetrics and Gynecology in Chinese Medicine. New York: Churchill Livingstone, 1998.
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Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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