Carolyn Dean, M.D., N.D.
Most women have heard of endometriosis and many have at least a
general concept of what it is. In my practice, I remember it being
called "the working women's disease." That's because there
was a theory a couple of decades ago that endometriosis was related
to a high stress lifestyle.
What is Endometriosis?
Stress definitely has a role in endometriosis, as do most chronic
diseases, but let's go back to the basics. Endometriosis, in the
simplest possible terms, is tissue from the uterine lining growing
where it shouldn't. During healthy menstruation, women shed their
endometrial lining, or the endometrium, each month. The material
is expelled from the body as part of the monthly menstruation. While
many women would probably like to bypass this inconvenient and sometimes
painful monthly routine, it is the key to life itself.
However, in the 5.5 million North American women with endometriosis,
cells from the uterine lining have migrated from where they're supposed
to be -- inside the uterus -- to other parts of the body, most often
within the pelvic area, on the bowel, bladder, ovaries and the outside
of the uterus. It's sometimes called retrograde menstruation. Rogue
endometrial tissue has been known to migrate as far as scar tissue
on the arms and legs.
This misplaced tissue develops into growths that respond to the
menstrual cycle in the same way the lining of the uterus does. Triggered
by hormonal signals, the tissue builds up and sheds each month.
While menstrual blood flows out of the body through the cervix
and vagina, endometriosis tissue and the cells it sheds have no
way of leaving the body. Trapped between layers of tissue, they
cause inflammation, scar tissue, adhesions and bowel problems. Endometriosis
can lead to intense pain and reproductive difficulties.
Stress enters the picture to cause uterine tension and toxicity,
often prompted by poor lifestyle choices and worsened by nutrient
deficiency-especially magnesium. Cycles of stress and deficiency
create a pattern of hormonal imblance throughout the body and in
some women focus on the uterus. Specifically in endometriosis, uterine
muscle tension and spasm in the fallopian tubes, due to magnesium
deficiency, can contribute to uterine blood and tissue migration.
More than 5 million North American women suffer from symptoms
of endometriosis that include:
- Pain before and during periods
- Pain during intercourse
- Chronic pelvic pain
- Cramping at any time of the cycle
- Painful bowel movements
- Painful urination
- Gastrointestinal upset such as diarrhea, constipation
The Essential Estrogen Balance
While modern medicine insists the cause of endometriosis is unknown
and there is no cure, it can be relatively simple to treat and control
the symptoms. The standard medical treatment involves taking synthetic
hormones, such as the birth control pill, that stops menstruation
and therefore stops the buildup of blood and endometrial tissue
outside the uterus. But there are new ways of approaching endometriosis
that are much kinder to the body and address an underlying problem
that certainly relates to the condition.
Current scientific theory points to estrogen dominance as a major
factor in endometriosis. According to many integrative medicine
practitioners, bringing progesterone and estrogen into natural balance
will frequently result in symptom relief and, in some cases, even
shrink rogue endometrial tissue.
Treatment usually means obtaining a prescription from your doctor
for a natural progesterone cream -- called bioidentical progesterone
-- available from a compounding pharmacy. (You can find a compounding
pharmacy near you by contacting the International Academy of Compounding
Pharmacists at www.iacprx.org.)
Testing Your Estrogen Levels
Along with progesterone cream has come a new method of hormone
testing that captures the fat-soluble hormones more accurately than
blood tests. Highly accurate saliva testing can give a women and
her doctor a much better picture of her estrogen and progesterone
levels compared to relatively antiquated and unreliable blood hormone
As a general benchmark, a range of 30 to 50 mg. of bioidentical
progesterone cream from days 8-26 of the menstrual cycle are usually
sufficient. Medical supervision is necessary to individualize treatment.
Doctors who use bio-identical hormones do not subscribe to the one-size-fits-all
pharmaceutical method of drug prescribing.
I said earlier that stress plays a huge role in endometriosis and
de-stressing needs to part of the treatment.
What we now know about hormones is that when women have a great
deal of stress, their production of the stress hormone cortisol
as well as estrogen increases dramatically!
The Effects of Estrogen Overload
Normal estrogen levels may cause some breast swelling or nipple
tenderness in the few days before the onset of your period. It's
often the way you know it's coming. However, when you have an overproduction
of estrogen, often called estrogen dominance, those estrogen symptoms
In addition to stress-triggered estrogen production, we are seeing
women with out-of-whack hormones related to environmental estrogens,
known as xenoestrogens.
We have seen xenoestrogens wreak havoc in wildlife and fish affecting
sexual development and fertility. It's only in the past decade that
we turned the magnifying glass on ourselves and found sperm abnormalities
and serious female fertility issues created by xenoestrogens.
Xenoestrogens most often enter the body through the food supply
such as meat and dairy products from "hormonally-enhanced"
That's why recent Italian research showed that women with the highest
consumption of meat and dairy products increased their risk of endometriosis
by 80 to 100 percent, while those who ate a diet rich in green vegetables
and fresh fruit reduced their risk by 40 percent.
Get Your Estrogen Back on Track Naturally
As a naturopathic doctor as well as a medical doctor, I advise
diet, exercise and detox before accepting a prescription for bioidentical
progesterone. Unfortunately many women do not have integrative medicine
doctors to turn to and need naturopathic solutions they can implement
on their own. Sometimes, clearing up lifelong constipation is all
that's needed to turn the tables on endometriosis.
I recommend a detoxification program for women with endometriosis
- A high fiber diet
- Onions and garlic to help chelate toxins from the body
- Sauna therapy Epsom salt baths and hydrotherapy
Liver support with milk thistle (up to 240 mg. daily,
in divided doses) and other safe herbs in liver support
Eliminating elements of stress that can cause adrenal
fatigue and toxic stress levels
Endometriosis also often responds to treatment with other supplements,
Black cohosh (40 to 80 mg. daily) to help relieve painful
Calcium and magnesium (up to 1,500 mg. of calcium and up to
900 mg of magnesium in divided doses) to help the liver more
efficiently metabolize hormonesand to prevent spasms and tension
in muscles and nerves
Vitamin B complex with extra panthothenic acid to support the
Iron (up to 60 mg. daily in divided doses, if necessary) to
help relieve iron deficiency that may result from excessive
bleeding. (use a brand that chelated and/or combined with iron-rich
Endometriosis is one of those diseases that has many "hitchhikers,"
or other conditions that often accompany it.
The Endometriosis Association says it is now becoming apparent
that women with endometriosis are more apt to be troubled by:
- Chemical sensitivities
- Chronic fatigue syndrome
- Asthma and eczema
- Food intolerances
- Mitral valve prolapse
- Autoimmune disorders, including lupus and Hashimoto's
Interestingly, many of these accompanying conditions are associated
with candida yeast overgrowth, an area of particular interest to
The Endometriosis Association agrees that many women with endometriosis
also suffer from allergies, chemical sensitivities, and frequent
Many yeast experts, including the late Dr. William Crook, author
Yeast Connection and The Yeast Connection and Women's Health,
believed there was a strong connection between the two conditions.
In fact, Dr. Crook and many practitioners, including me, have achieved
excellent and lasting results by treating endometriosis and yeast
overgrowth simultaneously with a yeast-free diet, natural antifungals
like caprylic acid, olive leaf extract and probiotics.
Yeast overgrowth may not be the main cause of endometriosis but
it's one of those hitchhikers that you want to avoid if possible.
Dean, M.D., N.D., is health advisor to Woman's Health Connection
and is featured on the website's "Ask A Pro" page. Her
latest books are The
Miracle of Magnesium and Natural Prescriptions for Common Ailments.