Endometriosis – It’s Sticky and Tricky

One of the many complicated syndromes we see in our clinic is endometriosis.

We treat the wide range of symptoms that can be attributed to this complicated inflammatory syndrome. Our endometriosis patients range from those who are having heavy pain with their cycles, to many who are working hard on conception.

Since endometriosis affects 5–10% of women of reproductive age, and up to 80% of women with pelvic pain, and 20–50% of women with infertility, it represents the many woman who are mystified by their cycles being very complicated. Mild and complicated cases can go unnoticed until women start to have infertility issues or difficulty getting pregnant.

They don’t realize they have endometriosis!

This syndrome affects those who have never given birth, those with a family history, and women who have menstrual cycles shorter than 27 days with bleeding lasting longer than 8 days, obstruction of normal menstrual flow (tampons, cups, etc.), or a history of pelvic infection.

Many of our patients come to us with an endometriosis diagnosis from their physician.  And, if undiagnosed, it is often discovered while couples are undergoing treatment infertility.

What is Endometriosis? How Does it Happen?

Endometriosis is a chronic condition that affects a woman’s reproductive organs.  It occurs when the tissue that normally lines the inside of the  uterus grows outside of it.

How does the tissue get outside the uterus? 

Most likely, the cause is retrograde (back flow) menstrual flow.  Which means that when you get your cycle, some blood and tissue flow backward into your pelvis rather than out onto your pad, cup or tampon. Endometriosis can run in families, so it can also be considered genetic.

Interestingly, since endometriosis involves your ovaries, fallopian tubes, and the tissue lining your pelvis, the “misplaced” endometrial tissue continues to thicken, shed, and bleed, just as it does during your menstrual cycle. This creates heavy bleeding and hormonal chaos.

The exact cause of endometriosis is unknown, but it is believed that it may be caused by a combination of genetic, hormonal, and environmental factors.

It is not considered an autoimmune disease but an inflammatory disease. 

Pelvic Pain

The main symptom of endometriosis is pelvic pain, which can range from mild to severe. Oftentimes, our patients complain of debilitating cramps where they stay in bed during their cycle. And there are also those who see us with an endometriosis diagnosis who have never had pain. It is a really mixed bag.

Common symptoms can include: 

• Chronic pelvic pain and bloating
• Painful cycles
• Pain during sexual intercourse
• Heavy or irregular cycles
• Fertility issues
• Bowel irregularities during cycle: painful bowel movements, diarrhea and constipation
• Urinary symptoms: painful or bloody urination

How Do I know If I Have Endometriosis?

Mostly, the diagnosis of endometriosis includes locating “cysts”.  Endometriosis is sticky and sticks to organs and anything it can find.  When enough stickiness occurs, cysts can form.

• Pelvic exam: During a pelvic exam, your doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it’s not possible to feel small areas of endometriosis unless they’ve caused a cyst to form.
• Ultrasound: A standard ultrasound won’t definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis.
• MRI: An MRI helps with surgical planning, giving your surgeon detailed information about the location and size of endometrial implants, and cysts.
• Laparoscopy: In some cases, your doctor may refer you to a surgeon for a procedure that allows the surgeon to view inside your abdomen (laparoscopy). While you’re under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for signs of endometrial tissue outside the uterus. A Laparoscopy can provide information about the location, extent and size of the endometrial implants. Your surgeon may take a tissue sample (biopsy) for further testing. Often, with proper surgical planning, your surgeon can fully treat endometriosis during the laparoscopy so that you need only one surgery.

*Descriptive information provided by the Mayo Clinic

Endometriosis Treatment Options 

Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. This may help slow the growth and local activity of both the endometrium and the endometrial lesions. Treatment also prevents new areas and scars (adhesions) from growing, but it will not make existing adhesions go away.  

Treatment can also include pain medication (NSAIDS), an anti-inflammatory diet, and laparoscopy surgery.  

Where does Chinese Medicine Fit?

At Many Lives Chinese Medicine we see so many fertility patients that are challenged with endometriosis blocking their attempts at a successful conception and healthy pregnancy.

Since endometriosis is an inflammatory issue Chinese medicine is a perfect fit.  And Chinese medicine does a whole lot more…. such as stop excessive bleeding, reduce masses, improves blood circulation, helps to reduce pain and calms and balances the spirit.

In the Chinese medicine diagnostic system, endometriosis can be seen as three different separate diagnosis’:  blood stagnation, yang deficiency or qi sinking.  Blood stagnation is a condition where “flow” is compromised and not moving freely.

Patients with blood stasis have abnormal blood flow, which triggers a negative response from the immune system, due to the endometrial cells growing outside the uterus (severe inflammation). It is this stasis that causes severe pain, especially in the lower abdomen during menstruation.

So, going for the “root” of the issue, we can ease endometriosis by using acupuncture and herbals to address the three different diagnosis.  In general, acupuncture relieves pain, balances out temperatures, regulates blood circulation and corrects qi (energy) imbalances.

If it all sounds a bit confusing, it is!  That is why it is important to choose a practitioner that has hormonal/fertility knowledge and who has experience addressing inflammatory issues like endometriosis.

Endometriosis and Fertility

Endometriosis affects fertility because it can block the fallopian tubes or damage the lining of the uterus, making it difficult for a fertilized egg to implant. Endometriosis can also cause changes in hormone levels, which can interfere with ovulation. The endometrial tissue can bleed with hormonal stimulation causing swelling and triggering an inflammatory response which then can create scar tissue and adhesion which are not fertility friendly.

We advise these patients to follow their MD’s advice and if their doctor deems laparoscopic surgery necessary we support them through this process. Then we use Chinese medicine to help with recovery and to slow the rate the endometriosis returns.

No matter where you are in your cycle, we can help create a path for healthy cycles and less painful periods while preparing you for your fertile times. It is always good to balance hormones and create a healthy plan for fertility goals. We look at treatment for three full cycles and if there is not resolution or change in pain or symptoms, medical treatment might be required.

What About Chinese Herbs for Endometriosis?

There are several studies that show that Chinese herbal medicine is effective for the treatment of endometriosis.  There are several base formulas that are given depending on the diagnosis of the patient.  The herbal formulas are key for maintaining the goals of the treatment between acupuncture visits.

Each herbal formula is made up with 14-20 different herbs, all selected to assist and balance one another.  Chinese formulas (the recipes) are age old and past down through the years.  It is very important to have an acupuncturist, who is also an herbalist, recommend herbal medicine.

Better Nutrition

Acupuncture, herbal medicine, and supplements can all help to reduce pain and many other symptoms associated with endometriosis. Nutritional recommendations can really help to improve the endometriosis picture.  Often anti-inflammatory foods are recommended such as ginger, turmeric and seafood.  It is a good idea to leave the sugar, alcohol and grains behind as they all can cause a substantial amount of inflammation.

Nutritional recommendations are based on individual constitution and a diagnosis from the practitioner.

Pulse diagnosis and tongue observation along with signs and symptoms that are reported can help to create a complete treatment plan and provide substantial relief form the journey of endometriosis.

Moving Forward

Because endometriosis is a complex disorder, it’s always recommended to combine the Chinese medical “root” approach with conventional medical treatment.  The key to treating long-term syndromes is patience. Sometimes there can be an immediate effect from treatment, but acupuncture, herbal, supplemental, nutrition and lifestyle changes can take months.

Working on your health can take time and can be endlessly frustrating, but the results are so worth it. Whatever path you are taking, pain management, cycle regulation, pre-conception preparation, surgical preparation or general hormonal balancing, we are here for you.

Schedule a consultation to learn more.

Beth Schiffman
Many Lives Chinese Medicine
Acupuncturist Redwood City
650-366-4299
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