Endometriosis is not like other period problems. It’s not a hormonal condition like PMS and PCOS. It’s affected by hormones, yes, but fundamentally endometriosis is an inflammatory disease and probably an autoimmune disease.
Conventional treatment has not yet caught up with the new autoimmune research. Hormonal suppression remains the primary treatment, which is unfortunate, because it has many side effects and does not work all that well.
There is another way.
What is endometriosis?
Endometriosis is best defined as an inflammatory disease in which bits of uterine lining grow throughout the pelvis on structures such as ovaries. It causes pain (sometimes severe), scarring, and infertility.
Risk factors include genetics and exposure to toxins such as pesticides and dioxins. The microbiome (good bacteria) also plays a role. For example, endometriosis sufferers have high levels of gram-negative bacteria and the bacterial toxin LPS (lipopolysaccharide) in their pelvis, which has been shown to actively promote endometriosis.
Endometriosis is common, and often starts young (although it can take 10 years to diagnose). One study found that two-thirds of teens reporting ‘chronic pelvic pain’ will eventually go on to be diagnosed with endometriosis. See my post When Period Pain Is Not Normal.
Surgical excision of the lesions is effective for both pain and fertility, but in 50 percent of cases the lesions grow back within five years. That’s why surgery is usually followed by hormonal suppression.
Hormonal suppression with birth control (or stronger drugs such as Lupron) works by shutting down ovulation and inducing estrogen deficiency. Estrogen deficiency slows the growth of the lesions, but it does not cure the disease. It has many side effects including depression and bone loss.
Mirena intrauterine device (IUD) works locally to suppress growth of the uterine lining and lesions. It is preferable to other methods of hormonal birth control because it does not shut down ovulation or cause global estrogen deficiency.
Natural treatment of endometriosis
The following natural treatments work because they improve autoimmunity and reduce inflammation. They can be used on their own or in conjunction with surgery and/or hormonal suppression. (Fortunately, many of my patients find they do not require hormonal suppression.)
Avoid dairy and possibly gluten. Both A1 casein (dairy protein) and gluten disrupt immune function and stimulate the release of inflammatory cytokines. That’s why avoidance of those foods is effective treatment for inflammatory diseases in general, and for endometriosis in particular. In one study, 75 percent of endometriosis-sufferers improved after 12 months on a gluten-free diet. In my own work with patients, I have found women to do even better on a dairy-free diet, and I am convinced that the avoidance of A1 casein (normal dairy) is the single most effective treatment for endometriosis we currently have.
Berberine has several anti-inflammatory actions. It repairs intestinal permeability (thereby improving autoimmunity), and neutralises the bacterial toxin LPS. Caution: Do not take berberine if you are pregnant or breastfeeding, and do not take for more than three months continuously except under supervision. Be cautious when combining with other medications.
Probiotics. In one clinical trial, the probiotic strain Lactobacillus gasseri OLL2809 stimulated natural killer cells and significantly reduced endometriosis pain after just 12 weeks. I often prescribe a two month course of berberine followed by a two month course of a probiotic.
Turmeric reduces the size and activity of endometriosis lesions. It works by reducing the inflammatory cytokine NF-kappa B, and by blocking estrogen’s stimulating effect. Turmeric works best as a concentrated capsule or tablet. It’s safe for long-term use.
Zinc is a key anti-inflammatory nutrient, and has been demonstrated to be deficient in endometriosis-sufferers. Zinc repairs intestinal permeability (thereby improving autoimmunity) and reduces prostaglandins and pain.
Other helpful treatments include selenium, rosemary, NAC (N-acetyl cysteine), DIM (diindoylymethane), fish oil, castor oil packs, and natural progesterone.
I’d love to hear your experiences with endometriosis. What has worked for you or your patients?
Yours in health,