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Endometriosis
listed in women's health, originally published in issue 142 - December 2007
Endometriosis is a relatively common condition, believed to affect around 15% of women, in which the womb lining (endometrium) is found growing in places outside the womb.
The most likely locations for endometrial cells are within the pelvic cavity, particularly on the ovaries, fallopian tubes, bowel and bladder. Endometrial tissue implants itself and then responds to the normal monthly fluctuations of hormones, bleeding when it is time for a period. As the blood cannot escape as it would during a period, it becomes trapped causing pain. Fibrous tissue may develop followed by scarring and adhesions which ‘glue’ the pelvic organs together. Characteristic ‘chocolate’ cysts may be found on the ovaries which are cysts filled with dried blood.
Endometriosis often goes undiagnosed. I see many women who have been convinced by medics to put up with painful periods as part and parcel of ‘normal’ menstruation. It is only years later, and many painkillers later, that endometriosis is found when they are given a scan after having difficulty conceiving.
My client, 28 year-old Nicola, had been diagnosed nine years ago with endometriosis and, due to its severity, an operation had been recommended and booked in for three months time. She had also been given the option of steroids. The opinion of her Consultant was that is was very likely that one ovary would need to be removed due to the extent of the endometriotic cells on this ovary, and that there was a strong possibility that the other ovary may also need to be removed, resulting in a hysterectomy. Nicola, as you can imagine, was very distraught at this prospect, as she had not yet had any children.
For the past four years her periods had been extremely painful and heavy (so much so that she needed to change a super tampax every two hours). For six months, before seeing me, her periods lasted up to an incredible 17 days. Her cycle was short at only 21 rather than 28 days. She was taking up to 12 painkillers per day pre-menstrually, and had severe cravings for sweet foods at the time. She also felt ‘completely depleted’ of energy. She had been unable to tolerate the Pill, which is commonly prescribed for endometriosis, so had opted to ‘grin and bear it’.
Nicola’s low immune system was reflected in frequent coughs, colds, and other ‘flu-like’ symptoms pre-menstrually. The large amount of antibiotics that she had taken for frequent infections at this time would have compromised her beneficial bowel flora which are so important for strong immunity. Her digestion was poor as she suffered from frequent bloating after eating. A food intolerance test some years earlier had revealed a problem with wheat, which she had subsequently reduced in her diet. But she confessed she tended to replace the wheat with sweet foods.
Her diet was rather unbalanced, more in favour of high GI (glycaemic index) foods and too little protein. Not liking eggs and having cut out cheese and wheat following her food intolerance test, her diet was quite limited.
The protocol that I gave to Nicola was fairly standard nutritional therapy and easy to apply. I recommended a ‘Stone-age’ diet with plenty of fish, some meat, a small amount of goat or sheep milk cheese and live yoghurt, fruit, vegetables, dried fruit and nuts. She found a good rye bread and ryevita to replace the wheat, and reduced her tea consumption. Encouraging her to eat foods rich in plant oestrogens (which have a normalizing effect on the oestrogen and progesterone balance in the body) such as beans, peas and lentils proved a challenge but at least she enjoyed hummus.
She took supplements of mineral citrates of zinc, manganese, magnesium and calcium, together with vitamins A and B Complex and additional chromium which is so important for blood sugar balance.
She also took a high quality, pure fish oil which has an anti-inflammatory action, and the herb Agnus castus in liquid form, before breakfast. Agnus castus works on the pituitary gland, the master controller of the hormonal system, to balance oestrogen and progesterone. It is particularly useful for lengthening a short cycle and balancing the luteal (second phase) of the cycle when progesterone is the dominant hormone.
The results two months later were quite spectacular. The length of her period shortened to five days from 17 and considerably reduced in pain and heaviness. There was still moderate pain but she managed without painkillers. Her cycle became regular at 28 days instead of 21. Her cravings for sweet foods had gone, and she experienced a great increase in energy. She claimed she had not felt as good as this for seven years. After discussion with her GP, it was decided that the operation would be cancelled as she was feeling much better.
Once again, an example of how Nutritional Therapy could improve patient health and quality of life, and save the NHS money.
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