Endometriosis is a condition in which the endometrium (the tissue that lines the uterus) is found in places outside the uterus.   It is a painful condition that affects a surprising number of women, but the good news is that there are natural ways of managing the condition. Some places in which it can be found include the ovaries, on rather than in the uterus, the bowel, the bladder, and the Pouch of Douglas (an extension of the peritoneal cavity between the rectum and back wall of the uterus).  Once the endometrium has implanted, it begins to respond to the hormones that regulate menstruation in the same way that the endometrium inside the uterus does. 

If a pregnancy does not occur, the endometrium begins to break down ready to be shed from the body.  However, in the case of endometriosis, the blood cannot escape from the body, bleeding directly onto the surface of organs and tissues.  This bleeding causes irritation which leads into inflammation, scarring, and the development of adhesions between the organs in some cases.

Endometriosis is the second most common gynaecological condition and it is estimated to affect around ten percent of women during some stage of their menstruating years.  It is found in the entire spectrum of women, and can occur from any time between puberty and menopause.

Symptoms

Following is a list of some of the symptoms that may be experienced by women that have endometriosis.  However, not all women will suffer from all of the symptoms and the severity of the symptoms will differ between individuals.

• painful periods
  
• lower back pain
  
• pain while ovulating
  
• pelvic and/or abdominal pain
  
• heavy and/or prolonged bleeding
  
• irregular bleeding or menstrual cycles
  
• painful bowel movements
  
• premenstrual syndrome 
  
• swollen abdomen
  
• depression
  
• irritability

Treatment Options

Endometriosis can be treated using both conventional medicine and natural therapies.  These are explained further below.

Conventional Medicine

Conventional medicine is one option for managing endometriosis and it involves the use of pain medication, hormone therapy, surgical treatment, and raising the body’s level of serotonin.  Unfortunately, there is no permanent cure for endometriosis apart from a radical hysterectomy.  However, eighty to ninety percent of women will experience complete or partial relief from their symptoms.

Non steroidal anti-inflammatory drugs/pain medication – pain relieving medications work well because they manage the levels of pain that are experienced as well as reduce the menstrual flow.  Over the counter pain medication is sufficient in most cases, but in really severe cases, prescription drugs may be required.

Hormone therapy – the contraceptive pill used continuously (without taking the placebo pills) will stop the menstrual cycle and the symptoms that may be caused by an irregular cycle.  There are also some other hormone medications that may be used in the control of endometriosis.

Surgery – the two main surgical options are a laparoscopy and hysterectomy.  A laparoscopy is a diagnostic tool and can also use various means to ablate or remove endometriotic tissue.  A hysterectomy removes the uterus and surrounding tissue and, combined with a salpingoophorectomy (removal of the ovaries and uterine tubes), is the only cure for endometriosis.

Raising serotonin levels – a low serotonin level results in a lower pain threshold, meaning that pain is felt more severely. Serotonin levels may be increased by avoiding coffee and alcohol, light therapy, and increasing tryptophan levels.

Natural Therapies

There are several natural therapies that can be used for managing endometriosis.  Some of the most popular ones are outlined below.

• Traditional Chinese Medicine - TCM uses herbal medicine and acupuncture in order to ease endometriosis.  The specific acupuncture points and herbal medicines that are used will depend on the person’s own diagnosis, as each person manifests their illness differently.  Common acupuncture points used for endometriosis include those on the ears, abdomen, wrists, feet, legs, and back, with the needles being left in from anywhere between 20 and 45 minutes. 
  
  
• Acupuncture will need to be carried out for a period of time in order to rebalance the body’s systems, both energy and physical.  Acupuncture is thought to help endometriosis as it improves the circulation in the body and stabilises the production of hormones.  It can also help to release endorphins, which reduce pain.
  
  
• Herbal therapy – herbs are used both to rebalance hormones and to heal tissues.  In some cases, the immune system is also strengthened.  Some common herbs that are used for endometriosis include Vitex, evening primrose oil, dandelion, black cohosh, motherwort, burdock, wild yam, cramp bark, and horsetail.  Specific herbs will be prescribed to you depending on what symptoms you are suffering from and how severe they are.
  
  
• Dietary therapy – a good diet can help to manage the symptoms of endometriosis.  Fatty foods should be avoided, as well as sugary foods and caffeine.  Eating plenty of fresh fruits and vegetables is important as they contain chemicals and compounds that can help to minimise the severity of endometriosis.  Vitamin, mineral, and herbal supplements can also be very beneficial.  Magnesium can be used to control cramps for example, while vitamin B6 can help with fluid retention, bloating, and breast tenderness. See nutrition for more info.
  
  
• Stress management – managing stress is very important when dealing with endometriosis.  Relaxation techniques such as controlled breathing, visualisation and meditation are all very useful.  Ensure that you are getting enough sleep every night so that you are not unduly tired throughout the day.  Self-hypnosis and biofeedback are also great for promoting relaxation as well as pain management.
  
  
• Exercise – is an effective way to lift a person’s mood and help control mild depression.  Gentle exercises such as walking, swimming and yoga help keep you fit and promote relaxation.
  
  
• Aromatherapy – involves the use of essential oils.  In endometriosis, oils such as rose, chamomile, lavender, jasmine and neroli can be used as they are healing on the muscles and tissues as well as being anti-spasmodic.
  
  
• Osteopathy – carrying out osteopathic techniques through the vagina can reduce certain types of adhesions caused by endometriosis.  Different osteopathic techniques can also encourage pelvic drainage, reduce uterine congestion, and relieve period pain.
  
  
• Massage – is a great way to help control pain.  Acupressure massages are a good way of treating painful cramps, with even just a short massage being capable of relieving pain for hours.  Shiatsu massage can be used to control the pain associated with the various symptoms of endometriosis.  Tui Na massage was originally developed to restore the body’s structural alignment but in women with endometriosis, it can be used to treat back pain, a stiff neck, an aching body, emotional tension, and headaches. 
  
  
• Homeopathy – in homoeopathy, the role of the practitioner is to stimulate your immune system so that the body heals itself.  Herbs may be used in this process.  When you meet with a homoeopath, a treatment plan will be devised specifically for you.  There is no standard treatment as each woman that has endometriosis will have different symptoms.