What is the best treatment for Endometriosis?
Treatment for endometriosis falls into three broad categories
- Medical treatment with medications such as pain relief and hormonal therapy to suppress estrogen production
- Surgical to remove endometriosis. However surgery is unable to remove the microscopic endometriosis and this is why endometriosis is likely to proliferate and grow again.
- Complementary treatments such as dietary adjustments, counselling, herbal medicine, physical therapy and acupuncture.
Receiving the right treatment will depend on your symptoms, your genetic profile, the severity of the condition and whether you are trying to become pregnant or maintain your ability to have children.
Diet and lifestyle
As endometriosis is an estrogen driven inflammatory condition it is imperative to make diet and lifestyle changes to minimise exposure to environmental and plant based estrogens along with assisting estrogen metabolism and reducing inflammation.
Treatment should be individualised to achieve the best response however some guidelines to assist in the management of endometriosis:
- Avoid food intolerances and allergens that may exacerbate inflammation. Food intolerance testing is ideal to discover what foods you are reacting too.
- Avoid foods that are estrogenic such as soy based products.
- Know your genetic profile and expression of genes such as MTHFR, COMT and PEMT to establish underlying genetic reasons for estrogen issues, immune response and antioxidant production. This will also enable a tailored dietary, lifestyle and supplement protocol for you to assist with estrogen metabolism.
- Avoid toxins that may mimic estrogens in the body such as dioxins, pesticides and polychlorinated biphenyls (PCB’s).
- Assist estrogen metabolism with cruciferous vegetables such as broccoli, brussel sprouts and cauliflower. These vegetables are a rich source of sulfur containing compounds known as glucosinolates. When chewed they generate indole-3-carbinol.
- Ensure good gut and liver health to assist with estrogen and toxin metabolism.
- Moderate to intense frequent exercise has shown to reduce the size of endometrial lesions in some studies.
- Stress less as stress may contribute to the development and severity of endometriosis through dysregulation of the hypothalamic-pituitary axis and promoting release of inflammatory markers
Chinese Medicine Approach and Endometriosis
Traditional Chinese medicine alongside conventional medicine utilises a number of different approaches and techniques to treat the symptoms of endometriosis using diet therapy, manual techniques, acupuncture and Chinese herbal medicine. To date research has shown some promising results however more research is required in this area.
Acupuncture has shown to reduce pain and serum markers associated with endometriosis, according the authors of a systematic review. The results showed that acupuncture yielded better reductions in pain associated with dysmenorrhoea, and led to a better reduction in peripheral blood CA-125 (a marker for endometriosis) when compared with control interventions .
Whilst a recent research article showed that Acupuncture increase’s the release of endorphins, the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses associated with pain and digestive issues. [10-11].
Endometriosis the future
The complex nature of endometriosis and misconceptions around menstruation and infertility have led to delayed diagnosis and many hit-and-miss treatments. Myths continue to surround the endometrial phenomena such as ‘surgery will cure my endometriosis whilst medical/surgical classifications continue to evolve as consensus on classification is debated. Meanwhile many women continue to suffer.
It is time for women to take control educate and empower themselves to address the underlying reasons for endometriosis. Finding this can seem overwhelming and can take time. For some it is a matter of months some years. But remember every small step towards change is better than staying where you are.
1 Pinkert TC, Catlow CE, Straus R. Endometriosis of the urinary bladder in a man with prostatic carcinoma. Cancer. 1979;43:1562–7.
2. Fukunaga M. Paratesticular endometriosis in a man with a prolonged hormonal therapy for prostatic carcinoma. Pathol Res Pract. 2012;208:59–61.
3. Simsek G, Bulus H, Tas A, Koklu S, Yilmaz SB, Coskun A. An unusual cause of inguinal hernia in a male patient: Endometriosis. Gut Liver. 2012;6:284–5.
4. Schenken, R, Barbieri, R, Eckler, K 2019, Endometriosis: Pathogenesis, clinical features, and diagnosis, Up to date 2019.
5.Gustofson RL, Kim N, Liu S, Stratton P. Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 2006; 86:298.
6. Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 1986; 67:335.
7. Lasmar, Ricardo Bassil, Lasmar, Bernardo Portugal, & Pillar, Claudia. (2012). Diagram to map the locations of endometriosis. International Journal of Gynecology & Obstetrics, 118(1), 42-46
8. Sourial, Tempest, Hapangama 2014, Theories on the pathogeneses of endometriosis International journal of reproductive medicine 2014.
9. Xu, Wenli, Li, Ahao, Bu, Song 2017, Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis, PLoS One. 2017.