Endometriosis

Once a medical rarity, endometriosis has become fairly common, but it's still poorly understood. Up to 25 percent of American women in their 30s and 40s have this disease, which is characterized by severe menstrual cramps, pain during intercourse, chronic pelvic and low back pain and heavy menstrual bleeding. Some women even experience nausea, vomiting, painful bowel movements and constipation. Researchers believe that several decades of environmental exposure to toxins (including the dioxin found in tampons) and the malabsorption of nutrients (from long-term use of antibiotics and steroids) has caused a prevelance of endometriosis. In extreme situations, misplaced endometrial tissue forms cysts, or lesions, in the ovaries, bladder or vagina (and in rare cases, the lungs or other tissue), resulting in agonizing pain during periods and intercourse. And a full one-third of women with endometriosis have difficulty conceiving.

In endometriosis, the mucous membrane cells that make up the inner lining of the uterus (known as the endometrium) also grow within the pelvic cavity. One theory holds that endometrial cells are being unnaturally shed into the fallopian tubes--a kind of reverse menstruation. In some women, the immune system overreacts to these abnormally located endometrial cells, "attacking" them by increasing the local inflammation, resulting in endometriosis.

Why these cells grow outside the uterus is unclear. The prevailing beliefs, however, point to a combination of inherited genetic inclination, lowered immune function and the effects of excess estrogen from overproduction by the ovaries, liver malfunction or exposure to environmental toxins.

Tori Hudson, N.D., medical director of A Woman's Time, an integrative medical clinic for women in Portland, Ore., offers encouragement to women with endometriosis. She stresses that diet and exercise can improve immunity, reduce inflammation and balance estrogen levels. One place to start is with a vegetarian diet that's low in fat and high in fiber.

Good ways to include fiber in your diet are eating plenty of fruits, vegetables and whole grains and adding ground flaxseed or flaxseed oil to salads and cereals. Flaxseeds contain anti-inflammatory essential fatty acids and are high in lignans, a type of fiber found to help estrogen-related conditions. Cruciferous vegetables, such as broccoli, cauliflower, brussels sprouts, kale and cabbage, contain a hormone-balancing compound called I3C (indole-3-carbinol). Beans, such as soy, adzuki, kidney and pinto, and legumes like red lentils and yellow split peas, are also effective in balancing estrogen. Besides being excellent sources of protein, they contain plant compounds called isoflavones (specifically genistein and daidzein), which lower estrogen levels too.

Foods to skip include pesticide-laden nonorganic foods, excessive amounts of dairy products, red meat, caffeine, refined sugar and alcohol. Due to the high fat content, dairy products sponge up environmental contaminants.

And don't forget about starting (or maintaining) a regular aerobic workout program. Exercise contributes to everyone's health by decreasing the rate of estrogen production and keeping off excess weight,but it has added benefits for women with, or at risk for, endometriosis, such as conditioning the muscles in the pelvic area. But listen to your body--when you're experiencing pelvic pain, avoid strenuous exercise.

To improve immunity, Hudson suggests taking vitamin C and betacarotene: vitamin C, 1,000 milligrams (mg.) per day (in divided doses), increasing to 3,000 mg. per day (or to bowel tolerance); beta-carotene, 25,000 to 50,000 international units (IU) daily.

To reduce symptoms, Hudson recommends choline (a B vitamin) and methionine (an amino acid) to enhance liver function and help deactivate estrogen. Take 100 to 200 mg. of choline and 50 to 100 mg. of methionine, three times daily.

Help for inflammation and cramps comes in the form of 400 to 600 IU of vitamin E and 300 mg. of omega-3 fatty acids daily. Good sources of the latter include soy, ground flaxseeds, pumpkin seeds and walnut, borage, black currant and evening primrose oils. For women with severe menstrual cramps, Hudson recommends DHA supplements, of which the best sources are fish oils and those derived from algae, as an additional source of omega-3 fatty acids.

Endometriosis research still has a long way to go, but it is reassuring to know that we can take some control simply by improving our diets and exercising regularly.

AMBER ACKERSON, N.D., is a naturopathic physician who has been published in many journals, including the Townsend Letter for Doctors and Patients.

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