Our Top 10 suggestions for managing Endometriosis symptoms.
Endometriosis is a gynecological disease characterized by the presence and growth of tissue similar to that of the uterine lining (the endometrium) on areas outside of the uterus. It causes symptoms such as painful periods or painful ovulation, chronic pelvic pain, painful bowel movements or urination, fatigue, digestive issues, infertility, or spotting before menstruation. In honor of March, endometriosis awareness month (and as someone with endometriosis herself!), I wanted to explain my favourite tools for supporting and treating endometriosis, whether your goals are symptom management or fertility.
Treatment Strategies for Endometriosis
1. Acupuncture. Acupuncture is one of my favorite tools for treating endometriosis. It transmits signals through the nervous system to reduce inflammation, modulates the immune system, and promote healthy blood circulation. A systematic review and meta-analysis concluded that acupuncture reduces pain and serum CA-125 (inflammatory) levels. The review also stated that acupuncture has an analgesic effect to reduce pain, suppresses excess estrogen levels (which fuels endometriosis growth), and enhances the ability of the immune system to more actively eliminate harmful cells.
2. Cold laser. Also known as Low Level Laser Therapy (LLLT) or photobiomodulation, is a non-invasive, pain-free, light-based therapy that uses red and infrared light to stimulate the mitochondria of inflamed, injured, or diseased cells. Your cells absorb the photons and turn it into ATP, or cellular energy. Its powerful anti-inflammatory effects are great for reducing pelvic inflammation and supporting healthy egg quality. LLLT also helps with microcirculation and can benefit the microbiome. Here is a list of 7 benefits to Low Level Laser Therapy and how they may reduce the symptoms associated with endometriosis.
3. Naturopathy. Our naturopathic doctors are specifically skilled in fertility and reproductive health. They use their extensive knowledge to recommend various functional medicine testing and subsequent holistic treatment tools such as nutritional counseling, nutrient IVs, supplementation, or herbal medicine to bring your hormones back into balance, reduce inflammation, optimize gut function, and boost fertility. This can reduce symptoms of endometriosis.
4. Supplements. There are some great supplements to support your body’s processes in managing endometriosis. Antioxidants are helpful to counteract the high levels of oxidative stress and inflammation in the body. One of my favorites is NAC, which is helpful for reducing inflammation and improving egg quality by supporting mitochondrial health. NAC has been found to be particularly beneficial for those with ovarian endometriosis. Vitamin D supplementation over 2 months was found to reduce period pain and CRP levels (a marker for inflammation) in people with endometriosis. Zinc is a mineral that modulates the immune system, repairs intestinal permeability, and reduces inflammation and period pain. Curcumin and omega 3 fatty acids have been found to reduce period pain and slow the growth of endometriosis.
5. Chinese herbs. Chinese herbal formulas are a combination of various herbs used to elicit a physiological response. I take them regularly myself and find it integral for reducing PMS and period pain. In a study of 48 people with endometriosis, a Chinese herbal formula taken for 3 months was found to manage heavy menstruation, reduce painful intercourse, reduce pelvic floor spasms, reduced inflammatory markers, and improved pregnancy rates (26.7% achieved pregnancy in the study).
6. Regulate your nervous system. High levels of stress can disrupt hormone balance, harm the microbiome, tank your immune system, and promote inflammation. Making sure you are getting at least 7 hours of sleep, not over OR under-exercising, and eating enough to keep your blood sugar stable will help keep your stress hormones balanced. Incorporate daily meditation, breathing techniques, yoga, or mindfulness practices to regularly get your body back into parasympathetic mode. This can help reduce symptoms of endometriosis.
7. Anti-inflammatory diet. Endometriosis is primarily an inflammatory disease, so anything that can reduce inflammation can reduce pain and symptoms. The best way to reduce inflammation is through diet. I always instruct my patients with endometriosis to eat a blood sugar stabilizing, anti-inflammatory diet. Check out these hacks to keep your blood sugar stable. Consider reducing or eliminating common inflammatory foods like gluten, dairy, refined sugar, alcohol, and caffeine. Take a look at Acubalance’s Fertility Diet e-book for more information and recipes.
8. Support gut health. More and more research is showing that there is a huge gut component to endometriosis. A microbiome with a healthy balance of gut flora is key for reducing inflammation and reducing endometriosis symptoms. Because the gut is an important part of healthy estrogen detoxification, probiotics can help inhibit the activity of beta-glucuronidase in the intestines which reduces the amount of estrogen reabsorbed and recirculated. I also recommend my patients with endometriosis test for any but infections like SIBO or dysbiosis, eat plenty of fiber, and reduce inflammatory foods. More info about functional medicine testing and treatment approaches for your gut microbiome.
9. Pelvic floor physiotherapy. The pelvic floor muscles consist of all the muscles that surround the bowel, bladder, uterus, and vagina. Pelvic floor issues are involved in an estimated 22% to 94% of cases of chronic pelvic pain, and 42-58% of those with endometriosis experience tenderness of the pelvic floor, abdomen, and uterus upon palpation. One study found an improvement in pelvic pain in 63% of patients with endometriosis after 6 sessions of pelvic physical therapy. I always recommend my patients with chronic pelvic pain search for a local pelvic floor physiotherapist.
10. Consider surgery. Surgery doesn’t always have to be a last resort for reducing endometriosis symptoms or infertility. Complete excision surgery performed by a surgeon that specializes in endometriosis is considered the gold standard of treatment. Laparoscopic excision of endometriosis was found to be effective at reducing pain and improving quality of life in 80% of patients and can last up to 5 years. The natural pregnancy rate for those with all types of endometriosis within 3 years after surgery was 47%, while another study showed that 73% were able to conceive within a year. Excision surgery for more severe endometriosis was 2.45 times more likely to conceive during IVF than those that had endometriosis and did not undergo surgery before IVF.
P.S. Acubalance is hosting the Vancouver screening of the documentary film, Below the Belt, and we have a panel of experts (Acupuncturists, excision surgeon, pelvic floor therapist, Naturopathic doctor, reproductive endocrinologist and Laser therapist) to answer your question following the screening.
Save the date April 19th, 2023 (Wednesday)