|Publisher:||New World Library|
|Sold by:||Barnes & Noble|
|File size:||2 MB|
About the Author
Julia Stonehouse is a lecturer and writer specializing in reproductive health issues. She lives in London.
Read an Excerpt
The Endometriosis Natural Treatment Program
A Complete Self-Help Plan for Improving Health & Well-Being
By Valerie Ann Worwood
New World LibraryCopyright © 2007 Valerie Ann Worwood and Julia Stonehouse
All rights reserved.
The name endometriosis comes from the word endometrium, the lining of the uterus. In endometriosis, tissue resembling uterine endometrial tissue is found outside the uterus — within the abdomen and elsewhere. Like tissue inside the uterus, endometrial tissue outside the uterus is thought to react to the hormonal signals of the monthly menstrual cycle, which act to build up tissue, break it down again, and eliminate it from the body by menstrual bleeding. However, unlike uterine tissue, which passes out of the body through the cervix and vagina, endometrial tissue in the abdominal cavity and elsewhere has no way to exit the body. Instead, it attaches to the lining of the abdomen or to other internal organs, often causing scar tissue or adhesions (abnormal tissue structures that bind organs or surfaces together).
Because endometrial cells can migrate within the body, endometriosis can develop anywhere within the pelvic or abdominal cavity. It is commonly found on the lining of the abdominal cavity (the peritoneum), on the ovaries, and on the outer surface of the uterus — especially the fundus (top), the right and left uterosacral ligaments, the right and left broad ligaments, the fallopian tubes, and the cul-de-sac (adjacent to the coccyx, or tailbone) — as well as on the bladder, the sigmoid flexure of the colon, the intestinal tract, the cervix, the vagina, the perineal area between the vagina and rectum, and even the vulva. Implanted endometrial tissue has also been found in the rectum and along surgical scars. Rarely, endometrial tissue is found outside the abdominal cavity — on the lung, eye, thigh, arm, and other sites.
The implants can vary considerably in appearance, ranging from clear or grainy to white, reddish, brown, or blue-black. They can form into large cysts (endometriomas) attached to an ovary, some of which are termed "chocolate cysts" because of their dark blood color.
Endometrial cells can form a variety of implants, creating a condition medically categorized in four stages of severity:
1. Minimal disease: Top surface, or "superficial," implants, few in number, are present.
2. Mild disease: Deeper implants, greater in number, are present.
3. Moderate disease: Many implants are present. The ovaries are affected to some degree. Scar tissue, seen as filmy adhesions, is also present.
4. Severe disease: Many deep implants are present. Large endometriomas exist on one or both ovaries, along with scartissue adhesions.
Each woman's experience of endometriosis is unique. Some women may have extensive endometrial tissue but feel little or no pain, while other women may have only a few implants but feel tremendous pain. In other words, the degree of pain a woman experiences does not necessarily reflect the severity of her disease. This is one of the factors complicating endometriosis diagnosis and treatment.
DO YOU HAVE ENDOMETRIOSIS?
Researchers have estimated that it can take four to nine years for a woman with endometriosis to get a firm diagnosis. That's too long. Part of the difficulty, from a doctor's point of view, is that endometriosis has a huge number of possible symptoms, which vary in severity in every case.
Some women with endometriosis have no symptoms at all, and the condition is discovered only during a surgical procedure, such as sterilization, or during an examination into the cause of infertility.
Some women have pain only at certain times. For example, one of the most common sites of endometrial implants is on the uterosacral ligaments that hold the uterus in place. When the uterus is stimulated during intercourse, the woman might experience tremendous pain, although she may not experience it at other times.
Some women experience pain throughout the whole menstrual cycle, possibly because the endometrial implants or adhesions are located in sensitive areas.
SYMPTOMS OF ENDOMETRIOSIS
Some women have no symptoms, others have one or two, and some have many. The following is a list of possible symptoms, with the most common indicated by an asterisk.
Abdominal and pelvic pain before, during, or after menstruation *
* chronic pelvic pain
* intermittent pelvic pain, either locally sharp or generalized
* lower pelvic pain, from buttocks to groin
* severe abdominal cramps
* continual dull abdominal and/or backache
Menstrual irregularities *
* variable amount of bleeding, either heavy or scanty
* premenstrual spotting
* bleeding almost continuously over the month, or on a cycle lasting forty to sixty days
* unpredictable occurrence and length of menstrual bleeding
* blood clots
Other pain, aches, and soreness
* backache (especially before and during periods)
* pain in the coccyx *
* pain in one or more joints
* pain in the front of the thigh
* pain in the chest area
* pain in the shoulder
* pain around the rib cage (left, right, or both)
* pain under the rib cage
* pain in the rectum
* pain upon tampon insertion
Sexual and reproductive symptoms
* pain during or after sexual intercourse (dyspareunia) *
* infertility *
* ectopic pregnancy
* hot flashes
* tender breasts
* PMS (premenstrual syndrome)
* painful defecation *
* bloating (often progressive over the course of the day) *
* constipation (often because it hurts to pass stools)
* rectal bleeding or blood in stools
* sharp gas pains
* fluid retention
* nausea or vomiting
* sugar craving
* loss of appetite
* irregular urination, either frequent or urgent, or retention of urine
* lower abdominal pain on urination
* blood in urine
* kidney tenderness
* high blood pressure
Mind, mood, and emotional states
* apathy, fatigue
* poor concentration or memory
COMMON SYMPTOMS: A CLOSER LOOK
Intense pain prior to and during menstruation is the most common symptom of endometriosis. The amount of pain felt largely depends on the location of the endometrial implants, the amount of scar tissue, and whether there are ovarian cysts or adhesions within the abdominal cavity, or internal bleeding.
In addition, endometrial cells and rupturing endometrial cysts release inflammatory chemicals, such as prostaglandins and histamine, that irritate pain receptors. Pain receptors affected by these chemicals become more sensitive with each successive exposure. Prostaglandin-induced uterine contractions in some women with endometriosis have been shown to equal or exceed in severity those of labor contractions in childbirth. Women who experience pain when not menstruating have described it as knifelike, sharp, or burning, particularly during ovulation.
Endometrial cells can also invade the tissues of other organs, causing their dysfunction and often additional pain. Moreover, the characteristic adhesions caused by endometrial implants can impede the flow of blood and oxygen to the affected organs, as well as trapping toxins. Unfortunately, even when the visible endometrial cells are surgically removed, the pain may persist.
Infertility and Miscarriage
Endometriosis is one of the main causes of female infertility. Several studies have shown that between 30 and 60 percent of women with endometriosis cannot conceive. The difficulties arise, first, from the physical damage any endometrial implants and scar tissue have caused to the reproductive organs, particularly the ovaries, fallopian tubes, and uterus. Hormonal imbalance disrupts the menstrual cycle, making ovulation uncertain or difficult to identify. And women who experience pain during intercourse tend to have sex less frequently, thus reducing their chances of conception. In addition, some of the medications used to treat the condition may impair fertility or conception.
Fertility is a mystery in the best of times, and even partners who seem to be in perfect reproductive health can have difficulty conceiving. There are many causes of infertility, including physical problems, hormonal imbalances, emotional issues, stress, nutritional deficiencies, side effects of medications, and chemical incompatibility between partners. It's no wonder that the precise effects of endometriosis on fertility have yet to be determined.
Pain during Intercourse (Dyspareunia)
When endometrial tissue is located in parts of the body that are stimulated during intercourse, it can cause intense pain. This is particularly the case when the uterosacral ligaments are affected.
HOW ENDO CAN AFFECT YOUR LIFE
Most people don't realize how severely endometriosis can affect a woman. Because the condition has a way of seeping into all aspects of life, it often leads to feelings of depression, low self-esteem, anxiety, and stress. When the endometriosis is undiagnosed, the sufferer may be accused of malingering or shunning her responsibilities. Even when the condition is diagnosed, a woman's family and friends may disbelieve the degree of pain she is experiencing. Women with daughters may feel further anxiety and guilt at the possibility of passing the condition on to them. The potential for experiencing debilitating pain at any time makes planning holidays and social events difficult. Sexual relationships are put under tremendous strain. All this can leave the sufferer feeling misunderstood and alone. In addition to the medical symptoms described above, other physical and psychosocial problems often affect women with endometriosis:
Premenstrual-type symptoms. Women with endometriosis may experience feelings of anger, hostility, irritability, and tiredness, as well as sugar cravings.
Difficulties at work. Women who are incapacitated by endometriosis for several days a month frequently suffer a loss of productivity and attendant loss of self-esteem, to say nothing of reduced chances of advancement. In some cases their absences may threaten their jobs. In addition, colleagues who do not understand the severity of the condition may suspect an endo sufferer of malingering and feel resentment toward her if they have to cover her work, straining work relationships and further contributing to the endo sufferer's feelings of isolation and depression.
Difficulties in personal relationships. The pain caused by endometriosis can impair sexual relationships. Intercourse is expected to lead to pleasure, not intense pain, and this conflict between expectation and actuality is often deeply disturbing to the male partner as well as to the woman. If a woman experiences pain with intercourse and has not been diagnosed with endometriosis, her partner might accuse her of being frigid or neurotic. This can lead to emotional and mental trauma, and even to the destruction of the relationship. Pain caused by endometriosis may also impair participation in other activities with one's partner, children, and friends, who may not be sympathetic if they do not fully understand the reason.
Loss of self-worth. A woman who cannot control her symptoms may feel a loss of control in other aspects of her life and a lack of self-confidence. She may also feel abnormal, isolated, and unfeminine. Moreover, if the woman lives in a culture where she is defined by her ability to produce children (and where a man's masculinity is defined by the number of children his wife produces), female infertility can also lead to a social stigma, resulting in divorce, social exclusion, and even suicide.
Difficulties with social life, plans, and travel. A woman whose symptoms are severe may have to plan holidays, family events, and other activities around her menstrual cycle.
Difficulties with spirituality and religious observance. Many religions and cultural traditions have taboos associated with menstruation. Some women whose menstrual bleeding is prolonged by endometriosis may find themselves frequently excluded from their places of worship, religious services, and other ceremonies and suffer further social exclusion as a result.CHAPTER 2
Securing an Accurate Diagnosis
Diagnosing endometriosis has proved difficult for the medical profession. Here we examine the main reasons and make some recommendations that may help you to obtain a timely and accurate diagnosis.
For many other conditions, definitive medical tests are available. For endometriosis, no such test exists, although there are certain biochemical "markers" that are more likely to be found in women with endometriosis. Inflammation, for example, can be assessed by looking for C-reactive protein (CRP) in the blood. But the only sure way to know if there are endometrial implants and scar tissue within the abdominal cavity is to perform a surgical procedure known as laparoscopy, in which a tiny camera is inserted into the abdomen through a small incision to allow visual inspection of the potentially affected areas.
From the pattern of symptoms, physicians can sometimes speculate where endometrial implants may be located. For example, vomiting and abdominal swelling can indicate implants on the small intestine. Pain when passing stools may indicate implants on the bowel. However, such speculation can be confirmed only by laparoscopy.
Some authorities suggest that the woman allow her physician to examine her at the height of her menstrual flow, when the endometrial implants in the abdominal cavity (as well as the endometrial cells within the uterus) are more swollen and therefore easier to detect. Although this process is not commonplace and may sound unpleasant, it is something you may wish to discuss with your physician.
BARRIERS TO DIAGNOSIS
The most common reasons women have difficulty securing an accurate diagnosis are as follows.
Some women do not provide their gynecologists with enough information about the full range of their specific symptoms. Anyone concerned with your condition, including you, has a better chance of understanding it, monitoring it, and treating it if he or she has a full and accurate picture of your physical and mental health, past and current treatments, diet, activities, and lifestyle. You can help in this by filling in the forms in chapter 11 and by keeping a daily diary of all your symptoms, including emotional states such as depression or anxiety.
It is particularly important to record abdominal pain. Measure each incident of pain in terms of the following:
Exact location in your body
Severity, on a scale of one to ten, with ten being the worst
Type: for example, sharp, dull, heavy
Also record all menstrual bleeding, noting:
Duration (on the last day, record the number of days)
Amount of flow
The presence of clots
Record all other physical complaints, such as constipation, diarrhea, bloating, headaches, and nausea. If there is back pain or leg pain, identify the exact location. Also note any unusual appetite patterns or food cravings and any other symptoms (see above). It may be helpful to record any sexual activity as well.
All existing diagnostic procedures have significant disadvantages. Although laparoscopy is considered minor surgery, it is nevertheless an invasive procedure requiring scheduling, anesthesia, and recovery time. Ultrasound screening is noninvasive but less reliable.
Laparoscopy is relatively safe, but there have been a few cases where women suffered internal injury during the procedure, which led to the formation of scar tissue. It is usually carried out under a general anesthetic, although a few women opt for local anesthesia. Carbon dioxide is pumped into the abdominal cavity to separate the internal organs for clearer viewing. After the procedure, if some of this gas is left in the abdomen, it can cause pressure, usually perceived as shoulder pain, until it eventually disperses.
Ultrasound can be done in two ways. In transvaginal ultrasonography, or TVS, a small transducer is placed inside the vagina; in a transabdominal scan, it is placed on the lower abdomen. Another technique, color Doppler imaging (CDI), shows peripheral blood flow to the area. This is very helpful when trying to distinguish adenomyosis from fibroids (see pages 18–19). Ultrasound analysis should be done both before and after menstruation to detect changes in the activity of the ovaries or ovarian follicles. Changes in suspect tissue between the first and second scans allow physicians to distinguish between the presence of endometrial tissue and other disorders.
Excerpted from The Endometriosis Natural Treatment Program by Valerie Ann Worwood. Copyright © 2007 Valerie Ann Worwood and Julia Stonehouse. Excerpted by permission of New World Library.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
ContentsIntroduction. A Blueprint for Success,
Who Is This Program For?,
PART ONE: UNDERSTANDING ENDOMETRIOSIS,
Chapter 1. About Endometriosis,
Chapter 2. Securing an Accurate Diagnosis,
Chapter 3. Causes of Endometriosis,
Chapter 4. The Importance of a Holistic Health Approach to Endometriosis,
PART TWO: THE NATURAL TREATMENT PROGRAM,
Chapter 5. Inner Preparation for the Endometriosis Natural Treatment Program,
Chapter 6. Detoxification,
Chapter 7. The Endometriosis Natural Treatment Program,
Chapter 8. Complementary Therapies for Endometriosis,
PART THREE: SUPPORTING INFORMATION,
Chapter 9. Essential Oils,
Chapter 10. Nutritional Supplements,
Chapter 11. Endo Data Files,
Measurement Conversions: Metric and Imperial,
Treatment Plan Supplies,
About the Authors,