Endometriosis - a way forward with herbs
Endometriosis is a profoundly challenging condition affecting 1 in 10 women between menarche (first menstrual cycle) and menopause, and can significantly impact their quality of life.
The condition is characterised by growth of endometrial tissue in sites other than the uterus, most commonly the peritoneum (lining of pelvic cavity), ovaries, bladder and parts of the bowel. In approximately 10% of sufferers endometrial tissue is found at other sites in the body such as the respiratory passages. Wherever it’s located, it is responsive to cyclic hormonal levels with displaced endometrial tissue causing inflammation and scarring.
Common symptoms of endometriosis are heavy menstrual bleeding, period pain, pain during or after sex, chronic pelvic or lumbar pain, bloating, fatigue and constipation. Sadly, endometriosis can lead to infertility with between 30% and 50% of infertility cases thought to be associated with the condition.
Endometriosis is understood to be caused by the interplay of numerous factors and these include retrograde menstrual flow, hormonal and immune imbalance, and chronic inflammation.
The NHS focus is on hormonal treatment in the first instance with NSAIDs for pain management. Surgical procedures available include removal of endometrial lesions and ovarian cysts, endometrial ablation to thin the lining of the womb and, as a last resort, hysterectomy and/or removal of ovaries.
Despite these treatments reducing symptoms in 80-90% of patients, symptom recurrence is common once treatment is stopped.
Getting a diagnosis can be a frustrating and lengthy process taking on average 7.5 years, and there are long waiting times for referral to an NHS specialist. Whilst an All Party Parliamentary Group with Endometriosis UK is are trying to improve this situation and to improve integrated care, for those suffering from the condition it remains a frustrating process, and other solutions are important.
So, how can a herbs and a herbal approach help those suffering from endometriosis?
There is much herbalists can do to help, both by providing symptomatic relief and by addressing the underlying causes of endometriosis.
Endometriosis is considered to be a condition of relative oestrogen dominance where levels of oestrogen are too high compared to those of progesterone. Approaches here are to advise the patient how they can reduce their exposure to environmental oestrogens, along with herbs such as dandelion root, to support the liver in its work of metabolising hormones. Constipation is often associated with endometriosis and an essential part of herbal support is to normalise bowel function, ensuring hormonal metabolites are cleared from the body. Herbs such as black cohosh and chaste berry can help to raise progesterone levels.
A herbalist also places great importance on addressing anxiety and stress experienced by the sufferer. Of course, this improves their quality of life, but it also helps to balance hormones. The reason for this is that the stress hormone cortisol is derived from progesterone, so when cortisol levels rise progesterone levels are reduced. There are many herbs that relax and strengthen the nervous system reducing feelings of low mood and anxiety, and we can also draw on adaptogenic herbs that normalise the body’s response to stress.
There is an association between endometriosis and a dysregulated immune response. Sufferers are often more susceptible to infection, and this immune imbalance also seems to hinder clearance of retrograde menstruation as well as leading to a greater likelihood of increased endometrial tissue implantation. Helpful plants here are the immune modulating, lymphatic and anti-inflammatory herbs such as Echinacea, Calendula, feverfew and ginger.
Other approaches herbalists can take are to support pelvic circulation, improving the blood stagnation which is considered to be a part of endometriosis. Additionally, there are herbs - such as Centella and Calendula - that can prevent scar formation.
Anti-spasmodic and analgesic herbs such as cramp bark and ginger are helpful for symptomatic relief of pain, with herbs such as yarrow and lady’s mantle effective at reducing heavy menstrual flow.
A holistic healthcare approach addresses many of the contributing factors of this complex condition. With changes to diet and well-being practices in place, improvements can be sustained even after herbal treatment has stopped, and the need for medication or surgical intervention in the future may also be reduced.
If you would like to find out more, I offer a free 15 minute introductory call for you to explore how this approach could help you.