finding information on effective alternative treatments. Can you help?-C.C.,
A. Endometriosis is a gynae-cological condition where cells of the mucous
mem-brane lining the womb become deposited elsewhere in the body. It affects
around 10 per cent of women of reproductive age, causing symptoms such as
painful, heavy or irregular periods, bowel and bladder problems, tiredness,
insomnia and depression. However, some cases have no symptoms at all.
Endometrial deposits are most commonly found on the ovaries, fallopian tubes
and peritoneum. But other sites may be involved-even, in rare cases, the
eye. The cells then behave just as they do in the womb, bleeding during
menstruation, caus-ing inflammation and often forming fibrous adhesions that
make organs stick to each other. Inflammation or scarring of the
reproductive organs, particularly the fallopian tubes, can result in
No one knows exactly what causes endometriosis or how to cure it, so the
goals of conventional medicine are pain relief, slowing its progression and
relieving infertility, if present. However, the treatments
prescribed-painkillers, hormonal drugs and surgery-all come with high rates
of recurrence and significant risks (Coch-rane Database Syst Rev, 2009; 3:
CD006568). Gonadotropin-releasing hormone (GnRH) agonists, for example,
among the most popular drugs for the condition, can induce a
'pseudo-menopause', complete with hot flushes, vaginal atrophy, mood swings
and osteoporosis (Aust Fam Physician, 2006; 35: 864-7). Happily, there are
safer ways to manage the condition.
Although more research is needed, the evidence so far suggests that the
following may be helpful for women with endometriosis.
- Avoid toxic chemicals. Certain environmental pollutants, such as
dioxins and polychlorinated biphenyls (PCBs), may play a role in
endometriosis (Environ Health Perspect, 2009; 117: 1070-5). Experts believe
that over 90 per cent of human exposures to these chemicals comes from food,
mainly animal fat, so eating an organic, wholefood diet low in animal fats
may be beneficial.
- Limit caffeine. Caffeine intake may be related to endometriosis and
infertility. Women who consumed more than 5 g/month of caffeine (about 1.5
cups of coffee a day) were nearly twice as likely to have endometriosis and
be infertile as a result (Am J Epidemiol, 1993; 137: 1353-60).
- Eat more fruit & veg. In more than 1000 women in northern Italy,
those with low intakes of fresh fruit and green vegetables had a
signifi-cantly higher risk of endometriosis. Those who ate a lot of beef and
red meat were also more likely to have the disease (Hum Reprod, 2004; 19:
- Exercise. This may influence the risk of endometriosis. Women who
reported frequent, high-intensity, physical activity had a 76-per-cent lower
risk than those who did not engage in any such physical activity (Am J
Epidemiol, 2003; 158: 156-64).
- Increase antioxidants. Endometri-osis sufferers were found to have a
lower intake of antioxidants (vita-mins A, C and E, zinc and copper) than
women without the disease. Consuming more of these nutrients through either
diet or supplements may help (Reprod Biol Endocrinol, 2009; 7: 54). Indeed,
in women with pelvic pain possibly due to endometriosis, taking vitamins E
(1200 IU/day) and C (1000 mg/day) for two months led to improvement in pain
in 43 per cent of cases. In contrast, none of the women taking a place-bo
reported pain relief (Townsend Lett, 2004; 253/254: 36).
- Boost omega-3 fats. Animal and test-tube experiments show that
omega-3s can help by reducing inflammation (Fertil Steril, 2008; 90 [4
Suppl]: 1496-502; Fertil Steril, 2001; 76: 717-22), although whether
supple-ments will benefit women in real life remains to be seen. However, a
daily dose of omega-3 (1080 mg of eicosapentaenoic acid and 720 mg of
docosahexaenoic acid) plus
1.5 mg of vitamin E improved symptoms of dysmenorrhoea
(pain-ful menstruation), which may be related to endometriosis (Am J Obstet
Gynecol, 1996; 174: 1335-8).
- Take Chinese herbs. A review of all randomized controlled trials
found that Chinese herbals were just as effective as the hormone drugs
gestrinone and danazol for symptom relief-with fewer side-effects (Cochrane
Database Syst Rev, 2009; 3: CD006568). A variety of herbs can be used, so be
sure to consult a qualified practitioner for advice.
- Consider curcumin. Derived from the popular Indian spice turmeric,
curcumin has properties that suggest benefit for endometriosis. A study in
mice showed significant antiendometriosis effects, although these results
may not necessarily apply to humans (Indian J Biochem Biophys, 2009; 46:
- Try acupuncture. This well-known pain treatment was both safe and
effective for endometriosis-related pelvic pain in adolescents (J Pediatr
Adolesc Gynecol, 2008; 21: 247-57), and was just as effective, if not more
so, than the drug danazol in relieving symptoms-and again, with far fewer
side-effects (Zhongguo Zhen Jiu, 2006; 26: 863-5).
- Use biofeedback. A small study of five women reported that thermal
biofeedback helped to improve the pain and other symptoms of endo-metriosis
(Appl Psychophysiol Biofeed-back, 2003; 28: 279-89). Other mind- body
techniques, such as hypnosis and meditation, may also help to control
endometriosis-related pain (see Special Report, pp 6-9).
- Join a support group. Sharing with other sufferers may also help in
coping with the condition. When women had a chance to speak with other
endometriosis patients and to meet with a counsellor, they all reported
being highly satisfied with their overall care (J Psychosom Obstet Gynaecol,
1997; 18: 255-8).
Vol. 20 06 September 2009