After years of severe menstrual cramps and pelvic pain, I recently had laparoscopic surgery and was diagnosed with endometriosis. What can you suggest in terms of vitamins, herbs or other therapy recommendations?
—H. W. via e-mail
Stansbury responds: Endometriosis is a condition where the uterine lining spreads to the outside of the uterus. This malpositioned endometrial tissue releases blood into the pelvic cavity as the uterus sheds the endothelial tissue with the menstrual flow each month. How and why this happens is still uncertain, even though endometriosis is fairly common and has been investigated for decades. Some cases require surgical removal of the inappropriately placed tissue if it continues to spread, causes severe pain, or invades the ovaries, bowels, bladder, or other organs and tissues. Other cases are mild, slow to progress, and subside as the menses cease at menopause.
My approach has been mainly herbal. If symptoms indicative of excessive hormonal stimulation are present (breast tenderness, PMS, cyclical occurrence of acne, constipation, headaches, bloating, etc.), reducing the hormonal load on the body may help halt the progression of endometriosis. Avoid birth control pills, hormones ingested in animal products, and exposure to chemicals, fumes, and pesticides, many of which have been found to bind to hormonal receptors and elicit a hormonal effect. Consider herbs, such milk thistle (Silybum marianum), yarrow (Achillea millefolium) and burdock to assist the liver in metabolizing the body’s hormones. The liver-supportive nutrients choline, methionine and inositol may also help here.
Seen from the Traditional Chinese Medicine perspective, endometriosis may be viewed as a condition of “stuck” blood, as well as an excess of blood, the most yin fluid. Using blood movers, pelvic decongestants and yang plant energies may help correct the situation. Ginger (Zingiber officinale) and cinnamon (Cinnamomum verum) are blood movers and may help decongest the pelvis and pull more blood to the periphery of the body. Yarrow acts as a peripheral vasodilator, improves liver metabolism of hormones, and may reduce blood congestion in the pelvis.
A combination of these herbal ideas, as well as an excellent hormone-free diet and liver-supportive nutrients, may improve the condition when continued for many months. Acupuncture and energy-moving physical therapies, such as yoga and tai chi, are also recommended.
Willard responds: Endometriosis is often very uncomfortable, especially in the acute stage during and/or just before menstruation and sometimes at ovulation. I use a two-stage approach to treat endometriosis, one designated for the acute stage, followed by a treatment stage to reverse the condition.
For the acute stage, take gingerroot tea—it helps reduce cramping and brings blood into the pelvic area. To make, boil a few slices of fresh gingerroot in 2 cups of water for about 10 minutes, then strain and drink. Also, take licorice extract (Glycyrrhiza glabra), 250 to 1,000 mg per day. Licorice has both anti-inflammatory and estrogenic properties and has proven to be excellent for endometriosis. Cramp bark (Viburnum opulus) tincture, in a dose of 30 drops three times daily or as needed, is my all-time favorite for cramps, especially in the pelvic region. I have also found that cramp bark aids in calming down some of the emotional fluctuations often associated with endometriosis.
The homeopathic tissue salt Mag Phos 12x (take 3 pellets, dissolved under tongue three times daily or as needed) is useful for any type of cramping. Wild yam tincture (take 30 drops three times daily) is useful for its antispasmodic properties, reducing cramping and soothing the pelvic area.
For the long-term treatment stage, the most important herbs are dong quai (Angelica sinensis), 500 mg twice daily; black cohosh (Cimicifuga racemosa), 80 mg twice daily; and cordyceps mushrooms (Cordyceps sinensis), 500 to 1,000 mg twice daily. The combination of these three herbs has been very effective for its ability to dissolve scar tissue in the endometrium. Both dong quai and black cohosh are useful in normalizing female hormonal levels. Also take echinacea (Echinacea spp.), 300 mg twice daily, to heal inflammation and aid in tissue building. The following nutrients also help boost immunity and build healthy tissue: beta-carotene, 30,000 IU twice daily; vitamin C, 1,000 mg twice daily; vitamin B6, 100 mg twice daily; and zinc, 15 mg twice daily. You should start the long-term treatment while working on the acute stage and continue it for three to nine months.
I often find that bowel toxicity, candida yeast overgrowth or low essential fatty acid levels are associated with endometriosis. The most common problem is candida, as it can create microperforations in the uterus, giving a place for the endometrium to grow. This whole area needs essential fatty acids to remain flexible. Bowel toxicity will lead to poor blood circulation in the pelvic area. To rule these problems out, you should consult a naturopath, herbalist or other nutritionally minded practitioner. Moderate exercise is beneficial for reducing endometriosis, but excessive exercise has been shown to contribute to this problem, as it can change the hormone profile. As usual, it helps to eat a healthy, well-balanced diet, especially high in roughage and healthy oils.
Terry Willard is a clinical herbalist, president of the Canadian Association of Herbal Practitioners, and founder of the Wild Rose College of Natural Healing in Calgary, Alberta, Canada. He is the author of eight books and a CD-ROM, Interactive Herbal.
Jill Stansbury has been a naturopathic physician for more than ten years, with a private practice in Battleground, Washington. She is the chair of the Botanical Medicine Department at the National College of Naturopathic Medicine in Portland, Oregon, and the author of many books including Herbs for Health and Healing (Publication International, 1997).
The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.