March is National Endometriosis Awareness Month in the US.
Endometriosis is defined as functional endometrial glands and stoma outside the uterine cavity. Symptoms include, but are not limited to dysmenorrhea, dyspareunia, chronic pelvic pain, and/or subfertility. Twenty to ninety percent (20-90%) of infertile women are estimated to have this condition which is 4-10% of all women. This population is at a higher risk for asthma, autoimmune conditions, cutaneous melanoma, ovarian and breast cancer, cardiovascular disease and atopic disease (allergic reactions). Pathogenesis has three theories, all with accepted supporting evidence.
- Implantation of endometrial cells onto peritoneum due to retrograde menstrual flow. (For this reason, yoga inverted poses are contraindicated during menses.)
- Transformation of multi-potential peritoneal cells into endometrial glands.
- Transport of endometrial glands through vascular and lymphatic systems.
Some lab considerations IH providers should consider are:
- celiac profile, since there is an increased prevalence;
- assess cortisol and DHEA levels,
- assess estrogens and estrogen metabolites,
- assess GI function via stool sample,
- assess IgG and IgE food allergy profiles,
- Test for CA125 due to cancer link, and more.
Treatment considerations include hormonal therapy, anti-inflammatory diets and/or medications, support of gut health, improve lymph drainage and circulatory function, lifestyle changes and surgery. (Select information from The College of Integrative Medicine in Hampstead, MD 2015 training module on endometriosis.)
This article offers comprehensive supplement treatment options as well. https://www.collegeofintegrativemedicine.org/uploads/filemanager/source/IM%20Approacho%20Endometriosis%20Article.Orig%20Int.%208.2016.pdf