Endometriosis Information

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Endometriosis

 

Definition: Patches of endometrial tissue that are normally found only in the uterine lining (endometrium) growing outside the uterus, usually in the abdominal cavity (ovaries, uterine ligaments, intestines, ureters, bladder, vagina, surgical scars) , although it may appear in other parts of the body (chest lining, brain).  It quite commonly is attached to the outside of internal organs and most often adheres to the ovaries and uterine ligaments.  This tissue still keeps the same traits it would have if it still were present inside the uterus; grows and builds mid cycle, and bleeds during menstruation.  This causes pain of varying degrees in different women.  When this continues for some time, the misplaced tissue may cause scarring that leads to an adhesion (sticking together) of internal surfaces (organs, ligaments) and may eventually inhibit proper functioning of certain aspects of the body. 

Causes: Endometriosis seems to run in families (mostly Caucasian).  Also, giving birth for the first time after the age of 30 seems to be a risk factor.  The best theory to date of why this condition comes fourth is said to be during menstruation, some of the endometrial tissue that is usually shed through the vagina, flows backward out the uterine (Fallopian) tubes.

Signs & Symptoms: pain in the lower abdomen and pelvic region, irregular menses, spotting between periods or before periods, infertility (difficulty conceiving), pain during sexual intercourse, abdominal swelling, pain during bowel movements, bleeding from the rectum during menstruation, lower abdominal pain during menstruation, and there are sometimes no symptoms at all.

Diagnosis: when a woman shows typical signs described above, or has unexplained infertility one may suspect Endometriosis.  There may also be palpable masses in the lower abdomen.  To see if there is endometrial tissue outside of the uterus, a doctor will use a small fiber optic viewing tube called a laparoscope that enters the abdominal cavity through a small incision made just below the navel.  Sometimes it may not be conclusive by only viewing so a biopsy (small sample) will be taken.  Ultrasounds, MRI’s, barium enemas, CT scans, and x-rays may also be used to determine the extent of the disease.  Blood tests that show antibodies for endometrial tissue are also a signal that the body may be attacking regular body tissues that are out of place. 

Acupuncture Treatment: when you go to see your acupuncturist or Chinese medicine practitioner, they will take you through a series of questions quite unlike your western medical physician.  These questions are based on finding a Wholistic pattern of disharmony in the body.  The belief is that when the bodies disharmonies are balanced, and the patients constitution strengthened, the healing powers of the human will run at optimal levels.  They should also go through many other aspects of your life to determine what may be energetically contributing to the disease condition.  The following are common patterns people fit into, and common Acupuncture treatment points that will be administered.

From a Chinese Medicine points of view this disease usually falls under the categories of Painful periods or abdominal masses.

 

Qi deficiency with Blood Stasis

                chronic, irregular painful periods, dislike massage, large clots, infertility, pain during sex, Spleen                 deficiency symptoms- fatigue, bloating, heavy pressure on the anus, T- swollen pale with                 teethmarks purple, P- deep thin weak

                P/T – nourish Qi to move Qi and Blood

                Acupuncture – Ren, foot Yangming, Du 20, Ren 6, BL 20, ST 36, BL 32, Zi Gong, GB 36

                                - heavy painful anus- Du 1

Heat stagnation with Blood Stasis

                painful, dislike massage, large clots, infertile, irregular menses, heat shows more during menses,                 trichomonas infection, thirst, constipation, P- wiry rapid, T- red, yellow coat

                Acupuncture – sedate, LI 11, SJ 6, BL 17, SP 6, 10, Zi Gong, LR 5, Ren 1

Cold stagnation

                Acupuncture – Ren 4, 6, 8, GB 26, ST 25, KI 12, Ren 1 (heavy moxa)

 

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Infertility, Traditional Chinese Medicine, & Endometriosis

Endometriosis is a modern disease. Chinese medicine treats the western disease diagnosis of 'endometriosis' by reframing the signs and symptoms displayed by the client into traditional Chinese medical disease categories. The most common symptom associated with endometriosis is pain surrounding menses. The traditional Chinese medical disease category for pain during menstruation would be 'Painful Periods'. Another common symptom of endometriosis is the inability to conceive. This becomes reframed into the traditional Chinese medical disease category of 'Infertility'. Thirdly, there can be erratic bleeding cycles, i.e. bleeding outside of the cycles, early spotting, spotting mid cycle, or spotting after the end of the cycle for several days. The traditional Chinese Medical disease category in these instances would be 'Erratic Menses'. There may also be profuse bleeding during the period (the bleeding is very heavy), this would fall under the category of 'Profuse Menstruation'. Therefore, the western medical diagnosis of 'endometriosis' can be reframed into at least 1-5 different traditional Chinese medical disease categories depending on the signs and symptoms displayed by the woman, mainly painful periods, infertility, and profuse menstruation. This is representative of how traditional Chinese medicine treats the individual person, not the disease.

The question, 'How much relief will someone with severe endometriosis benefit from treatment with Chinese medicine?' is really dependant on the degree of compliance and commitment the client displays toward the requirements necessary for success. One must be willing to invest in themselves, make room for some lifestyle changes, modify their diet (sometimes drastically), undergo regular acupuncture treatment, religiously take the prescribed herbal formulas, and practice the intention required by the body mind and spirit to overcome a severe health condition. With time and diligence, 70-80% of women being treated with traditional Chinese medicine can expect to see significant reductions in their symptoms. 20% of women will get minimal to no results (as in every type of disease, there is always a small group of people who will not respond to the treatments, there is no explanation for this). Some women see results within just a few treatments, although, it should be noted that it is not unrealistic to expect six months to one-and-a-half years of treatment with traditional Chinese medicine to see results with lasting effect. If you are looking for a quick fix and are not willing to dedicate to the necessary commitments stated above for at least 6 months, it would be advisable to opt for laser surgery and have the major scaring removed. Laser surgery has more of a 'bandage' effect, meaning, the displaced endometrial tissue usually grows back in time, and it will be necessary to revisit this style of treatment 1-2 times per year. If surgery is your choice, consider traditional Chinese medicine to help remain symptom free for longer periods of time between hospital visits.

During treatment with traditional Chinese medicine, the woman's menstrual cycle can change, sometimes drastically. Some months it may look like things are heading in the right direction, and some months it may seem as though things are going backwards. The more severe the condition, the longer the body must take to heal. Many women that find no relief with traditional Chinese medicine have set unrealistic expectations, and quit before changes can occur. Treatment with traditional Chinese medicine is, in most cases, a more permanent fix, but, it must be remembered that it takes time for traditional Chinese medicine to make the adjustments and changes that must occur within the reproductive body tissue.

Decide today that you will be free of the suffering associated with endometriosis.

Check out 'Mayway' and 'New Herbs' online. They carry herbs and herbal plasters made of Okra that treat endometriosis as well as many other gynecological conditions.


Diet Recomendations for Endometriosis

Women with endometriosis should be particularly vigilant about increasing their consumption of kelp and wheat germ.

Endometriosis has been linked to thyroid dysfunction and kelp is particularly good for thyroid problems. The vitamin E in wheat germ improves the healing of scar tissue caused by internal endometrial bleeding. Women who suspect endometriosis should cut down on their yeast consumption, as yeast overgrowth has been recently implicated in endometriosis. Also, since yeast thrives on sugar, strictly avoid sugar, as well as any artificial sweeteners and dairy, though yogurt can be helpful for this problem.

In general, women with endometriosis should stick to a high-fiber, vegetarian based diet. Particularly, the elimination of fats from animal sources such as meat and dairy products is beneficial. Women with endometriosis should also particularly avoid caffeine and salt and should indulge in antioxidants such as sweet potatoes, yams, apricots, cantaloupes, carrots, spinach and broccoli, whole grains and beans for necessary B vitamins, and citrus fruits for bioflavonoids and natural vitamin C.

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SOMEWHERE BETWEEN HEAVEN AND EARTH

(A PERSONAL EPILOGUE)
Jolene Albrecht DTCM R.Ac


Dedicated to Rachel Dykerman, a woman who taught me about being one, and the late Dr. Ben Le for my first inspirations.


What hurts most about chronic pain is the impact it has on our over all life style. Pain causes emotional imbalances, social change, physical change, as well as mental change. What most people do not know about me is that I suffer from varying degrees of pain everyday of my life. I have endometriosis, a disease found somewhere in the depths of my genetics, and one that has drastically changed the last two years of my life. What I hope to accomplish through this personal epilogue is a deeper understanding and compassion for pain sufferers, more specifically women with endometriosis.

I remember being fifteen years old and suffering from unbearable dysmenorrhea. I was quickly prescribed birth control pills to regulate my cycle and relieve my pain. It worked magic, but little did I know how it was affecting my Tian Gui and uterine qi. Upon studying the art of Traditional Chinese Medicine, the beauty of menstruation, and researching the affects of “the pill” I took myself off of it. It was then that the damage done to my cycle, and the symptoms of endometriosis became apparent. I suffered from anovulation for over two years, and when my menstruation finally returned it hovered anywhere from forty-six to sixty-four days. On June 18th, 2003 I was rushed to the emergency room with unbearable left ovarian pain. Ultrasound located a seven centimeter hemorrhagic cyst that later burst in my abdomen. Pain became a constant part of my life, affecting how I sat, walked, interrupting with my bowels and my bladder, as well as hindering my sexual activity. Daily levels of high pain began eating away at my Shen. Before ovulation and menstruation I became irritable and frustrated; post-ovulation and menstruation left me depressed, sad, and very solemn. For eighteen months I woke every morning either hurting the same level as the day before, or worse. Time to recollect my thoughts and heal was a must and I was forced to defer a license exam, postpone a semester of school, and take a seven month leave of absence from work. It was during this time I desired to learn as much as possible about my disease.

Endometriosis is a disorder of the blood with the primary pattern of moderate to severe blood stasis. However the disease can be complicated with blood, qi, yang, and/or yin deficiency, as well as damp or qi stagnation. Uterine cells migrate outside the uterus, attach to areas of the pelvic cavity, and resume responding to fluctuations of a menstrual cycle. This means these cells grow an endometrial layer and bleed into the pelvis at the time of menses. The blood that would have normally been shed becomes stagnant and causes pain. As the stasis becomes chronic, inflammation and stagnation ensue forming lesions and adhesions. One of the least understood characteristics of endometriosis is the behavior of the uterus itself. The uterus of a woman with endometriosis produces prostaglandins that act like cramp hormones. The effect is a blanching of the uterine lining during menses, much like that of ringing out a towel. The only treatment western medicine offers is to create a pseudo pregnancy, or pseudo menopause; by shutting off ovulation the ramifications of endometriosis magically become ignorable. That is why birth control is so readily prescribed, and hence the reason I agreed to take it at a young age. However, what most women do not know is that it is not a treatment for endometriosis, but merely a pain management tool. The pill regulates hormone levels so the cramp hormones mentioned above are not produced. Pain ceases while endometrial lesions are aloud to grow unnoticed.

I desired to understand more about my cycle and began paying great detail to how my body was changing each month after coming off “the pill”. I now have compiled four and a half years worth of charts and analyze my estrogen levels via saliva tests, cervical mucous, cervical position, as well as monitor my basal body temperature (BBT). The pattern of blood stasis in endometriosis is supported by the “stair stepping” (alternation of high and low temperatures) of my BBT, and higher post menstruation temperatures are indicative of deficient heat arising from yin and blood deficiency. What I found the most interesting was how I was able to find a pattern of yin and yang waxing and waning in my charts. As estrogen, a yin hormone, rose preparing for ovulation my cervix would soften, open to allow passage of sperm into the uterus, and cervical mucous would form; yin rising to nurture my body for the next ovulation, or possible implantation. After ovulation as progesterone, a yang hormone, rose my temperatures would stay high as my body prepared the endometrium for implantation; yang rising for creation. The yin and yang rollercoaster of menstruation follows exactly the same rollercoaster of the yin and yang of the full moon (ovulation) and new moon (menstruation). These phenomena lead me to wonder. If we desire to follow natural order to live in harmony with nature, could you thereby balance emotional changes of a menstruation cycle by following the rise and fall of yin and yang of heaven and earth?

The I Ching is the earliest most detailed book describing the unity of Heaven and Humanity. The first two Gua of the I Ching relate specifically to the waxing and waning of a menstrual cycle, and help support the rational of regulating it to that of a lunar cycle. Qian, the first Gua, is Heaven and can be translated as Initiating. It is an image of the sun rising and spreading qi for the nourishment of Kun (Earth). Heaven is the symbol for the most firm, most healthy, and purest yang energy in the universe. It is the provider of the purest yang and most powerful strength for the regulation of all under heaven. Kun, the second Gua, is Earth and can be translated as Responding. It is an image of yin energy extending over Earth and is the function of Earth responding to Heaven. Earth is the purest yin, most responsive, flexible, and devoted. Earth can not create or develop on its own, and must receive pure yang from Heaven. The sequence of the first Gua says “After heaven and earth have come into existence, myriad beings are produced. Qian and Kun are the origin and source of creation”. (The Complete I Ching, Taoist Master Alfred Huang, pg. 22, 1998). From the I Ching we can develop a deeper understanding of the macrocosm of Heaven and Earth and the interdependence of the wax and wane of yin and yang. “Creation and reception, initiation and submission, yang and yin, should unite into one and complement each other”. (The Complete I Ching, Taoist Master Alfred Huang, pg.38, 1998).

From the I Ching we learn the functions of the four seasons are originating, developing, maturing, and declining. This sequence is also represented by the new moon and full moon as it relates to the yin and yang of menstruation. The following diagram illustrates the wax and wane of yin and yang as the macrocosm depicts the microcosm.


The originating sequence of the follicular phase is the point at which yang becomes yin and yin begins to rise. This is the new moon and is represented by Day One, or the first day of bleeding. This sequence is governed by yin so not only is a woman loosing both yin and blood, her LV/KD yin must be sufficient enough to reinitiate the maturation of a new follicle for the next cycle. It becomes easy to understand why the patterns of endometriosis are so difficult to treat, why birth control added fuel to the fire, and why my shen was disturbed. The principle of treatment is to supplement LV/KD yin, tonify LV blood, and nourish the HT to calm the spirit. If this phase is too short there is heat usually due to deficiency of yin. Too long of a phase is indicative of KD yin deficiency, or less frequently the KD yang and/or SP qi are too deficient to perform the transformation. The quality of yin affects the quality of the egg itself, as well as the growth of the follicle protecting it. Regeneration of the endometrial layer begins 2-3 days after the onset of menses so this formula should begin on Day 4.

Shu Di
E. Jiao
Tu Si Zi
Yu Zhu
Suan Zao Ren
Ze Xie
Gou Qi Zi
Wu Ling Zhi
Gui Ban
Hei Zhi Ma
Sha Shen
Lian Zi
Shan Zhu Yu
Mu Dan Pi
Ye Jiao Teng
Da Zao


The developing sequence of the follicular phase is governed by the movement of LV qi and Blood. LR qi triggers the transformation of yin into yang to support ovulation. The free flow of liver qi is a must so ovulation can happen. Ovulatory pain is indicative of blood stasis, and that of bloating is LV qi stagnation. The yin and blood must continue to be nourished, so the above is modified with additions and subtractions, and should begin on Day 8.

Bai Shao
Yi Mu Cao
Xu Duan
Xiang Fu
Dong Chong Xia Cao
Chaun Xiong
Dang Gui
Chen Pi
Zhi Ke
Shan Zha
Gou Qi Zi
Sha Shen
Hei Zhi Ma
Dan Shen
Da Zao


The maturing sequence of the luteal phase is the point where yin becomes yang. The exact moment of the transformation is ovulation and the time of the full moon as yang begins to rise. This sequence is governed by KD yang and SP qi. The luteal phase must be fourteen days for the sole purpose of successful implantation to occur. Less than fourteen days is indicative of KD yang and SP qi deficiency, spotting that of heat, qi and/or blood stasis, and breast tenderness that of qi stagnation. The following is administered after the full moon/ovulation.

Ji Xue Teng
Dang Gui
Long Yan Rou
Bai Zhu
Fu Shen
Sha Ren
Lu Rong
Ren Shen
Fu Zi
Yin Yang Huo
Gui Zhi
Du Zhong
Chi Shao
Shan Yao
Gan Jiang
Bu Gu Zhi
Huang Qi


Lastly, the declining sequence of the luteal phase is the premenstrual phase. This is where yang begins to turn back into yin to prepare for menses, and the most important time to move blood strongly so the body can rid itself of chronic stasis. The following formula should be taken on Day 22.

Tao Ren
Hong Hua
Chuan Xiong
Xiang Fu
Dang Gui
Yan Hu Suo
Yu Jin
Sheng Di
E. Zhu
Bie Jia
Dan Shen
Huai Niu Xi
Ji Xue Teng
Sheng Jiang
Bai Shao


Yin and yang of Heaven and Earth encompass us everyday of our lives; The I Ching supports this, the lunar cycle is one of many balances created by this, and the menstrual cycle depends on this. So it only makes sense to utilize the greater being and strive for regulation of the menses through the virtues of Heaven and Earth. I can not tell you if I will ever be completely pain free, but I stand to tell you that I have not felt this balanced or grounded since I was a young woman. The sequence of the fortieth Gua says “Things cannot remain in hardship with out end. Thus after Hardship, Relief follows”. (The Complete I Ching,Taoist Master Alfred Huang, pg. 327,1998). I know in my heart it is my turn for Relief.


BIBLIOGRAPHY

Huang, Alfred, Taoist Master. The Complete I Ching. Vermont: Inner Traditions International, 1998.

Lewis, Randine, Ph.D. The Infertility Cure. NewYork: Little, Brown and Company, 2004.

Lyttleton, Jane. Treatment of Infertility with Chinese Medicine. Edinburgh: Churchill Livingstone, 2004.

Nofziger, Margaret. A Cooperative Method of Natural Birth Control. Tennessee: The Book Publishing Comapany, 1992.

Weschler, Toni, MPH. Taking Charge of Your Fertility. New York: HarperCollins Publishers Inc, 2002.


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