Dr Hassan Nada born in Cairo-Egypt, graduate from Cairo University medical school 1971, earned his M.D. in general medicine, work as medical consultant. Associated with his medical career in Canada since 1990, researching on medicinal plants, and its potential to ease so many health problems facing humankind.Great amount of information about nutrition and alternative food supplements that eventually reaches the public through the 12 published books are already in the Middle East market.
Saturday, September 12, 2009
Endometriosis, the mysterious disease; can be treated with Chinese herbs
Endometriosis is one of the most far-reaching, devastating and misunderstood diseases in the world today. It is estimated that there are over 70 million women and girls who have Endometriosis world-wide. It is more common than breast cancer or Aids, and many other diseases, that are well known. Despite the huge numbers of women who suffer from this disease, few people have actually heard of it, but this is gradually changing, though very slowly.
This disease is becoming more and more common. It seems to be gaining ground. This could be for a variety of reasons.
The methods of detecting and diagnosing the disease are improving all the time, so statistics reflect this as growing numbers of cases are detected.
The seriousness of the disease is gradually gaining momentum and more people are finally beginning to hear about it. This may be through television programs, magazine articles, the internet, or talking to friends. So there is an ever increasing public awareness. This public awareness helps to alert women who have concerns about their health, especially regarding pelvic and menstrual pain, so more women are able to determine whether they have Endometriosis.
More women are taking their pelvic pain and period pain seriously, rather than thinking of it as normal, so they are pursuing answers from the medical profession.
Finally, the numbers of women who have the disease appears to be increasing in actuality, especially in the last 30 years or so. It is also more common in industrial countries, where pollution is higher.
SO WHAT IS ENDOMETRIOSIS AND WHAT DOES IT DO? Fundamentally, Endometriosis is a serious biological malfunction which focuses on the reproductive organs and the pelvic region of a woman’s body. This disease will start quietly, insidiously and unnoticed. Then gradually symptoms of painful periods, pain at other times of the month, and a general feeling of being run-down, will start to develop.
In women with Endometriosis, the natural bodily processes of the reproductive system goes seriously wrong. The disease is linked and affected by the menstrual cycle and the hormones that make menstruation happen.
Physically, what happens is that tiny, and sometimes microscopic particles that are similar to the lining of the womb, find their way into the pelvic cavity. These particles behave in the same manner as the lining of the womb. The lining of the womb is called the endometrium, which is where this disease gets its name.
The natural process of the endometrium is to react with hormones produced in the body and each month the endometrium builds up with blood cells and other chemicals to prepare for pregnancy. When pregnancy does not occur then the endometrium sheds this blood and women have a period.
A similar reaction takes place in the stray cells that have found their way into the pelvic cavity. Each month they react to hormones, and break down and bleed, but the blood and tissue shed from these endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from these sites and leads to inflammation.
This process continues for months, or even years before symptoms of serious pain begins to develop. Many women start to suspect something is wrong because the amount of pain they feel with their periods starts to get worse and worse as the months go by. It is then that women start to investigate and question the state of their health.
For other women the disease may not throw up any noticeable symptoms, but they may be having problems with their fertility and are not successful in conceiving. It is then that they seek medical advice which could lead to having a laparoscopy. It is during this procedure that the disease may be found.
As time goes by, this disease will progress and start to do more damage in the pelvic cavity. Eventually it can lead to scar tissue formation, adhesions, bowel problems, as well as a gradual decline in general health.
ENDOMETRIOSIS IN CONTEXT Endometriosis is not usually fatal (though there can be rare occasions where the symptoms can pose a serious threat to life and it is not cancer. It is not a disease that you catch from another person, nor is it a micro-organism that starts this disease like the processes of other infectious diseases. Basically it appears that the body, and its natural healing processes are defective. It can strike women at any time of their reproductive life but we are seeing more and more cases of young girls who have Endometriosis.
Recent studies are beginning to indicate that women with the disease are at greater risk of other health problems, but this could be an indicator that women with this disease are actually suffering from a break-down in the immune system. This situation seems to ‘ring true’ as many women who have Endometriosis seem to suffer from a myriad of other health problems.
Endometriosis is serious. It is affecting millions of women around the world. It is not simply disrupting women’s lives, it can be devastating for most women. It affects her health, her quality of life, her possibilities of having children, her income earning potential, her emotional well-being, her relationships, her sex life, her economics if she lives in a country where she has to pay for treatment, her social life; in essence it affects her entire life.
These are the hard facts that surround Endometriosis today. Many women suffer for years and years. They may have one surgical procedure after another. They may spend thousands of dollars on treatment, especially if their health insurance does not cover it. They may travel miles in pursuit of sympathetic and informed medical treatment. This list goes on and on.
But there are some glimmers of hope beginning to appear. Many women today are beginning to take care of their own health with regard to dealing with Endometriosis. They are starting to realize that all is not clear cut with the objectives and priorities regarding health care in the modern world.
The hope and courage for many women is gained through gathering and sharing information, especially from other women who have the disease. Many self-help measures are being exchanged between fellow sufferers, and where these measures are proving successful, this instills the value and proof that these methods will help.
How do you know that you have endometriosis? Currently, health care providers use a number of tests for endometriosis. Sometimes, they will use imaging tests to produce a "picture" of the inside of the body, which allows them to locate larger endometriosis areas, such as nodules or cysts. The two most common imaging tests are ultrasound, a machine that uses sound waves to make the picture, and magnetic resonance imaging (MRI), a machine that uses magnets and radio waves to make the picture.
The only way to know for sure that you have the condition is by having surgery. The most common type of surgery is called laparoscopy . In this procedure, the surgeon inflates the abdomen slightly with a harmless gas. After making a small cut in the abdomen, the surgeon uses a small viewing instrument with a light, called a laparoscope, to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis. He or she can make a diagnosis based on the characteristic appearance of endometriosis. This diagnosis can then be confirmed by doing a biopsy, which involves taking a small tissue sample and studying it under a microscope.
Your health care provider will only do a laparoscopy after learning your full medical history and giving you a complete physical and pelvic exam. This information, in addition to the results of an ultrasound or MRI, will help you and your health care provider make more informed decisions about treatment.
Endometriosis Symptoms The symptoms of Endometriosis vary from one woman to another but the most common symptom is pelvic pain.
One of the biggest problems regarding Endometriosis is that the signs of this disease in the early stages, appear to be the ‘normal’ bodily changes that take place with the menstrual cycle.It is only as time goes by that a woman begins to suspect that what is happening, and the symptoms she feels, are not normal. The pain of her menstrual cycle gradually and steadily becomes worse and worse as the months go by.
This is only the beginning of what will become a gradual decline in a woman’s general health, as well as the health of her reproductive system.Having said that, there are odd instances where some women do actually have Endometriosis, but they are nearly free of any symptoms. These women will only be diagnosed by default, for example when they have surgery for other issues, and only then is Endometriosis found. That is what makes this disease so mysterious.
Endometriosis does not follow any distinct pattern, which is why it is difficult for the medical profession to know that a woman has the disease.
Some of the symptoms will mimic those of other health problems, including: . ovarian cysts
. ectopic pregnancy
. Pelvic Inflammatory Disease
. irritable bowel syndrome
. ovarian cancer
. fibroid tumors
. colon cancer
The most common symptoms of Endometriosis are: Pain before and during periods
Pain with intercourse
General, chronic pelvic pain throughout the month
Low back pain
Heavy and/or irregular periods
Painful bowel movements, especially during menstruation
Painful urination during menstruation
Diarrhoea or constipation
Other symptoms which are common with Endometriosis include: Headaches
Low grade fevers
Hypoglycaemia (low blood sugar)
Susceptibility to infections, allergies
In the later stages of Endometriosis, adhesions usually develop in the pelvic cavity, which are caused by untreated cysts, which can ‘glue’ pelvic organs together. These adhesions will seriously interfere with normal functions of organs in the pelvis, causing bowel obstructions, digestive problems, infertility, urinary problems, agonizing pains when the adhesions are pulled, mobility problems.
As Endometriosis develops a woman’s immune system becomes more and more impaired and this leads to further health problems. Due to increased research, as well as surveys of Endometriosis patients, it is now becoming clear that women with the disease are susceptible to other serious health problems including:
. Chronic Fatigue Syndrome (100 times more common in women with endometriosis)
. Hypothyroidism — under-active Thyroid gland (7 times more common in women with endometriosis)
. Rheumatoid arthritis
It does seem clear that as women with Endometriosis are more receptive to other health problems, then their immune system is the key to their problems.
No two women will have the same symptoms for Endometriosis, and will not suffer the same knock -on health problems, but the most common symptom experienced among Endometriosis sufferers is acute pain.In some instances the pain of Endometriosis can prohibit a woman to contribute in every day activities as well as her ability to sustain a career.
Possible Locations of Endometriosis
Endometriosis symptoms in relation to location of the disease in the body
There are various areas where endometrial tissue can develop in the pelvic cavity including:
. The outside surface of the uterus
. Fallopian tubes
. Ligaments supporting the uterus
. Internal region between the rectum and the vagina
. Lining of the pelvic cavity
Other organs within the abdomen
Pelvic pain Pelvic pain is one of the most common symptoms of Endometriosis. The pelvic pain of Endometriosis can be excruciating and debilitating for many women. It may be experienced constantly, it may be intermittent or it may be related solely to the menstrual period. Pain can be provoked by certain activities such as walking, standing too long etc. or it may occur unpredictably.
Occasionally abdominal and pelvic pain may be caused by Irritable Bowel Syndrome (IBS). These two diseases are quite common together, so it is advised to take note of the times you experience pelvic pain, as it may coincide after meal times.
Lower Back Pain Lower back pain is another common but poorly recognized symptom that often accompanies period pain. It is commonly associated with endometriosis in the pouch of Douglas, uterosacral ligaments, and rectovaginal septum.
Ovulation Pain Ovulation pain can occur in women who do not have Endometriosis, but this pain will normally be a small twinge. In women with Endometriosis, ovulation pain can be rather acute. Pain usually begins 12-24 hours before ovulation and may last for a few days. It results from the normal enlargement of the ovary during ovulation which causes stretching of endometrial implants and adhesions lying on the surface of the ovary. The pain is often described as ‘stabbing’ and it may radiate throughout the pelvic area and into the buttocks and thighs.
The Main Reproductive symptoms of Endometriosis are:
Chronic or intermittent pelvic pain
. Ectopic (tubal) pregnancy
. Dysmenorrhea (painful menstruation is not normal!)
. Painful ovulation
Uterosacral/Presacral Nerve Endometriosis
. Leg pain
. Painful Intercourse
Cul-de-sac ("Pouch of Douglas") Endometriosis
Dyspareunia (pain during intercourse)
. Gastrointestinal symptoms
. Pain after intercourse
. Gastrointestinal Endometriosis
. (rectosigmoid colon, rectovaginal septum, small bowel, rectum, large bowel, appendix, gallbladder, intestinal tract)
The bowel symptoms of endometriosis are often overlooked or dismissed because many people think endometriosis affects only the reproductive organs. Many bowel symptoms are caused by irritation to the bowel from endometrial implants lying on adjacent areas such as the Pouch of Douglas and the back of the uterus, but some are due to endometrial deposits lying on the outside of the bowel wall.
The gastrointestinal disorder which is most common with Endometriosis is Irritable Bowel Syndrome which can cause many of the bowel symptoms mentioned above. Candida has also been found to be prevalent in women with Endometriosis, and this too can cause many distressing digestive upsets and discomfort.
The main gastrointestinal symptoms of Endometriosis are: Nausea
Blood in stool
Sharp gas pains
Painful bowel movements
Other Locations and Symptoms of Endometriosis Urinary Tract (bladder, kidneys, uretheras, and urethra) Endometriosis
The urinary tract symptoms of Endometriosis are usually the result of endometriosis lying on the outside of the bladder or irritation from endometrial implants lying on the front of the uterus.
The main symptoms of urinary tract Endometriosis are: Blood in urine
Painful or burning urination
Tenderness around the kidneys
Flank pain radiating toward the groin
Urinary frequency, retention, or urgency
Pleural (lung & chest cavity) Endometriosis Very occasionally Endometriosis can travel to the lungs, which will give rise to strange symptoms, and are usually relate to the menstrual cycle.
Coughing up of blood or bloody sputum, particularly coinciding with menses
. Accumulation of air or gas in the chest cavity
. Constricting chest pain and/or shoulder pain
. Collection of blood and/or pulmonary nodule in chest cavity (revealed under testing)
. Shortness of breath
Sciatic Endometriosis/ Hip pains Hip pain or pain that radiates from the buttock and down the leg is common in women where endometriosis has affected the sciatic nerve. Also, endometriosis in the groin area can feel like hip pain.On occasion endometrial adhesions can restrict the hip ligaments, causing pain and limping. Hip joint pain that worsens in a cyclical fashion in line with the menstrual cycle will usually be caused by endometriosis.Surgical treatment to remove endometrial implants is sometimes under taken in hope of relieving the hip joint pain associated with endometriosis.
Painful nodules, often visible to the naked eye, at the skin’s surface. Can bleed during menses and/or appear blue upon inspection.
Dyspareunia (painful sexual intercourse) Dyspareunia is a common symptom of Endometriosis. Pain may be felt during intercourse as well as up to 48 hours after sexual activity. It is often associated with endometriosis in the pouch of Douglas or adhesions in the pelvic cavity.
Fatigue and Endometriosis seem to go hand in hand. No-one knows what causes the acute fatigue women suffer with Endometriosis, and is not often recognized as a symptom of Endometriosis.
Fatigue can be one of the most debilitating aspects of the disease, and most women with endometriosis experience fatigue around the time of their period and some experience it throughout the month. The fatigue may be related to the constant pain and/or medication, or it could be the bodies reaction to the disease at a deeper level.
Abdominal Bloating Abdominal bloating may be a sign of endometriosis. It is thought to be due to inflammation in the pelvic cavity caused by the endometriosis. As mentioned above, Irritable Bowel Syndrome (IBS) can cause pelvic pain, and can also cause severe abdominal bloating. With IBS, the bloating is usually caused by intestinal gasses which expand and distend the abdomen and can cause severe pain and discomfort. IBS is very common in women with Endometriosis.
The Undetected Disease Obtaining a true and correct diagnosis for Endometriosis can be one of the most drawn out, frustrating, and distressing experiences for many women. These women know there is something wrong with their health as time goes by, but in most cases they are dismissed by their doctors as being neurotic, or told that their symptoms are normal, or they are given an inaccurate diagnosis, which in many cases is that of Pelvic Inflammatory Disease.
If you are suffering from any of the symptoms associated with Endometriosis, you need to get a diagnosis of what is causing your problems. If your doctor appears unsympathetic or dismisses your symptoms, then you need to assert your suspicions of the seriousness of your health problems. If you have no success then change your doctor or get a second opinion. The longer that this disease goes undiagnosed the more damage it can do. It is well documented that for many women, it can take anything up to ten years to finally get a true diagnosis.
Part of the problem that causes the delay in diagnosis of Endometriosis, is that many people in the medical profession are not fully aware of the extent of this disease today. It is suspected that between 10 to 20 percent of women of reproductive age have Endometriosis.
Also, many women have not even heard about Endometriosis, so they do not seek help when they do have symptoms, because many women think their symptoms are normal. In fact a lot of women have only found information on Endometriosis in magazines and from friends rather than from their doctor.
Another reason there is a delay in diagnosis, is that the symptoms may initially be attributed to a variety of other health problems like fibroids, kidney stones, irritable bowel syndrome, as well as pelvic inflammatory disease.
METHODS OF DIAGNOSIS There are a variety of methods that can be used to assess whether a woman has Endometriosis, but the only reliable way to confirm the presence of the disease is by visually inspecting the abdominal organs by a procedure called a laparoscopy. Before a laparoscopy is done a full gynecological evaluation should be done covering the patient’s medical history.
Diagnosis methods of Endometriosis can include:
A pelvic examination involves the physician feeling and looking for abnormalities that are associated with endometriosis. Physical findings depend on the severity and location of the disease. There may be palpable nodules or tenderness in the pelvic region, enlarged ovaries, a tipped-back (retro-displaced) uterus, or lesions on the vagina or on surgical scars.
Laparoscopy A laparoscopy is an exploratory procedure that allows the physician to see inside the pelvic region to observe and check for endometrial growths. The procedure involves making a small incision near the navel and inserting a laparoscope (a long, thin, lighted instrument) into the abdomen. The abdomen is distended with carbon dioxide gas to make it easier to see the abdominal organs. Usually, the endometrial growths can easily be seen.
Because Endometriosis implants or growths vary in appearance and can be mistaken for other conditions, the lesions should be surgically removed and examined under a microscope to confirm the presence of the disease.
Imaging tests Imaging tests (e.g. pelvic ultrasound, magnetic resonance imaging) may be used to identify individual endometrial lesions, but they are not used to determine the extent of the disease. The implants are not easily identified using this method.
Biochemical markers There has been extensive investigation of a membrane antigen called CA-125 in women with Endometriosis. Several reports suggest that levels of CA-125 are elevated in women with Endometriosis, particularly those in the advanced stages of the disease. A recent study of this antigen level, showed it to be high in 90 percent of women with Endometriosis. Possible diagnosis with a blood test to check levels of CA-125 could be used to check for Endometriosis.
Stages of Endometriosis Endometriosis is categorized in four stages based on the severity, location, amount, depth and size of growths.
Stage 1 — minimal disease, superficial and filmy adhesions
Stage 2 — mild disease, superficial and deep endometriosis
Stage 3 — moderate disease, deep endometriosis and adhesions
Stage 4 — severe disease, deep endometriosis, dense adhesion
The stages of the disease do not indicate the level of pain, infertility or symptoms.
What does Endometriosis look like! Endometriosis can develop in almost any color, shape, size and location. This includes clear, microscopic implants that can lodge themselves on the underside of organs or beneath the skin. The implants can be black, blue, red, brown, clear, and vary from microscopic to clearly visible in size. The implants or growths can be spread throughout the entire abdominal cavity including the bowel, bladder as well as the outer walls of the uterus, the ovaries and fallopian tubes. One of the most common sites for endometrial growths is on the ovaries.
Treatment options for Endometriosis The treatment for Endometriosis is an intensely debated subject both in the medical profession and among women who suffer this disease. One of the key problems is that no-one really knows what causes Endometriosis. So trying to find a successful remedy for this particular disease is like trying to fix something even though the cause is not actually known. This can lead to treatment methods which are not relevant or safe and carry the risk of serious side-effects. Until a concise answer is found to the cause of Endometriosis, then the treatment being offered is unfortunately no more than a stab in the dark.
The options for treating Endometriosis being offered by conventional modern medicine depends on the severity of the disease, with the main aim being to help alleviate the key symptoms. These being the symptoms of pain and infertility. There are general points which should be taken into consideration when helping a woman decide which treatment option to go for.
These should include: The severity of the symptoms
The type of symptoms
The age of the patient
The desire to get pregnant or not
Length of treatment
Coping with side-effects of drug treatment
Cost (in countries where women have to pay for treatment)
How does the treatment work Endometriosis fed by estrogen. Estrogen is the hormone that is produced in a woman’s body continuously, but each month there is a surge of this hormone, which causes the uterine lining to thicken to prepare for pregnancy. Then the estrogen levels drop and if there is no fertilization of the egg that month, the lining of the uterus shed and a woman has her period.
The aim of some treatments is to reduce or stop the estrogen produced in a woman’s body, so that it does not continue to feed the Endometriosis growths. This achieved by hormone drug therapy. This type of treatment is only successful for milder cases of Endometriosis where the growths are relatively small and few in numbers. In more severe cases then treatment with surgery is usually need to remove the growths.
You may find many different references and names for the growths relating to Endometriosis. They can call cysts, lesions, endometrial tissue, endometrial cells, as well as endometrial implants. These different terms are sometimes using to define different stages of the disease.
Treatment options The options for which treatment to have are usually dependent on the extent or severity of the disease.
The options include: . Observation with no medical intervention
. Hormone treatment
. Combined treatment
Observation with no medical intervention This approach can be use for milder cases of Endometriosis, with regular visits to your doctor or gynecologist to monitor your health. Analgesics may prescribe to help with any pain, and non-steroidal anti-inflammatory drugs can help.
Hormone treatment Treatment of endometriosis with hormone drugs can result in temporary improvement of symptoms such as painful periods, pain on intercourse and pelvic pain, but there are many side effects with all drug treatments offered for Endometriosis.
Medical treatment does not improve the chances for pregnancy, and as the treatment is hormonally based, it will delay conception even further due to the hormonal imbalances introduced into the body.
Medical treatment suppresses endometriosis, rather than removing it and is effective only for short-term management of symptoms, the active endometriosis returning gradually over 12-24 months after stopping the drugs.
The aim of drug therapy is to break the cycle of stimulation and bleeding. By stopping the ovary’s usual hormonal cycle and reducing estrogen levels, the endometrial deposits shrink down and become inactive. The endometriosis is still there, and will gradually become reactivated when the normal menstrual cycle starts again.
Ovarian endometriomas of greater than 3cm diameter are unlikely to respond to medical treatment, and similarly if there is a significant amount of adhesions — these will respond best to laparoscopic surgery.
This aim of drug treatment is to alter the chemical and hormone levels in the body which in turn will affect the natural bodily processes. This will also affect the behaviour of the Endometrial growths.
Pseudo-pregnancy — a state resembling pregnancy — used as one method to treat Endometriosis, and this can be achieved through hormone drug therapy. This approach was developed by observations that Endometriosis would regress during pregnancy. Pseudo-pregnancy can be induced by using oral contraceptives containing estrogen and progesterone.
Pseudo-menopause — a state resembling menopause — was developed as another means of treatment because it was observed that Endometriosis also regressed after menopause.
Drugs Commonly used to Treat Endometriosis All of these treatments can have various side effects. Some women suffer more than others do, but it is advised to be well informed about them before you decide on treatment.
Contraceptive pill — The Pill is one of the most commonly used treatments for endometriosis, and is often prescribed for young women with mild disease who also require effective contraception. Despite its long-established use, there has been only one study on the use of the Pill for endometriosis.
It compared the Pill with GnRH agonists and found an equal improvement with both drugs with regards to pelvic pain, painful periods and painful sex. When taking BCP for endometriosis rather than for contraceptive reasons you will take the pills continuously. This means that you will not have a period, as your body thinks that it is pregnant. By doing this you may find you have some spotting as your body adjusts to the pill. There are some side effects to bear in mind though and you will need to decide whether the pain of the endometriosis outweighs the risks of taking the pill. Side effects can include weight gain, acne and hair growth on the face.
Gestrinone — is a synthetic hormone that effects the production of estrogen by the ovaries. It is taken twice weekly rather than daily. Side effects of Gestinone include: weight gain, acne depression, mood swings, hot flushes and loss of libido. Gestrinone is a treatment used more commonly in Europe. It works in much the same way as danazol with similar, but milder, side effects.
Danazol — is a mild form of the male hormone testosterone and reduces the amount of estrogen produced by the ovaries to around the same level as during menopause. This is the drug that mimics Pseudo-menopause. Side effects include: weight gain, increased body and facial hair growth, acne, smaller breasts, increased muscle mass, voice deepening and mood swings. Danazol can also cause gastointestinal upsets, depression and liver disease.
GnRH agonists — GnRH stands for Gonadotrophin Releasing Hormone and an agonist is a drug that acts the same way as the body’s own hormone. The body normally makes GnRH in a small gland in the brain (the pituitary) and it is this hormone that stimulates the ovary to develop eggs and produce estrogen, leading to the normal menstrual cycle.
If you give GnRH agonists, this floods the system and confuses the delicately controlled balance, leading to a complete block of egg development, estrogen production and menstrual cycle. It effectively makes you ‘menopausal’ for the time that you use the treatment and without the estrogen stimulation, endometriosis shrinks down and becomes inactive.
There are several GnRH analogues available. Examples of GnRH agonists include: goserelin (Zoladex), nafarelin (Synarel), Buserelin (Suprecur) and leuprorelin (Prostap). They are all either given by injection or nasal spray — tablet forms are not available.
Side effects of GnHR agonists include : menopausal symptoms such as thinning of the bones, hot flushes, dry vagina, headaches, depression, loss of libido and night sweats. These side effects can be relieved, by adding back estrogen and progesterone, which does not effect the benefit of treatment.
This is known as Add-back therapy for Endometriosis. There is now evidence that the use of Add-back hormone replacement therapy (HRT) is effective in preventing the bone thinning and the unpleasant side effects of GnRH treatment.
One of the GnRH drugs which has been commonly prescribed for Endometriosis is known as Lupron. There is a lot of information about this drug on the internet, as well as lots of mention of it at Endometriosis chat groups. This drug is also use for other health problems in both men and women. So it is not designed specifically for the treatment of Endometriosis, and some women have found they now have serious long-term health problems caused by this drug.
Progesterone hormone tablets — oppose the estrogen effects on the endometrial growths which causes them to ‘shrink’. Progesterone also prevents ovulation which lowers the estrogen levels. Side effects include: irregular menstrual bleeding, weight gain, mood changes, bloating, fatigue, depression, and nausea.
Progestogens are the most commonly used medical treatment. Examples include the drugs medroxyprogesterone acetate (Provera), dydrogesterone and norethisterone.
It has long been known that progestogens can alter the blood lipids (fats) in an unfavorable way, which might theoretically lead to an increased risk of blood clots (thrombosis). Two recent studies have provided more evidence that this could be the case. Although they looked at progestogens used for period problems, the doses used are similar as would be for treatment of endometriosis, and the risk of thrombosis was around 5-fold higher than expected.
The Mirena Coil — The Mirena Coil is used by some doctors to treat the symptoms of Endometriosis by reducing the amount of blood flow in a woman’s periods.
The Mirena Coil is like many other types of Intrauterine Contraceptive Devices (IUD’s or coils) in that it is fitted by a doctor and remains in the womb for a fixed amount of time, after which it must be changed.
Most IUD’s make a woman’s periods heavier, but the Mirena actually makes periods lighter than usual. Because of this, it is frequently used as a treatment for heavy periods, and is now used as a treatment option for Endometriosis, for the same reason of reducing blood loss with the menstrual cycle.
It is made of a light, plastic, T-shaped frame with the stem of the ‘T’ a bit thicker than the rest. This stem contains a tiny storage system of a hormone called Levonorgestrel.
This hormone is also used in contraceptive pills. In the Mirena, however, a much lower dose is released than take the Pill (about 1/7th strength), and it goes directly to the lining of the womb, rather than through the blood stream where it may lead to the common progesterone-type side effects.
Although the IUD was originally developed as a contraceptive, the discovery that it leads to much lighter periods was seen as a bonus. Many gynecologists now suggest the Mirena as a treatment for heavy periods if tablet treatment doesn’t work.
After 3 months use, the average blood loss is 85% less, and by 12 months the flow is reduced by 97% every cycle About one third of women using the IUS will not have any periods at all. There is no ‘build up’ of blood, because the hormone in the IUD prevents the lining of the womb from building up at all.
Most of the current drug treatments on offer aim to reduce Endometriosis growths, and in turn reduce symptoms. Most are reasonably effective to different degrees, however, most are associated with nasty side-effects. Many of the drug therapies have no proven benefit in terms of improvements in fertility or reducing recurrence of the disease.
Surgery Surgical treatment for endometriosis is usually carried out in one of the following situations:
At the time of diagnosis for mild to moderate endometriosis
If medical treatment has not worked
If sub fertility is a problem
If there is moderate to severe endometriosis
When endometriosis recurs Surgery can either be conservative or radical. The aim of conservative surgery is to return the appearance of the pelvis to as normal as possible. This means destroying any endometriotic deposits, removing ovarian cysts, dividing adhesions and removing as little healthy tissue as possible. Radical surgery means doing a hysterectomy with removal of both ovaries and is reserved for women with very severe symptoms, who have not responded to medical treatment or conservative operations. Sometimes, if there are other reasons to carry out a hysterectomy it is done earlier than this.
Treatment at the time of diagnosis This approach is rapidly becoming standard practice in the management of endometriosis. It is typically carried out where the endometriosis discovered is mild to moderate and the extra time required to do the surgery will be able to be accommodated within the time of the operation.
Laparoscopy Laparoscopy surgery used for diagnosis and for treatment of mild to moderate cases of Endometriosis. This is known as conservative surgery, which attempts to restore the pelvic anatomy to as close to normal as possible. A Laparoscopy enables a physician to look directly inside the abdomen and pelvic area and observe the anatomy and health of the abdominal and pelvic cavity.
To perform a Laparoscopy a small incision is made, usually about ¼ inch, right underneath the naval. A very small telescope-like instrument is then inserted. This instrument is attached to a light source which illuminates the pelvic and abdominal cavity. The physician can then look directly inside the cavity. During this procedure any Endometrial growths can be removed.
Laparoscopic management of endometriosis
Mild to moderate disease The endometriosis spots are destroyed by diathermy, where an electric current is passed down a fine probe burning the lesion. Some surgeons use laser to evaporate the endometriosis.
Improvement in pain symptoms following this type of surgery can be expected in 70% of cases, more so if the location of adhesions divided corresponds to the area of maximum pain.
There has been only one good quality study of the effect of surgical treatment of mild to moderate endometriosis on sub fertility. It found that laparoscopic destruction of lesions resulted in a 13% increase in pregnancy rate — equivalent to, on average, a benefit for one out of every eight women receiving treatment.
Moderate to severe disease Where endometriosis is more than a few spots, and in particular where there is more severe scarring or an ovarian endometrioma, there is still the option of laparoscopic treatment. The aim of laparoscopy, as usual, is to restore things back to normal. For endometriosis cysts on the ovary, this will mean shelling out and removing the cyst from the underlying normal ovary tissue. An alternative is to make a hole in the cyst wall, empty out the ‘chocolate’ collection of blood and diathermies the cyst base so all endometriotic deposits are destroyed.
Removal of endometriosis and division of scar tissue can be expected to improve the pain symptoms of endometriosis. The success of surgery in improving subfertility is related to the severity of endometriosis in the first place. It is difficult to give exact estimations, but women with moderate disease can expect pregnancy success rates of around 60%, whereas the comparable figure with more severe disease is around 35%. If a pregnancy does not occur within 2 years of surgery for endometriosis, the chances of success are poor.
Risks of laparoscopy
Keyhole surgery is generally very safe, especially in experienced hands, but it is important to understand that any laparoscopy carries with it some degree of risk, as do all operations. When placing the laparoscope into the abdomen, there is a small risk of accidental injury to bowel, the bladder or blood vessels leading to hemorrhage — this risk is inherent in the procedure. It is greater if the surgery is more advanced involving dividing of adhesions, diathermy of endometriosis, removal of cysts, etc. Not all of these complications will have serious implications, but it might mean an unexpected open operation and a longer hospital stay. Complications are more common where there has been multiple previous open surgeries.
Laparotomy This procedure is used when Endometriosis is more extensive and widespread and the surgeon requires more room to work in the abdominal cavity. It is a more serious and involved operation and involves opening up the abdominal cavity.
Hysterectomy There are many, many women who are driven to the drastic measure of having a hysterectomy in the hope that it will rid them of Endometriosis. This extreme step does not solve their problems. Please see the link below.
Combined treatment This form of treatment involves combining surgery and drug therapy. An example is when Danazol is taken for 6 weeks prior to an operation to shrink the endometrial growths and ease the surgical removal. Following surgical removal of endometrial tissue, birth control pills may be prescribe that contain both estrogen and progesterone, to be taken continuously for up to nine months. This will induce a pseudo-pregnancy, with the aim to allow the body time to rest and heal.
Recurrence of endometriosis after surgery Recurrence rate for endometriosis has been estimated to be 10% per year. One study found it to recur in 40% of women within 5 years after conservative surgery. There is a 6 times higher risk of recurrence after hysterectomy if the ovaries are not removed. Even in women who have their ovaries removed, there is still a risk of further recurrence of Endometriosis.
Return of symptoms Although much relief can be gained from drug or surgical treatment for Endometriosis, it is very common for symptoms to return and for the disease to flare-up again. Additionally, women who use hormone replacement therapy during menopause may also see a return of the disease. This is because hormone replacement therapy uses estrogen along with progesterone to help alleviate the problems associated with the menopause. The estrogen drug therapy will cause the return of symptoms. It is considered by the medical profession to be uncommon for this to happen, but there are many reported cases of women on hormone replacement therapy for the menopause having a return of Endometriosis.
One of the biggest misconceptions about Endometriosis is that pregnancy will cure the disease. Unfortunately, this is not the case and most women will see a return of their symptoms after pregnancy, especially if the disease was more advanced.
Endometriosis — Alternative and Natural Treatment Alternative and Natural treatments for Endometriosis — how it works!
Alternative therapies and natural treatments for endometriosis are obtaining excellent results in actively assisting the healing of this disease for many women..
Many of the alternative and natural therapies deal with the mental, emotional, and spiritual aspects of health, in addition to the physical body. This is where natural treatments have a huge benefit for women with Endometriosis — because this disease affects the whole person, not just the body. The name ‘Holistic Medicine’ comes from the connection between mind and body. Holistic practitioners treat the whole person as opposed to the individual organs where symptoms occur.
Alternative medicine made up of a rich variety of techniques and medical systems that for the most part, are still unfamiliar to the majority of people in the West. They are therefore, an ‘alternative’ to what most people are using when they need health care.
Much of what is labeled alternative medicine comes from other cultures or from ancient healing traditions. The use of herbs as medicine is an ancient practice found all over the world. Acupuncture comes specifically from ancient China and has been documented as being in use as early as 2697 B.C.
The World Health Organization estimates that between 65 and 80 percent of the world’s population rely on traditional medicine as their primary form of health care.
WHAT IS THE DIFFERENCE BETWEEN ALTERNATIVE AND CONVENTIONAL MEDICINE?
Most high quality alternative medicine is founded on six core principles and practices that differ from the principles and historical practices of conventional medicine.
They are: . The healing power of nature first, and technique and technology second
. Patient centered rather than physician centered
. Do no harm — many alternative medical systems are rooted in the principle of ‘always use the least drastic harmful therapies first’. This means that alternative medical providers, in general, choose techniques and therapies which are the least invasive or harmful to get the desired result
. Results generally take longer — but this ensures long term health and not a quick fix it
. Use of natural and whole substances
. Higher standard of health
The whole area of alternative medicine is becoming more main- stream in western society as a means for people to take care of their health, for reasons including:
the realization that, contrary to previously held beliefs, conventional medicine (the medicine of antibiotics, surgery, chemotherapy etc.) cannot solve all of societies health problems
the growing acceptance that health is more than just ‘the absence of disease’ and involves more that just the physical body
the growing body of scientific research, as well as public awareness, that many alternative medical treatments are more effective, more economical, and less invasive and less harmful than conventional medical treatments
SO WHAT ARE THE DIFFERENT ALTERNATIVE AND NATURAL THERAPIES THAT CAN HELP ENDOMETRIOSIS!
Acupuncture and Endometriosis Acupuncture is part of Traditional Chinese Medicine and has been practiced in China for thousands of years, but became widely known in the West only in the 1970s, when its use as an anesthetic received sensational press coverage. Practitioners insert fine, sterile needles into specific points on the body as a treatment for disorders ranging from asthma to alcohol addictions, but most often in the West as a means of pain relief.
Chinese Herbalism and Endometriosis Chinese Herbalism is another part of the Traditional Chinese Medicine system.
Traditional Chinese medicine is able to understand endometriosis based on the different clinical manifestations, or symptoms, associated with each individual. It is important in TCM to diagnose the patient according to their own specific pattern. Each individual has a pattern that marks the foundation and progression of the disorder.
When determining the pattern of disease in the treatment of endometriosis, TCM takes into account the menstrual history, duration of the cycle, as well as pain, including the time that it occurs, the location, and the nature and severity.
Herbalism and Endometriosis Herbal medicine is the treatment of disease using medicinal plants, both internally and externally, to restore the patient back to health. It is a system of medicine that relies on the therapeutic qualities of plants to help the patient by enhancing the body’s own recuperative powers. It is a natural method of healing based on the traditional usage of herbs coupled with modern scientific developments.
Though there are those in the orthodox medical world who ignore herbal medicine, even condemn it, the constituents of herbs have provided the blueprint for many of the most effective and widely known drugs used today. ‘Orthodox’ medicine has its roots in herbal medicine.
Orthodox medicine is based on drugs isolated from plants, or more often manufactured in the laboratory. The herbalist advocates the use of the whole plant as a gentler and safer way to restoring a patient to health
For the treatment of Endometriosis, one of the first tasks in herbal medicine is to try and re-balance the hormone levels in the body. Then other herbs will be introduced to strengthen the immune system so that the body can then begin to eliminate the disease. As with other alternative treatments, using herbal medicine for Endometriosis will involve a time commitment to achieve success.
WE SELL BULK HERBAL PRODUCT TO HELP WOMEN SUFFRENING FROM ENDOMETRIOSIS, IT IS SAFE AND IT WORKS EFFECIANTLY.
THOSE HERBS LIKE: Bupleurum, Chih-ko, Red peony, Licorice, Platycodon. Tang-kuei. Cnidium, Rehmannia, Persica, Carthamus, Cyathula, AND other herbal formula already available on request.
Aromatherapy and Endometriosis Aromatherapy is a form of healing that utilizes the natural aromatic aspect of plants — the essential oils — both for their scent and for their inherent medicinal properties. These aromatic oils can be found in a wide range of species and are extracted from the seeds, bark, leaves, flowers, wood, roots or resin according to the type of plant.
Endometriosis — Diet and Nutrition Diet changes can help reduce the symptoms of endometriosis
Changing your diet to deal with Endometriosis is an excellent foundation to assist you in reducing the symptoms, and will help regenerate your health.
Adjusting what you eat can bring about many positive physical and metabolic changes, as well as improving our health. Many of you may be aware that various illnesses and diseases have responded very positively to changes in diet, and Endometriosis is no exception.
Some of the positive physical changes that take place when we change our diet, will at first not seem reliant on our food intake, but they are.
For example, eating the right kinds of foods can: . sharpen our mental alertness
. help us to stop feeling so sluggish
. give us more energy
. regulate sleep patterns
. regulate bowel movements
. balance blood sugar levels
. regulate metabolism
. regulate body weight
. control hyperactivity — especially in children
We are very much a reflection of what we eat. When someone has a diet loaded in fats, the first place it will show up is in their complexion, with greasy, sallow skin. When we are constipated, an Iridologist (alternative health practitioner specializing in diagnosis using the iris of the eye) will immediately see this in the lack-lustre appearance of the eyes. With a lack of vital nutrients in our system, the body will eventually give you tell-tale signs.
The diet in modern day western society has become depleted of vital nutrients for many reasons. Intensive farming has robbed the soil of vital trace elements which used to be taken up by the crops as they grew, and in turn we consumed them. We rely so much on convenience foods now, which are very low in goodness. Much of our ‘fresh’ produce like fruit and vegetables, is actually gassed and then stored in warehouses for months.
Many of us eat ‘fast food’, which is not very nutritious — the longer that food is left standing in a heated serving cabinet, the less nutritious value it has. People get lazy, they cannot be bothered to shop for valuable ingredients, yet alone cook good wholesome food anymore.
What the body needs is a simple, balanced, preferably organic diet, which is prepared using fresh ingredients, and is viewed as our means of sustenance rather than being viewed as ‘something to stop us being hungry’. We do have many problems and issues surrounding food in the West, with anorexia, comfort eating, and many other eating disorders. Food is also used in many social situations, but this is no excuse for not being able to feed yourself with good food when you are at home.
Food is our fuel, it makes us function, grow, replace worn out cells, gives us energy, and feeds the entire body. Food is the secondary requirement to life, with oxygen being the first basic requirement. More important than food is our daily requirement for water. We need lots of it; plain, fresh water. Yet most people only drink a small proportion of what the body really needs.
But going back to food; it provides us with energy. The foods we take in include:
. carbohydrates, which provide the chief source of energy for bodily functions and muscular exertions
. fats, which are the most concentrated form of energy. Three fatty acids, are essential in the diet because the body cannot make them itself.
. proteins, which are the building blocks in food, the construction materials for growth and repair of cells
. fibre, indigestible parts of plants which provides roughage and aids digestion
. vitamins and minerals — the organic substances which the body cannot make, but which it requires in small amounts to maintain health
Let’s start with pain and hormones in relation to diet
Endometriosis is an estrogen-sensitive condition, but the painful menstrual cramping that occurs is predominantly due to prostaglandin synthesis in the body. Prostaglandins are naturally occurring fatty acids, which are derived from dietary sources.
The body can produce different types of prostaglandins through a complex series of pathways. There are the ‘good guys’ and the ‘bad guys’ of the prostaglandin group . The goal of a controlled diet is to block the ‘bad guys’ for their negative actions on the body, and increase the ‘good guys’ for their opposite and beneficial actions. The action of the bad guys is to increase uterine contractions, and the good guys have a soothing effect. By changing the types of oils that are taken into the diet, the production of the good guys can be stimulated, which helps with uterine relaxation. These oils are composed of omega-3 fatty acids, which lead to positive prostaglandin production.
Excellent sources of the omega-3 fatty acid producing oils are:
. Walnut oil
. flax seeds/oil
It is also important to decrease intake of those fatty acids that will stimulate the bad guys which are found in saturated fats, butter, animal and organ meat, lard.
In addition to decreasing bad fat intake, the diet should also consist of high fiber. Not only does this help with good digestion, but it is also thought that a diet high in fiber can decrease total circulating estrogens. It is recommended to incorporate 25 grams per day of fibre.
Good sources are: . whole grains excluding wheat and rye
. beans, peas and pulses
. brown rice
. vegetable and fruits
The following foods are recommended to modulate estrogen levels by incorporating one or two servings a day:
FOODS TO AVOID. wheat * — this includes breads, cakes and pasta products, all based on wheat
. red meats — promotes negative prostaglandins
. refined and concentrated carbohydrates — bread, flour, cakes made from refined flours
. refined sugars and honey — causes inflammatory reaction
. alcohol — consumes vit B stored in the liver
. caffeine which is found in tea, coffee, soft drinks -increases abdominal cramps and increases estrogen levels
. chocolate — as it contains sugars
. dairy produce including all milk and cheese — inflammatory
. fried food, margarine and hydrogenated fats — can stimulate negative prostaglandins
. soy products and soy protein products — tamari can be used in small amounts
. tinned and frozen packaged foods as little as possible
. additives and preservatives — increase chemical load on the system
Note: Meat, dairy and eggs, promote the pro-inflammatory prostaglandins.
FOODS BENEFICIAL FOR THE IMMUNE SYSTEM
beans, peas, lentils
. garlic (raw or lightly cooked)
. carrots (contain beta-carotene)
. live yogurt (good for healthy intestinal flora)
. seeds and sprouted seeds
. green tea
HORMONE REBALANCING Foods containing natural plant sterols (phytoestrogens) can be helpful. They are thought to block the estrogen receptors, so in turn excess estrogen in the body cannot ‘lock-in’ to these receptors.
These include: . peas, beans and pulses
. red and purple berries
. brassicas: cabbage, cauliflower etc
. nuts and seeds
. celery, carrots
Although the best source of vitamins and minerals is through a well balanced diet, many foods today are depleted in these vital trace elements. Today, most of us need to supplement our diet with some of the vitamins and minerals that our bodies need to function optimally.
The following is a list of supplements that will help women with Endometriosis:
Magnesium — is a mineral and is believed to ease cramping with menstruation
. Zinc — is essential for enzyme activity, helping cells to reproduce which will help with healing. Zinc is also reported to boost the immune system and helping to create an emotional sense of well-being
. Calcium — levels of calcium in menstruating women decrease 10 to 14 days before the onset of menstruation. Deficiency may lead to muscle cramps, headache or pelvic pain.
. Iron — women with Endometriosis tend to have very heavy periods which can lead to an iron deficiency. This can lead to anemia which is characterized by extreme fatigue and weakness.
. B vitamins — these are important for the breakdown of proteins, carbohydrates and fats in the body. B vitamins are reported to improve the emotional symptoms of Endometriosis, and have proved helpful in dealing with PMT
. Vitamin C — is well known for helping to boost the immune system and help provide resistance to disease. It is also used in the body to build and maintain collagen within the body.
. Vitamin A — is another immune system booster
. Vitamin E — plays an important role by increasing oxygen carrying capacities and also strengthens the immune system
. Selenium — when taken together with vitamin E has been reported to decrease inflammation associated with Endometriosis, as well as immune system booster.
OTHER USEFUL SNIPPETS: Certain vegetables have substances that activate liver enzymes and help the liver to detoxify chemicals. This allows the liver to eliminate excess estrogen from the body more effectively. These vegetables include: broccoli, cauliflower and brussel sprouts.
. Auto immune diseases are thought to be triggered by free-radicals in the body, which could be an added factor in Endometriosis. Free radicals are destructive molecules and are found naturally in the body but can be made worse by pollution, stress, illness and smoking. There are minerals and vitamins that will help to fight off these free-radicals because of their antioxidant properties, including: vitamins A,C,E, CoQ10, selenium, vitamin B complex, as well as specific supplements being sold specifically as Antioxidants.
• It is very common for women with Endometriosis to suffer from Irritable Bowel Syndrome. I used to suffer from it myself, and it took quite a while to define which foods would trigger it off. These triggers can vary from one woman to another. Even simple things like drinking a hot drink when it was too hot would trigger it off in me. You need to really pay attention as to what your own subtle triggers are, as well as which foods will set it off.
TO SUM UP • increase omega-3 fatty acids
• avoid meat, dairy products, wheat and sugar
• increase fiber
• modulate estrogen
• avoid caffeine and alcohol
• avoid refined foods, e-numbers, additives
• minimize or avoid soy products as they contain high levels of phytoestrogens, and soy contains a particular toxin which seems to be particularly detrimental for women with Endometriosis
• peel fruit and vegetables to remove toxic chemicals
• eat organic produce wherever possible
• drink lots of filtered or mineral water
WE are waiting your order from our herbal collection to fight Endometriosis
Please send an e-mail of your:
Name of the Product/ Plant (as listed in the blog)
Phone No. for us to contact you for any further discussion or convenient way to send your order.
Payment of order can be made through bank into CIMB Bank Account No: 0512-0000174-10-5
(under name Nile Herb ).
Nile Herb Rasah Kemayan, Negeri Sembilan, Malaysia Dr Hassan Nada born in Cairo-Egypt, graduate from Cairo University medical school 1971, earned his M.D. in general medicine, work as medical consultant. Associated with his medical carrier in Canada since 1990, researching on medicinal plants, and its potential to ease so many health problems facing humankind and great amount of information about nutrition and alternative food supplements that eventually reaches the public through the 12 published books already in the Middle East market in Arabic language I am living now in Malaysia with my native Malaysian beloved wife Marina founded our company Nile Herb for health care. Our mission is to help peoples to solve some of there health problems. My published books designed to teach those with little clinical background how to maximize their health and longevity through the proper use of natural substances such as medicinal herbs, vitamins, minerals, amino acids and other co-factors. View my complete profile
At my office at Lucent Technology in Riyadh 1995
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