Endometriosis has become an increasingly common health condition worldwide. There seems to be a strong correlation between endometriosis and the increased stress levels experienced by so many working women today.
What is Endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus is located outside the uterus. Usually there are implants of this tissue in the pelvis. When the lining of the uterus bleeds during the menstrual cycle, these implants also bleed. This causes pain and scarring in the pelvis.
The main clinical manifestation of endometriosis is a recurrent, generally cyclical, lower abdominal pain that gets progressively worse. Dysmenorrhea, irregular periods, painful intercourse, fever during menstruation, dysfunctional vaginal bleeding, nipple discharge, abdominal masses, and infertility may also be associated with endometriosis. It is estimated that 15 percent of menstruating women between the ages 25 and 44 have endometriosis. Up to 50 percent of infertile women may have endometriosis (source: www.bioscience.org)
What are the treatment options available?
Standard treatment choices for endometriosis include surgery, hysterectomy, and drugs. Surgery is often only a temporary measure, because endometriosis recurs in most women. Treatment with synthetic hormones will suppress the symptoms of endometriosis, but the disease itself is not cured, and symptoms will often return after discontinuing the hormone therapy. (Flaws, 2007)
Traditional Chinese Medicine is an alternative that can be considered to manage endometriosis. In Chinese medicine, the primary pattern, or mechanism, that causes endometriosis is Blood Stasis. Blood Stasis can be caused by emotional disturbance, chronic illness, exposure to cold temperatures, surgery, and genital infections. When the pattern of disease is Blood Stasis, the objective of the treatment is to invigorate Blood and remove stasis, using both acupuncture and Chinese herbal medicine. The most frequently used herbs for dispersing Blood Stasis are: salvia (Dan Shen); red peony root (Chi Shao); persica seed (Tao Ren); safflower (Hong Hua); bur-reed rhizome (San Leng); and zedoary (E Zhu).
In addition to Blood Stasis, there are often other disease-causing factors which are part of the patterns of endometriosis. Cold, Heat, Deficiency, or Excess patterns are frequently part of the mix, and are differentiated based on the clinical manifestations associated with each case of endometriosis. The timing, location, nature, and severity of pain are taken into account, along with associated symptoms. Following are five common patterns of endometriosis:
- Qi Stagnation and Blood Stasis.
- Kidney Deficiency and Blood Stasis.
- Cold Retention and Blood Stasis.
- Qi Deficiency and Blood Stasis.
- Heat Obstruction and Blood Stasis.
How does TCM View the high incidence of Endometriosis in working women?
There seems to be a high incidence of endometriosis among working women. Women with endometriosis tend to live stressful lives - this face cannot be denied. This stress is not just work related but has to do with a number of stressors women experience in contemporary culture. Pain is one of the major symptoms that affect working women’s efficiency. There is increasing pain as the period progresses ending in dragging pain in the lower abdomen. The woman may complain of physical and mental fatigue, dizziness, giddiness, lack of appetite, diarrhea, rectal prolapse, hemorrhoids, and tenesmus or bowel cramping.
From TCM point of view, Qi stagnation leads to blood stasis and vise versa. Both may lead to pain in the lower abdomen, dysmenorrhea and infertility. The most common cause of Qi stagnation is stress. Stress energetically is Qi trying to flow in a certain way or 'direction' externally which it cannot freely and patency. This then causes internal congestion of the Qi, since maintaining potency of the Qi is primarily the function of the liver. Qi stagnation usually results in liver depression. Stagnant food due to over-eating, blood stasis due to trauma, long-term blood vacuity, and dampness may all impede the free flow of the Qi and therefore, can also contribute to Qi stagnation.
How can acupuncture and diet help in treating Endometriosis?
Scientific studies are suggesting that endometriosis is a neuro-immuno-endocrine related disease. Acupuncture can improve the functioning of the immune system and increase the flow of energy through the meridians, or energy pathways, in the body. It has been found that acupuncture treatments promote the release of endorphins and other “healing” chemicals in the body. These chemicals assist in healing and pain management. In gynecology and reproductive medicine, acupuncture has been utilized to manage pain from dysmenorrheal, pelvic inflammation, endometriosis, mittelschmerz, premenstrual tension syndrome, breast disease, urinary bladder distress and to promote healing and hormonal regulation in chronic bladder infection, uterine fibroids, dysfunctional uterine bleeding, anovulation, premature menopause and menopausal conditions.
Diet is also an important factor in controlling endometriosis. A low-fat, high-fiber, dairy-free diet is recommended, along with the addition of certain foods such as Daikon radish (moves Qi) and kelp (dissolves masses and stasis). Avoiding cold foods and drinks is also very helpful.
How should working women prevent Endometriosis?
Chinese medicine believes that prevention is always better than treatment. Making few simple change in lifestyle could make a big difference. Here are some advices that can be considered:
- First advice is to avoid fear, anger, and excessive emotions in general, since emotions and qi flow are essentially the same thing. Maintaining an even, free flow of moderate emotions is the same as maintaining an even flow of qi and blood.
- Second advice is to avoid strong, vigorous movement or exercise during menstruation so as to prevent qi and blood from leaving their path. Such erratic qi flow may result in menorrhagia, hemoptysis epistaxis and uterine bleeding.
- Third advice is that women should not allow themselves to become fatigued prior to and during menstruation. Excessive fatigue means the consumption of the qi and blood and vacuity of the qi and blood during menstruation may injure the penetrating and conception vessels causing blood stasis and thus leading to a number of chronic menstrual disease.
“I suffered an exceptional pain on the first 3 days of my menses 4 months ago. Consistency feeling a dull ache exists on the left side of my lower abdomen. Since then, my gynecologist did an ultrasound and found a 18 cm cyst in my left ovary. She suggested me to repeat the scan 3 months later to rule out the possibility of functional cyst. To my disappointment, the size of the cyst has grown almost double to 3.3 cm and my gynecologist has then made a diagnosis my condition as endometriosis with an endometriotic cyst. The suggestion given to me was a keyhole surgery ASAP to remove the cyst considering the speed of growth of the cyst. I was reluctant to go for the surgery learning that the recurrence possibility is high and I have to follow through a treatment of the birth control pill. I decided to try TCM for a more holistic approach trying to cure the root cause of the disease before the ultimate choice of surgery.
I found Raffles Chinese Medicine and physician Zhao to follow up on my condition. She put me through an acupuncture treatment and Chinese medication. I found the dull ache was gone immediately after the first session of acupuncture. The size of the cyst has also shrunk 1cm after two and half weeks’ treatment. Besides that, I also found myself overall feeling better with smoother menstrual cycle. I am still on regular follow up with the physician and hopefully my cyst is gone one day.” - Ms. Leong