One of my friends was diagnosed with endometriosis a few years ago, and has some symptoms that may be from this condition, including severe cramping, mild pain after intercourse, and frequent pelvic pain. Endometriosis seems like a perfect candidate for the sort of condition that the medical industry would have no real answers for, but where communities such as paleo may be able to come up with something. If possible I'd like to be able to help her solve or at least lessen this problem.
So the first step in dealing with this sort of problem is to consider the mechanism involved. Let me know if I'm getting this wrong, but my understanding is that cells from the lining of the uterus (the "endometrium") somehow get moved to other parts of the body--namely the fallopian tubes, pelvis (?), etc. These cells somehow establish themselves, and replicate out of control. As the first line of defense--preventing the establishment of these cells--has failed, the body responds by trying to quarantine these cells by building scar tissue around them, all of this leading to structural changes in these areas of the body.
As these are uterine lining cells, they respond to hormonal signals in the same way as the wall of the actual uterus, and thus bleed during menstruation. The bleeding from cell formations in certain areas (such as the fallopian tubes perhaps?) is able to be excreted in the same way as normal menstrual fluid, but other areas, such as when the cells are established in the pelvis (read this somewhere, not sure what "pelvis" refers to here), the bleeding is trapped and unable to move, and thus end up sticking around and causing further inflammation and scar tissue formation.
The symptoms here would be from the structural changes. Most obviously you get pain, which I assume is because of this extra tissue pushing on areas that our pain-receptor system doesn't expect tissue pushing on. One of the other symptoms that may come from these structural changes is something my friend experienced--ectopic pregnancy. This is where the egg doesn't reach the womb, but instead gets stuck somewhere along the path. Hers got stuck in one of her fallopian tubes, presumably because of the scar tissue build-up around the transplanted cells obstructing the path.
Now with the mechanisms explained pertaining to after the establishment of the transplanted cells into significant formations, what's next is of course to discuss how the transplanting occurs, and how it establishes itself. One of the theories is related to retrograde menstruation--where some of the menstrual fluid goes backwards, and doesn't get removed properly. With uterine cells in this fluid (because the fluid is the uterine lining shedding), you get these uterine cells lingering around in other areas of the reproductive structure--such as the fallopian tubes--where they may or may not establish as a significant structural change.
But why would they establish themselves? The theory is that every woman deals with retrograde menstruation to some degree, and only some actually experience the establishment of these cells, just as everyone has cancerous cells in their body, but in only some cases are they able to run out of control, and replicate to a dangerous degree. In the case of cancer, the answer is that either (1) the baseline cancerous-cell load is increased beyond a certain threshold--for example because of greater circulating toxin load, or (2) because immune system activity responsible for dealing with these cancerous cells has been compromised. In either case you get runaway formation, and establishment that not even a strong immune system could handle.
So in the same way, the theory is that although there is a certain degree of retrograde menstruation for every women, in certain cases the retrograde-menstruation load is either (1) increased beyond the threshold at which a normal immune system is able to respond to, as one function of the immune system is to search, retrieve, and destroy or remove rogue or damaged cells, or (2) the immune system in this way has been compromised to a degree where it cannot handle even a normal retrograde-menstruation load, or (3) a combination of these two factors.
For the first, how to approach this issue to ask what conditions have changed since the ancestral environment--what our immune systems are optimized for. So how has menstruation load, and thus retrograde menstruation load, increased past what would have been a reasonable assumption for the evolution of these systems? My first thought is that women were of course off their period much, MUCH more often back in the day. With no period during pregnancy, and no period while breastfeeding, along with having multiple kids back to back, this amounts to years with no menstruation whatsoever, and then in turn no retrograde. Nowadays women get pregnant much less often, via modern contraception, and breastfeed much less often, due to using formula.
As for the latter, I can't think of any particular mechanisms, but of course anything damaging the immune system or really anything in the body will lead to a diminished ability to deal with transplanted uterine cells, or any other transplanted or damaged cells. My first thought is perhaps to inquire, Are there any other conditions that involve transplanted cells? Damaged cells that replicate are called cancerous. Cells that are transplanted somewhere, I've seen them called 'rogue cells' when reading about endometriosis. Are there any other conditions that involve rogue cells establishing themselves?
So the solution?
Anything to decrease flow per period, thus decreasing retrograde menstruation load per period (without causing other systemic effects--anything e.g. destroying libido, is out)
Anything to decrease frequency of period, thus increasing frequency of retrograde menstruation load (again without causing other systemic effects, which means the only possibility is pregnancy and breastfeeding, though this is perhaps out in my case because of my friend's fertility problem, which was in turn caused by this very condition--a vicious cycle is at work here, perhaps)
Anything to increase immune system ability in this particular, or assist in this particular--that is cleaning up rogue cells and preventing their establishment
My only other thoughts are (1) perhaps there's some sort of 'damage' to these transplanted cells, which could introduce another factor, perhaps related to toxin load, and (2) perhaps there's some condition that leads to a large percentage of normal menstrual load to end up retrograde, whereas throughout the past several paragraphs I've been making the assumption that increased retrograde load is simply a matter of increased general load, meaning the same rough percentage becomes retrograde in all instances--an assumption that may be wrong.
Is this anything I'm missing in the explanation of the mechanisms involved? Do we know of any cases where endometriosis was successfully solved naturally? Do any of you have experience with this problem, or experience with it getting better or worse via certain lifestyle changes? Any ideas for how to decrease flow? What am I missing in this discussion? It strikes me that I said nothing about hormones. Anything on the effect of hormone balance on endometriosis?
Thanks in advance.
asked byWakaanai (266)
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on December 31, 2012
at 03:22 AM
on December 31, 2012
at 02:47 AM
A lot of the more recent research on endo is pointing towards autoimmunity. Endo also seems to be more common in women with other autoimmune disorders, such as Chrone's, Celiac, and Hashimoto's. So I think as opposed to treating the symptoms ("retrograde" menstruation or hormonal imbalance), maybe it's better to look at reducing chronic inflammation via a paleo autoimmune protocol?
on December 30, 2012
at 08:39 PM
The theory of retrograde menstruation is antiquated, although many physicians still cling to it. Endometrial cells have been found upon autopsy in men and infant girls who, obviously, have never experienced retrograde menstruation.
Considering that endo appears to have a genetic component, I tend to lean more towards the theory of it being in the realm of autoimmune disease.
on December 30, 2012
at 08:24 PM
You have to look at the uterine lining like a series of cell layers in a way. Once the lining is full of blood that accumulates in a layer it's ready to be sloughed off (and once it gets hormonal cues as well). It's kind of a complex series. There are lots of layers though and cells can come off with certain, um, activities too. Backflow can happen if enough fluids aren't being produced to slough cells in a downward motion, or if enough hormone signals aren't happening to make the sloughage happen fast enough (in combination with fluids). I hope that sort of makes sense (I'm a grad student and I've taken anatomy, but bio is not my major).
here's what I was able to find online. now this article suggests eating more cruciferous veggies to help regulate natural estrogens, and reducing cortisol in the body (I recommend l-theanine personally) but getting at least 8 hours of sleep a night helps reduce that as well. IT also suggests a link in endometriosis and candida overgrowth, so maybe an elimination or GAPS diet is in order?
Now I'll be honest...from my experience in health care, once I've seen this happen in many women, most get a LEAP procedure and have their insides lasered and take birth control to regulate their hormone levels. This works sometimes (especially the laser part when done multiple times) and sometimes it doesn't.
I'm all for checking into an elimination diet though. Something to help her reduce the possible candida overgrowth, high levels of cortisol, and regulate hormones.
on December 30, 2012
at 08:17 PM
Endometriosis is an inflammatory condition and from just a couple of simple Google searches, I came up with some links that indicate that a gluten-free diet may be helpful:
on April 16, 2014
at 11:38 AM
I believe that endometriosis is far more complex of a disease as it may first appear.I have read a few success stories of women with endo.One woman cured herself through diet and acupuncture.Another with endo and PCOS with lugol's iodine solution.Some through fasting ,diet and supplementation
http://chuck-bluestein.hubpages.com/hub/How-to-Cure-Your-Endometriosis-End-Endo and another women fixed her thyroid problems which resolver her endo.
Personally acupuncture ,Chinese herbs and diet have dramatically improved my symptoms.
on February 09, 2013
at 05:54 AM
I recommend one link, great Specialist and Resource for Endometriosis, this might be helpful:
Center for Special Minimally Invasive & Robotic Surgery in Palo Alto, California
on December 31, 2012
at 09:18 AM
Some links that might be helpful:
The Diagnosis of Endometriosis by Electroenterography: A Disease of Insulin Sensitivity - http://www.johnmathias.com/endo.html
Low D causes infertility, polycystic ovary syndrome and endometriosis - http://drgominak.com/vitamin-d
For me, paleo diet (especially removing grains and dairy which used to be a large part of my diet) plus supplementation (b-complex, fish oil, magnesium, d3) helped a lot to ease my endometriosis symptoms (decreased period flow, pain almost completely gone).