Endometriosis Treatment Options: Naturopathic Care in Ottawa

Endometriosis treatments in Ottawa, ON Canada can be helpful in addressing some of the most problematic symptoms this condition can present. In addition to increasing the risk of infertility, it causes other symptoms which can lead to discomfort with digestion, urination, mood changes, irregular periods, and in severe cases even fainting.

Endometriosis is caused  by a combination of factors, and it affects approximately 1/10 Women of reproductive age globally. Some of the main factors which increase the risk for growth of endometriosis or encourage it to thrive are listed below.

What Causes Endometriosis?

1. Estrogen dominance: an increase in estrogen levels in the body, relative to lower progesterone levels which is common with endometriosis, creates an environment favourable for continued growth of the endometriosis or its persistence. 

2. Low Vitamin D levels may contribute, as low vitamin D lowers the COMT enzyme in the liver, which reduces the liver's capacity to effectively metabolize estrogen. COMT enzyme has a protective effect in the body by increasing the conversion of estrogen to less harmful forms of the hormone in the body.

3. Increased inflammation: the increase in inflammatory cytokines, produced by the endometrioma itself, creates an environment in the tissue local to it, to promote its own continued growth. 

4. Immune System Imbalance: the immune system fails to effectively target endometriosis tissue in locations outside of the uterus. A normal and healthy functioning immune system should target these tissues and help break them down. However, in patients with endometriosis there is a dysregulation in the immune system and natural killer cells are unable to target the endometriosis.

5. Continued Spread to other Tissues: this can happen by endometrial cells travelling to other sites by one of 3 pathways: through the circulatory system, the lymphatic vessels, and through retrograde blood flow (menstrual flow going in the opposite directions in to the Fallopian tubes and in to the abdominal cavity. 

Treatment Options for Endometriosis

1. Fertility Acupuncture: acupuncture for endometriosis can be helpful in improving blood flow to the uterus, reducing cramping and pain, improving hormonal balance, reducing stress and reducing inflammation.

2. Vitamin D Injections: can be helpful in increasing Vitamin D much quicker than an oral supplement. This is especially helpful in cases where Vitamin D blood test results show a significant deficiency.

3. Diet & Lifestyle: this is a cornerstone for treating endometriosis. Diet and lifestyle recommendations specific for this condition can help to improve fertility, reduce estrogen dominance, improve hormonal imbalance, reduce pain, and potentially reduce inflammation in the reproductive organs and body.

4. IV Therapy: can help to provide the antioxidants in high concentrations to support egg quality, and reduce damage to the eggs from oxidative stress, especially since oxidative stress and inflammation are in most cases elevated with endometriosis.

5. Bioidentical Progesterone Therapy: the BHRT with progesterone can help to support the low progesterone levels usually associated with endometriosis and support healthy implantation and pregnancy.                                                                                                                                                                  

Evidence-Based Approaches to Integrative Treatment Options for Endometriosis:

 

Endometriosis is a multi-system disorder. Meaning that it is not the result of just one factor, but rather the outcome of a combination of factors. Natural treatment options for endometriosis look to include approaches to reversing the physiological imbalances that created an environment conducive to endometriosis in the first place. 

 

1. Inhibiting Growth: growth of endometriosis is ensure by continually elevated levels of inflammation and estrogen. Inflammation makes it easier for the endometriosis to spread to neighbouring tissue, causes increased pain and can also harm fertility (reducing ovarian reserve and declining egg quality). Estrogen is produced from various tissues, including fat/adipose tissue, the adrenal gland, the ovary, and in the endometrial lesion as well. We see that elevated levels of estradiol support the continued growth of the endometrial lesions. Many medicinal herbs have been evaluated to support the treatment of endometriosis, and they have shown anti-proliferative activity. This means they can help to reduce the growth of the endometrial lesions. 

 

2. Anti-nociceptive: as mentioned above, the major symptom that brings patients in to the Doctor’s office with this condition is pelvic pain. While treating the symptoms will not remove the cause of the pain, it is important to provide symptomatic relief and support an improved quality of life. Various herbs have been investigated for their use in endometriosis and have demonstrated anti-nociceptive properties, meaning they can help to alleviate pain caused by endometriosis. 

 

3. Oxidative Stress: One of the pathogenic factors associated with endometriosis is elevated oxidative stress. Increased oxidative stress damages the DNA of the cells affected in that tissue. With regards to fertility, increased oxidative stress is strongly associated with a decline in egg quality and lower chances of success with fertility treatments. Therefore, one important aspect of treatment for endometriosis is the reduction of oxidative stress. Various herbs and micronutrients have been investigated and support a reduction in oxidative stress by exerting antioxidant properties.

 

4. Decreasing COX-2 enzyme activity: the COX-2 enzyme is the enzyme which causes an 

increase in inflammation. It produces more prostaglandin-E2 and this increases inflammation locally and in the neighbouring tissue. The use of micronutrients and various herbs have been studied to show a decline in COX-2 activity and reduce the production of inflammatory mediators. 

 

One of the commonly overlooked factors is the digestive tract in the treatment of endometriosis. In many cases of endometriosis there exists something called ‘estrogen dominance’ and one of the causes of this is that the body is not able to eliminate metabolized estrogen hormone from the body effectively. If the bowel movements and digestive tract are woking sub-optimally, the estrogen excreted from the liver to the bowels (via bile) is reabsorbed in the distal colon back in to the blood. Therefore it is critical that in the natural treatment of endometriosis we support the healthy functioning of the digestive organs and support liver detoxification.

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