July 29, 2011

Heavy periods, severe incapacitating cramps, fever, nausea, vomiting, infertility are often undiagnosed or misdiagnosed. All these symptoms conjure up a condition shrouded in fear and certainly little knowledge and too much oversight by conventional and alternative medicine practitioners.

Endometriosis literally means inflammation of the lining of the uterus. The name does not represent the most important issue, the fact that women who are suffering, and I do mean suffering with this terribly incapacitating illness, have pieces of the lining of their uterus literally tossed from their Fallopian tubes into the abdominal cavity.

The process occurs during menstruation when instead of shedding the lining of the uterus into the vagina and out of the body, little pieces of the lining of the uterus travel from the uterus into the Fallopian tubes which connect the uterus to the ovaries. The problem is that the Fallopian tubes open up into the abdominal cavity. They do not connect directly to the ovaries but allow a small gap to exist, opening directly into the abdominal cavity. This gap allows for stray tissue from the lining of the uterus to get propelled into the abdomen. This is how the problem of endometriosis starts.

This tissue which is under direct influence to hormonal stimulation found in the wrong place becomes the source of enormous problems. In the abdominal cavity, the tissue floats around but eventually has to settle. It may adhere to loops of bowel, to the tissue that covers the bowels, called mesentery, to the outside of the uterus, to the outside of the bladder and even to ovaries. Once settled down, the tissue starts to create problems by reacting to natural hormonal fluctuations.

The tissue grows and shrinks based on the hormone levels in the blood stream. Keep in mind; estrogen and progesterone in their cyclical rise and fall make the lining of the uterus become thicker and then shed as we get our period and the hormone levels drop., Think of what this situation does to tissue that now is attached to organs and areas of the body it does not belong to and has no place to go. The tissue grows and shrinks with the fluctuation of hormones and along with the growth of the tissue, pain, cramps, constipation, fevers and general sickness develops.

This is the underlying cause for endometriosis.

The only way to diagnose endometriosis is to put the symptoms together with a laparoscopic evaluation. Meaning, the surgeon needs to look into the abdominal cavity to see these lumps of uterine lining sticking out in the wrong place.

From my perspective symptoms alone will diagnose endometriosis. It is only when the situation is severe enough and has created serious interference with daily living or has caused infertility that surgical intervention does come in handy and cleaning up the tissue will help. The down side of the surgery is that once done, it will leave behind scar tissue that may also cause similar symptoms in the long run.

Non-surgical methods of treatment include synthetic hormone replacement therapies, anti-estrogenic drugs like Lupron, which literally neuter women and eliminate all hormone production in the hope of stopping the ebb and flow of hormones and thus of the symptoms as the endometrial tissue grows. The long term effects of these approaches are dangerous and unknown.  Keep in mind that while the anti-estrogenic drugs may eliminate the endometriosis, they also eliminate all things female too. Much thinking must go into the decision to take these drugs. Personally, I never recommend them to my patients. I believe the price is potentially too high.

Finally, there is one other way to treat endometriosis and that is with the help of natural, bioidentical hormones, supplements and diet adjustments. In my practice I have achieved great results with increasing the progesterone and even adding estradiol to the mix. Omega 3 Fish Oil, L-Carnitine and Coenzyme Q-10, Vitamin C, B complex, Folic Acid, Calcium Citrate, Magnesium, Zinc and Alpha Lipoic Acid are also helpful in the proper combinations and doses as part of a plan that incorporates as many variables as possible. Diet needs to limit stimulants, coffee, alcohol, spicy foods and processed foods with chemical additives.

While endometriosis is an uncomfortable and almost intolerable situation, it usually improves in time and a good integration of bioidentical hormone therapies on a conventional backdrop of surgical support, does help us make it to the next cycle.

Written By: Steven F. Hotze, M.D.

Steven F. Hotze, M.D., is the founder and CEO of the Hotze Health & Wellness Center, Hotze Vitamins and Physicians Preference Pharmacy International, LLC.


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