Disclaimer: The help I offer in this post is based mostly on observation of my patients whom I have had an opportunity to manage  and interact with over an extended period of time. I do not have any scientific evidence to support the conclusions I have drawn, and you should be sure to consult your individual provider(s) for personalized management.

DIET:
I recommend a diet emphasizing two components. First, your diet should reduce plant and animal sources of estrogen and estrogenic substances. Animals treated with ‘hormones’ to enhance animal growth rates and size may possibly contain estrogenic stimuli to existing endometriosis. There are also plant sources of ‘isoflavones’ and ‘phytoestrogens’ that may have the same potential effect. Think soy products, yams and the like.

Secondly, your diet should be of the ‘anti-inflammatory’ variety. There are a wide variety of these diets available to you online and I encourage you to look them up. The purpose of this component is to reduce the body’s inflammatory response to endometriosis. In theory, a reduction in the inflammatory response to areas of ‘endo’ might slow adhesion formation, swelling, vascular engorgement and micro-cellular influx.

SUPPLEMENTS:
The list of supplements my patients have tried is too extensive to discuss in detail here. However, I would like to mention:

Fish oil (be certain it is pharmaceutical grade): is a good source of omega-3 fatty acids. The anti-inflammatory benefits of omega-3s are well documented. Also, I prefer fish oil in liquid form. If your GI tract does not object, I would gradually increase daily intake up to 2 tbsp/day. Be sure to clear this with your regular doctor before initiating.

The B Vitamins:  are important aids to the metabolism of estrogens, and may also help in the conversion of fatty acids into the beneficial forms of prostaglandin.

HERBS:
I have followed many patients who have used herbal preparations on a regular basis and reported a better quality of life. Try them cautiously for intervals of time off and on to determine their value for you personally. Check with your primary care physician before initiating and be sure to rule out any interactions with current medications you may also be taking.

ACUPUNCTURE:
I have observed an inconsistent response to acupuncture in the patients that I have managed. Yet, I would suggest a trial for anyone anxious to see if pain relief or pain reduction can be achieved. I have never had a patient who tried acupuncture and had their endometriosis “disappear;” however, I have suggested it to patients as a means of possibly improving quality of life until ‘gold standard’ treatment can be obtained.

HOMEOPATHY:
For many years I have shared an occasional ‘endo’ patient with a Homeopath in Atlanta for whom I have great respect. Most of these patients have ultimately chosen ‘gold standard’ treatment. Yet, I can think of several who have bragged on their experience with homeopathy and wanted me to recommend it to others. By all means – give it a try. I have never cared for a patient whom I thought was injured by homeopathy, although, I have managed a few who wish they had not delayed surgical excision of all disease.

AROMATHERAPY:
For help with massage, calming, and meditative approaches, give it a try.

 

 

MASSAGE THERAPY:
Massage therapy comes in many forms, but I have observed many patients who have received benefit from one technique or another.

‘Pelvic floor’ physical/massage therapy can be an important adjunct to the gold standard treatment of ‘endo.’  Thankfully, it is not required by all patients. I will discuss pelvic floor changes in patients with endo in a later blog. For now, let me just state that after endometriosis is removed, the spasm in pelvic floor musculature may persist. A good pelvic floor therapist can usually reverse these changes over a period of time if there are no other ongoing reasons for this muscular spasm.

Caution: deep pelvic and lower abdominal massage is of some concern in specific situations. Yes, I do believe that deep massage is necessary in many kinds of back, hip and shoulder pain to achieve muscle relaxation, but if a large ovarian cyst is present, there is a small risk of cyst rupture. This happened to one of my patients who was attempting to delay definitive surgical treatment. She experienced an immediate increase in pain at the time of the massage and required an emergency Laparoscopy.

HEAT/COLD APPLICATION: COLD!
In my experience, most people suffering from an acute exacerbation of their pain benefit most from application of cold as directly to the area as possible. Cold tends to reduce blood supply and thereby reduce localized tissue swelling. Remember that ‘refrigerator cold’ is usually fine. ‘Freezer cold’ can be too cold and can actually create frostbite. Be careful.

HEAT/COLD APPLICATION: HEAT!
Heat can improve blood supply and speed healing where inflammation and swelling have occurred. Again, please be careful. Extremely high temperatures (such as achieved when a person puts a hot washcloth over the abdomen, covers it with a plastic moisture barrier, and then places a heating pad on top of that) can cause a permanent skin mottling in the area due to “fat dystrophy.” This is due to fat degeneration under their skin. Sadly, for some, the pain they experience with endometriosis is so intense that they choose a treatment that by itself is painful and destructive. They tell me ‘it is better than doing nothing.’

Alternating between cold and heat is a technique used for centuries to aid healing.

I will discuss my observations regarding pain relief approaches in a blog to come. Stay tuned!

Disclaimer: any and all material(s) presented herein are offered for informational purposes only. Such material is not intended to offer or replace medical advice offered by your personal physicians or healthcare professionals. No information herein should be considered as party to any doctor/patient relationship. All contents herein are © copyright by Robert B. Albee, Jr., MD except where otherwise explicitly noted. All rights reserved. This material may not be reproduced or utilized in any form, including electronic or mechanical, photocopying, recording, or by any information storage and retrieval system except for personal or teaching use with prior permission. Thank you.