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Hormone Testing

The importance of hormones for human health can’t be understated. The over 50 hormones in the human body act as chemical messengers that control most major bodily functions – from hunger, stress, mood and emotions to reproduction.

The body maintains an intricate balance of hormones, a state called homeostasis. When this delicate balance is challenged a wide variety of symptoms can occur – insomnia, fatigue, depression, anxiety, weight gain, acne, premenstrual syndrome, endometriosis, PCOS, diabetes, menstrual irregularities, and many, many more.

When identifying an unbalanced hormonal state, hormone testing can provide valuable information that will allow you to take steps to restore your optimal hormone balance, resolve symptoms, and restore optimal health.

Hormone Testing

Three important factors need to be considered when seeking testing for hormone balance.

            Timing of Testing

Time of day and time of month are important factors in getting valuable information from hormone testing. For most hormones, testing should be done first thing in the morning. An exception to this rule is cortisol, which is often tested at multiple points over the course of the day.

Time of month, or more accurately, time of the menstrual cycle, is also an important consideration for women. Generally hormones should be tested about one week before an expected period, when levels are at their peak.

Testing Sample Type

There are three main ways to test for hormone levels – blood (serum), saliva or urine. Each has it’s benefits and can be used, depending on the information needed.

Blood – a simple blood draw can give a great deal of information about thyroid hormones, insulin and blood sugar levels, vitamin D, prolactin, FSH and LH. It’s a quick process with well established reference ranges. However, it’s not considered the best test for steroid hormones like estrogen and progesterone, as levels in the blood stream do not accurately reflect free hormone levels available for action in the body.

Saliva – a home saliva test kit will provide excellent information about the free hormone levels of many steroid hormones: cortisol, estrogen, progesterone, DHEAS and testosterone. This test is often considered the most accurate reflection of hormone balance in the body. The drawbacks to salivary testing are the less well established reference ranges and the lack of testing for hormone detoxification pathways.

Urine – a newer testing type for hormone balance, the dried urine test for comprehensive hormones (DUTCH), gives a good overview of the steroid hormones estrogen, cortisol, progesterone, testosterone, DHEAS as well as the metabolites produced when our body breaks down these hormones.

            Balance Over Absolute Values

The last important consideration for hormone testing is that the results of your hormone test should be interpreted by a practitioner with a great deal of expertise in hormone testing and hormone balancing. When looking at a hormone test the most important information is the balance between the different hormones, rather than the absolute values of each individual hormone. A low normal progesterone with a high normal estrogen results in the same symptoms as a normal estrogen and a very low (or abnormal) progesterone.

Hormones are responsible for a vast variety of functions in our bodies, and their imbalance is an important (and common!) cause of symptoms. If you suspect you may have a hormonal imbalance, book an appointment with your Naturopathic Doctor today to discuss your options.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Naturopathic Acupuncture

As a Naturopathic Doctor, I have received extensive training in Traditional Chinese Medicine (TCM) and acupuncture. TCM is a system of medicine that has been used to prevent, diagnose and treat disease for over 5000 years. It is based on the Eastern philosophy of “Qi” (life energy). Traditional Chinese Medicine seeks to balance the flow of Qi in the body in order to maintain health, treat illness and relieve pain.

Acupuncture is the use of very fine, sterile acupuncture needles inserted into specific points (acupoints) in the body to manipulate and control the flow of Qi. Acupuncture has been proven to be beneficial in the treatment of many conditions including joint pain, chronic back pain, digestive difficulties, menstrual irregularities, depression, insomnia, migraine and many others.

In my practice I use TCM and acupuncture for a variety of conditions, most notably fertility enhancement, IUI and IVF cycle support, female and male hormone balancing, menstrual irregularities, endometriosis, labour induction, menopause symptoms (hot flashes, night sweats), anxiety, depression, insomnia, headaches and digestive complaints (diarrhea, constipation, heartburn). Acupuncture is safe and effective for all adults, including pregnant women. Acupuncture provided by Dr. Lisa is covered by most extended insurance plans under Naturopathic Medicine.

Endometriosis in Adolescence

Endometriosis is one of the most common causes of menstrual pain in women in their 20s, 30s and 40s. Recently doctors and scientists have begun to recognize that symptoms of endometriosis can begin during adolescence and be a significant cause of menstrual pain in teens as well.

Unfortunately, endometriosis is often overlooked in teenaged girls – one study found that women with endometriosis symptoms starting before age 15 had to see a doctor an average of 4.2 times before it was correctly diagnosed. That was more than in any other age group!

This same study found that more than one-third of women with endometriosis had symptoms starting before 15 years of age.

Early diagnosis of endometriosis is important for teenagers. Only with proper diagnosis can these young women receive appropriate education on the future of their reproductive health and treatments that can minimize or eliminate their pain and preserve their future fertility.

How Do I Know if I Have Endometriosis?

6979261624_6407c5ac68The most common symptoms of endometriosis are:

  • Pain before and during your period
  • Pain with intercourse (only in sexually active teens)
  • Infertility

For many teen girls pain with intercourse and infertility are not issues that they experience, which makes diagnosis more difficult. Other signs of endometriosis include:

  • Bleeding prior to your period (spotting)
  • Back or abdominal pain during your period
  • Pain with bowel movements
  • Painful digestive upset

In teen girls one symptom to look for is painful periods that do not respond well to pain medications like aspirin, ibuprofen, Advil, Aleve or naproxen.

Most teen girls with endometriosis will experience pain away from their periods; less than 10% had period pain alone and over 90% have pain both with their period and at other times during the month.

If you suspect you may have endometriosis your doctor will recommend an ultrasound and possibly a procedure called a laparoscopy. During a laparoscopy a small incision is made in the abdomen. A surgeon will be able to insert a camera into this incision and see if endometriosis is present – some endometriosis lesions can also be removed during this procedure.

Treatment for Endometriosis in Teen Girls

Naturopathic Medicine and EndometriosisThere are many available treatments for endometriosis. When started soon after diagnosis appropriate treatments can preserve a woman’s fertility and significantly decrease pain.

The most common mainstream treatment for endometriosis in adolescence is the birth control pill, used continuously or monthly, combined with pain medications to manage pain.

Naturopathic treatments focus on treating the underlying issues associated with endometriosis, normalizing hormone balance, decreasing pain and inflammation, optimizing immune function and supporting the body through the diet. You can read more about Understanding EndometriosisNaturopathic Medicine and Endometriosis, Acupuncture and Endometriosis and the Endometriosis Diet, all written by Naturopathic Doctor, Dr. Lisa Watson.

If you are a teen who wants to treat her endometriosis, book a consultation now to get started.  You can make a big impact on your future health if you act now.

References

Ballweg ML. Big picture of endometriosis helps provide guidance on approach to teens: comparative historical data show endo starting younger, is more severe. J Pediatr Adolesc Gynecol 2003;16(3 Suppl):S21–6.

Rowe T. Endometriosis: Diagnosis and Management. J Obstet Gynaecol Canada 2010;7(32)

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

The Endometriosis Diet

Niels H. Lauersen, MD says in his seminal book Getting Pregnant that endometriosis is “one of the most devastating, if not frustrating, of all gynecological ills”. 1 in 10 women suffer from the pains and frustrations of endometriosis, and there is no cure.

Despite this lack of cure, there is a lot that can be done to decrease the painful symptoms of endometriosis, prevent worsening of the endometrial growths, and support future fertility.

The first step in managing your endometriosis is to follow the Endometriosis Diet.

The Endometriosis Diet

The purpose of the Endometriosis Diet is multiple:

You can start the Endometriosis Diet soon after diagnosis, or at any time. This diet can help control the growth of endometriosis that has already appeared, decrease pain and other symptoms and in some cases prevent endometriosis from occurring at all.

Endometriosis Diet: Foods to Avoid

  1. Avoid alcohol

Alcohol depletes B vitamins that are necessary for hormone detoxification. It also has estrogen-like effects on the body and can worsen endometriosis symptoms.

  1. Avoid refined sugarFighting Sugar Addiction

Sugar is another culprit that can increase estrogen levels. It is also known to negatively impact immune function. Fruit is fine, but avoid all sources of refined sugars.

  1. Avoid caffeine

Women consuming two cups of coffee per day have twice the risk of developing endometriosis.

  1. Avoid red meat, especially grain-fed

Red meat is a rich source of arachidonic acid – which promotes production of inflammatory prostaglandins and increases inflammation and pain. Additionally, cattle and pigs fed grains treated with pesticides tend to concentrate these hormone-disrupting chemicals in their fat and muscle tissues. Consumption of these meats is a leading source of human exposure to organochlorines.

  1. Avoid dairy products

Dairy products are another potential source of hormone-disrupting chemicals, like the organochlorines. Organochlorines also impact the function of the immune system, weakening natural killer (NK) cell activity. Additionally, high fat dairy products may promote estrogen dominance, accelerating the growth of endometriosis.

  1. Avoid gluten

A 2012 study started 200 women with endometriosis on a gluten-free diet. 75% of the women reported an improvement in pain and none reported an increase in pain. All patients reported improved vitality and general health as well.

  1. Avoid refined and hydrogenated oils

Refined and hydrogenated vegetable oils contain omega 6 fatty acids that compete for absorption with anti-inflammatory omega 3s. Avoid canola, safflower, sunflower and so-called “vegetable” oils.

  1. Limit eggsFertile Cervical Fluid Testing

Eggs are a source of arachidonic acid and their consumption should be minimized.

  1. Limit peanuts

Another rich source of arachidonic acid. Healthier nuts include almonds, hazelnuts, pistachios, walnuts and cashews.

     10.  Avoid food sensitivities

Food sensitivities can contribute to inflammation, intestinal permeability and immune system disturbances. Food sensitivities are very individual – blood testing is generally recommended to identify what foods may causing negative effects in your body.

Endometriosis Diet: Foods to Enjoy

  1. Organic fruits and vegetables

Fruits and vegetables provide fiber that support healthy digestive function as well as nutrients to support immune function, detoxification and decrease inflammation. Women who consume two servings of fruit per day have a 20% decreased risk of endometriosis. Selecting organic fruits and vegetables will minimize intake of pesticides that disrupt hormone function.

  1. Vegetarian proteins

almonds are a source of calciumWomen who eat a vegetarian diet excrete 2-3 times more estrogen in their feces and have half as much estrogen in their blood as meat-eaters. Focusing on eating soy, almonds and other nuts and nut butters, beans, lentils and legumes.

  1. Fish

Fish, especially cold-water fish like salmon and mackerel, are a rich source of anti-inflammatory omega 3 fatty acids. Two servings per week is the ideal recommendation – more than this can result in undesirable exposure to PCBs and other environmental contaminants.

  1. Flax seeds

Another rich source of omega 3s, ground flax seeds also contain lignans that provide an ideal source of fiber to support digestion and healthy bacteria balance.

  1. Cabbage family vegetables

brussels sprouts are goitrogenicThe Brassica (cabbage) family of vegetables support detoxification and encourage a healthy estrogen balance by favouring production of the less active form of estrogen. Consume broccoli, brussels sprouts, cabbage, kale, kohl rabi and cauliflower regularly to reap these benefits.

  1. Leafy green vegetables

Leafy green vegetables provide key minerals for detoxification and support liver function. Frequent consumption of leafy greens (two servings per day) has been shown to significantly decrease the incidence of endometriosis.

  1. Onions, garlic and leeks

These vegetables contain organosulfur compounds that enhance immune function and induce enzymes that detoxify the liver. They are also rich sources of quercetin, a bioflavonoid that stimulates the immune system and decreases inflammation.

  1. High fiber foods

High fiber foods are incredibly important for endometriosis because they support the optimal balance of friendly bacteria in the digestive tract. Friendly bacteria support the elimination of estrogen in the feces. Focus on fiber in the form of vegetables, fruits and whole grains such as barley, quinoa, millet, brown and wild rice.

  1. Fermented foods

Fermented foods support estrogen balance by providing a food source of friendly bacteria. Olives, pickles, sauerkraut, kimchi, miso, tempeh and kombucha are excellent, delicious options.

Spices contribute to health     10. Spices

Spices such as ginger and turmeric are powerful anti-inflammatories and also support liver detoxification. Use them liberally throughout the day.

Far More Than Food

Following the Endometriosis Diet is going to improve more than just your endometriosis symptoms. It will likely improve your overall health and vitality as well. This is a healthy, whole-foods based diet that can help you feel great, inside and out.

Diet isn’t the only important aspect of endometriosis treatment. Other articles on this website cover Understanding Endometriosis, Acupuncture for Endometriosis, Endometriosis and the Immune System, Endometriosis and Infertility, Endometriosis in Adolescence and Naturopathic Treatment of Endometriosis. Read on, and if you’re ready to take a well-rounded, holistic approach to your endometriosis, feel free to book an initial consultation to get started.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Gluten-free diet: a new strategy for management of endometriosis related symptoms? Minerva Chir. 2012 Dec:67(6):499-504.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Naturopathic Medicine and Endometriosis

Endometriosis is a chronic condition affecting millions of Canadian women. It can begin at any age between the teens and 40s and impacts between 10-15% of women in these age groups.

There is no cure for endometriosis, but Naturopathic Medicine can offer women with this condition hope for improved hormone balance, decreased pain and support for fertility.

Prior to reading this article, I suggest you check out Understanding Endometriosis to learn how to recognize the symptoms of endometriosis and the underlying imbalances that lead to this frustrating condition.

Naturopathic Treatments for Endometriosis

A Naturopathic treatment plan for endometriosis will be highly individualized to each person, addressing their unique lifestyle, dietary and symptom needs. The treatment goals vary person to person, but always include a combination of the following:

  • Normalize the function of the immune system
  • Balance hormones
  • Support liver detoxification of hormones
  • Reduce and block pro-inflammatory chemicals produced by the body
  • Support the large intestine and microbiome (healthy bacteria)
  • Decrease stress

Vitamin CBy addressing these underlying imbalances in endometriosis Naturopathic Doctors can improve the overall health of women with endometriosis, decrease or eliminate symptoms of endometriosis and address the underlying cause of endometriosis.

Normalize Immune Function

There are many nutrients involved in healthy immune function. One of the largest categories of immune supportive nutrients are the antioxidants. Nutrients like vitamin C, beta carotene, vitamin E and selenium all enhance immune function and can be used to support endometriosis treatment. Many of these nutrients also decrease inflammation and can improve pain associated with endometriosis.

Vitamin D, an incredibly important nutrient for Canadians, has profound impacts on endometriosis. Vitamin D regulates cell growth and differentiation in endometriosis, enhances macrophage action and decreases inflammation. Vitamin D supplementation has been found in studies to reduce the weight of endometriosis lesions as well.

Balance Hormones

hormone balanceEndometriosis is a hormonally responsive condition – the growth of the endometrial lesions occurs under the influence of estrogen – so balancing hormone levels is an important treatment goal for all women with endometriosis.

Phytoestrogens, such as lentils, flax seeds and soy, can bind to estrogen receptors and have a less potent effect than our body’s own estrogen. When these phytoestrogens are bound to receptors they displace our own estrogen resulting in a lower estrogen effect overall. These foods should be incorporated into our diet daily for optimal hormone balancing effects.

Indole-3-carbinole and DIM (di-indolylmethane) from brassica vegetables are also estrogen regulating supplements that act much like phytoestrogens by binding estrogen receptors and decreasing our body’s estrogen response. Your Naturopathic Doctor may recommend these supplements, or recommend increasing consumption of broccoli, cauliflower, cabbage and brussels sprouts for hormone balancing in endometriosis.

Reduce Inflammation

Grapes are a source of resveratrolMany of the most profoundly effective treatments for endometriosis work by reducing inflammation in the body. Pycnogenol, a pine bark extract, has anti-inflammatory, immune supportive and anti-growth properties. Studies have shown significant improvements in pain symptoms in women using pycnogenol.

Resveratrol, a substance found in the skin of grapes, is especially beneficial for women with endometriosis and infertility. Resveratrol can decrease inflammation, reduce proliferation of endometrial lesions and protect eggs from the effects of aging.

N-acetyl cysteine (NAC) is one of the most promising treatments for endometriosis. Studies have found immune function improvements (increases in T regulatory cells, decreases in TNF-alpha), significant decreases in inflammation (including increases in glutathione – a cellular anti-inflammatory) as well as reduces in the size of existing endometrial lesions.

Support Liver Detoxification

The liver is essential for hormone balance as it is where our body detoxifies estrogen and prepares it for elimination. B vitamins are necessary for this function, allowing the liver to more efficiently inactivate and process estrogen.

Nutrients known as lipotropics also promote liver function by promoting the flow of fat and bile (containing estrogen for elimination) out of the body through the large intestines. Choline, betaine, methionine and dandelion are all prime examples of lipotropics that can be used to enhance liver detoxification in endometriosis.

oatmealSupport Large Intestines and Healthy Bacteria

Our body eliminates estrogen by attaching it to a carrier molecule (glucuronic acid) and excreting it through the bile into the stool. Unfriendly bacteria in the large intestines can prevent our ability to eliminate estrogen by breaking this bond between estrogen and it’s carrier. This estrogen is then recycled back into our body, resulting in higher circulating levels of estrogen.

We can modify this action, and support healthy hormone levels, by following the Endometriosis Diet which emphasizes healthy fiber and avoidance of unhealthy fats. Probiotic supplements can also be used in some cases to encourage healthy bacteria balance.

Decrease Stress

Stress occurs frequently in our fast-paced society, but we know that unhealthy levels of stress, or poor adaptation to stress is linked to decreased immune function and may trigger the kind of biochemical imbalances that lead to endometriosis. Studies have demonstrated that endometriosis grows more rapidly, or recurs faster and in greater quantities, during times of extreme emotional stress.

Breathing exercises, physical exercise, yoga, meditation, mindfulness, good quality sleep and adaptogenic herbs and supplements can decrease your stress response and help you to manage your endometriosis, naturally.

Not All Nutrients Are Beneficial

Just because it’s natural, does not mean it’s safe. It is strongly recommended to consult with a Naturopathic Doctor to develop a safe and effective endometriosis plan that will address your concerns and give you the best chances for success.

Additionally, some nutrients may negatively impact endometriosis. L-carnitine, an amino acid, was shown in one study to induce a condition resembling endometriosis with accompanying infertility when give to young female mice. We are not sure of the impact this may have on humans, but a cautious approach is recommended.

Treating Endometriosis

Understanding EndometriosisTo take a fully empowered, knowledgeable approach to your endometriosis I recommend you read the other articles written by Dr. Lisa Watson, ND on endometriosis: Understanding Endometriosis, The Endometriosis Diet, Endometriosis and the Immune System, Acupuncture and Endometriosis and Endometriosis and Infertility.  If you are ready to take the next step, book a complimentary 15 minute meet-and-greet appointment with Dr. Watson, or book an initial consultation.  You can feel better! Get started now.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Kohama T, et al. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. Journal of Reproductive Medicine; 2007:52(8),703-8

Vassiliadis S, Athanassakis I. A “conditionally essential” nutrient, L-carnitine, as a primary suspect in endometriosis. Fertil Steril. 2011 Jun 30;95(8):2759-60.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Acupuncture and Endometriosis

Millions of women across Canada suffer from endometriosis – a condition where endometrial cells are found in locations outside of the uterus. For most women this means pain, sometimes debilitating, before and during their periods. For some it also means pain with intercourse, pain during ovulation, pain during bowel movements, back pain, abdominal pain, pain, pain, PAIN. Women with endometriosis often report such high, prolonged periods of pain that they lead to exhaustion, depression and anxiety.

So what is a woman with endometriosis to do? There is no cure, surgery is somewhat successful but has recurrence rates up to 74%, and hormone therapies can have terrible side effects.

It’s not surprising that many women are looking to acupuncture for pain relief, and many are finding it.

Endometriosis and Traditional Chinese Medicine (TCM)

TCM fertility treatment TorontoIn Traditional Chinese Medicine diagnosis is made based on symptoms and categorized based on eight principles (yin and yang, empty and full, etc). Two women, both experiencing endometriosis, may be diagnosed differently based on their symptoms – where and when pain occurs, colour and texture of menstrual blood, aggravating and relieving factors, and others. Naturopathic Doctors are trained in TCM diagnosis and will individualize acupuncture plans for their patient based on their unique symptoms and experience of endometriosis.

The most common TCM imbalances that are found in endometriosis are:

  • Blood stasis
  • Qi stagnation
  • Spleen Qi deficiency
  • Damp heat stagnation and stasis
  • Kidney Yang deficiency

While these terms may sound unusual or exotic, they are just names for clusters of symptoms and provide guidance for the development of an acupuncture treatment plan.

Acupuncture for Pain

The main reason women with endometriosis seek out acupuncture is to help with pain management before or during their menstrual cycles, or during ovulation.   Acupuncture has been recognized for it’s ability to manage different types of pain by organizations around the world, include the World Health Organization (WHO).

Acupuncture has many different positive effects on pain – it improves local and systemic blood flow, decreases inflammation, decreases stress, regulate the production of prostaglandins and promotes production of endorphins, substances which alter our perception to pain.

It is also a safe and painless procedure that can be used on the vast majority of women without any negative side effects.

Acupuncture for Fertility

Acupuncture for endometriosisHalf of all women presenting at fertility clinics are diagnosed with varying degrees of endometriosis. For these women, treatment options are limited because of the potential negative outcomes on fertility that can result from hormonal treatments (and hysterectomy!)

The most common prescription for pain management with endometriosis is non-steroidal anti-inflammatory drugs. These NSAIDs may provide some women with adequate pain relief, but others may continue to suffer. For women trying to conceive with endometriosis they pose an additional concern – NSAID use has been associated with luteinized unruptured follicle (LUF) syndrome – a condition where the follicle does not rupture to release an egg at ovulation.  The pain management provided by acupuncture does not interfere with normal ovulation and can preserve fertility better than NSAID use.

Acupuncture also has it’s own benefits for improving fertility. It enhances blood flow to the ovaries and uterus, decreases stress and supports hormone balance. You can read more about the use of acupuncture for fertility in this article.

Beyond Acupuncture

Naturopathic Doctors are licensed to provide acupuncture in Ontario under their ND license. The benefit of seeing an ND for your endometriosis is the holistic approach they take to health care. Your ND will individualize a treatment for specifically you that may include dietary recommendations, herbal remedies, nutritional supplements, and lifestyle modifications in addition to acupuncture. You can also learn more about the naturopathic approach to endometriosis in the articles The Endometriosis Diet, Endometriosis and the Immune System, Understanding Endometriosis and Endometriosis and Infertility, or if you are ready to get started today, you can book an initial consultation and start on your road to better health.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Acupuncture for pain in endometriosis. Cochrane Database of Systemic Reviews: Plain Language Summaries [Internet]. 2011.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

 

Endometriosis and the Immune System

Endometriosis results when rogue endometrial tissue implants outside of the uterus. One of the leading theories behind the development of endometriosis is that retrograde (backward) flow of menstrual blood spills out of the fallopian tubes and implants on the fallopian tubes, ovaries and other areas. But studies have shown that nearly all women experience some degree of this backward flow – why do only 1 in 10 women develop endometriosis?

The answer, it seems, may lie in the immune system.

Immune Surveillance

When the immune system is functioning optimally, retrograde menstrual flow is met by a swift immune response, destroying the renegade tissue before it has a chance to take hold and grow. When there is a malfunction in this immune system surveillance the endometrial tissue is able to implant on the nearest organ and grow.

So what causes this disruption in immune surveillance? It’s hard to say. Scientists don’t necessarily agree – diet, stress, estrogen dominance, auto-immunity? Likely some or all of these factors contribute to the development of endometriosis in individual women.

Lacking a Killer Instinct

Endometriosis and immune functionScientists have identified several different immune system changes associated with endometriosis. The first is a suppressed natural killer (NK) cell activity. NK cells are tasked with keeping tumour and other abnormal cells in check by releasing cell toxins.

Not surprisingly, this decrease in NK cell activity results in decreased immune surveillance and defense against the invading rouge endometrial tissue.

We know from our scientist friends that there is a strong correlation between high levels of estrogen – also known as estrogen dominance – and decreased NK cell activity. Managing estrogen dominance is a key feature of treating endometriosis because the endometrial cells respond to estrogen. Decreasing estrogen can also give these NK cells back their killer instinct.

More Macrophages!

Perhaps as a result of the shoddy surveillance by NK cells, the pelvic cavity and fallopian tubes of women with endometriosis have higher than normal levels of macrophages – the immune cells that attack and consume foreign cells like viruses and bacteria. Macrophages release cytokines, hormone-like substances that kill sperm (unfortunately for women with endometriosis and infertility) and trigger inflammation.

Increasing Inflammation

Macrophages and cytokines are joined in endometriosis with high circulating levels of interleukins, T lymphocytes and tumour necrosis factors – all with the same end result – more and more inflammation. Targeting these pro-inflammatory immune cells and decreasing their activity with anti-oxidants and anti-inflammatories is one of the most promising treatment strategies for endometriosis.

Auto-Immunity

As if that wasn’t enough. High levels of immunoglobulins are also found in endometriosis. Specifically we see increases in autoimmune immunoglobulins or auto-antibodies – immune cells that cause destruction of the body’s own tissue. In the case of endometriosis we see high levels of these auto-antibodies against ovarian and endometrial cells. Evidence of our immune system trying to make up for it’s poor surveillance perhaps.

Beyond Immune Function

Endometriosis and InfertilityThe immune system malfunctions associated with endometriosis are numerous, and give us key opportunities for addressing and managing this debilitating and frustrating condition. In other articles we will be looking at Understanding EndometriosisEndometriosis and Infertility, The Endometriosis Diet, Acupuncture for Endometriosis and Naturopathic Approaches to Endometriosis. Read those for further insight, or consider booking an initial consultation to start healing your endometriosis and mastering your immune system.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.