This is one of the many questions I had in my mind when I first learned about my condition.
They both have their place in
preventing conception, and both are responsive to estrogen fluctuations. There
is no western cure for either, except hysterectomy. Eastern medicine, however,
gives them a common denominator - they are both considered processes of
inhibited, stagnated uterine blood which doesn't flow freely. The menstruate
has become blocked, and the normal process has become obstructed. Women with
either of these conditions often experience a sediment-like menstrual flow with
dark, brown, clotted, blood which has been allowed to oxidize. The rest of the
body responds and the immune system reacts to this silty, old blood. Our
neuroendocrine awareness is heightened. Remember, our body's immunologic
priority is to keep us safe from external or internal insults. It recognizes
the toxic state and mounts chemicals to clean up this debris. It knows that a
fetus won't survive in this environment.
Luckily, both conditions respond very well to Chinese medicine. Given time and
the proper treatment, the blood flow will improve, the sediment will clear, and
the body will overcome its immunologic protective mechanisms. Our
psycho-neuro-endocrinologic system will settle down. Our body can relax and
allow conception to take place.
Endometriosis
Endometriosis is described as the abnormal growth of endometrial tissue outside
the endometrium. Endometrial cells are those that are found in the uterine
lining. When those cells are found in areas outside of the uterus, the
diagnosis of endometriosis is made. Although the disease has been present
throughout history, it was first identified in 1860. In 1960 the disease
mechanism was first described because of the discovery and use in France of the
laparoscope. Endometriosis is therefore a surgical diagnosis. Modern science
does not know why endometrial cells are found elsewhere. One theory of its
origin is explained by retrograde menstruation. When a woman is supposed to
menstruate and blood should be discharged vaginally, it backs up through the
tubes and into the abdominal cavity. Yet this happens in most women, and most
women do not have endometriosis. Another hypothesis is that anatomic
abnormalities such as retroverted uteri and small cervical openings do not
allow the blood to pass through freely, and it therefore backs up into other
areas of the pelvis.
 |
| Endometriosis |
Another theory of the causative origins of endometriosis is that other cells
outside of the uterus are transformed by some unknown stimulus into endometrial
cells. Whatever the etiology, the misplaced endometrial cells then respond to
hormonal stimulus just like the endometrium is supposed to. But, during
menstruation there is no way for this menstrual blood to leave the body. Pain,
sometimes very severe, is the result. Prostaglandins are said to be the
causative factor in menstrual pain. Painful periods are an indication of
possible endometriosis, and women with endometriosis have higher levels of
certain of the prostaglandins. The bleeding tissue may also cause adhesions and
scar tissue.
Common sites of endometriosis include the cervix, the vaginal-rectal space,
ovary, fallopian tubes, colon and bladder wall.
Common accompanying symptoms include dysmenorrhea, pathological uterine
bleeding, and bleeding at sites other than the endometrium during menstruation.
Some women bleed at sites as distant as the nasopharynx during menstruation and
get nosebleeds during the menses. Endometriosis is classified as to its
severity.
Mild endometriosis - implants are small, flat patches of endometrial tissue
growing outside of their normal location.
Moderate endometriosis - includes "chocolate cysts" of endometriosis
may be smaller than a pea or larger than a grapefruit, located within the
ovary.
Severe endometriosis - in some cases, bands of fibrous scar tissues
(adhesions) bind the pelvic organs together.
Interestingly enough, except for the obvious mechanical obstruction found in
severe endometriosis, there seems to be no real correlation between the
severity of endometriosis and its impact on fertility. However, as many as half
of the women who have been diagnosed with infertility are found to have endometriosis
on laparoscopic examination.
Some women, in fact, have no symptoms at all, and diagnosis is only made
through laparoscopy. Symptoms which may accompany endometriosis include
abnormally heavy bleeding, associated with back pain or severe abdominal
cramping, painful intercourse, painful intestinal upset or urination during the
menstruation, and the inability to become pregnant.
Western medical treatment usually includes pain relieving medication,
laparoscopy and laser removal of the endometrial tissue. Other drugs may be
used to control the hormonal stimulation of the endometriosis. As menstruation
ceases each month, the misplaced endometrial tissue will be starved of hormonal
stimulus, and thus mollify the endometriosis response. Of course, ovulation is
also halted in this process, which defeats our present purpose.
The Traditional Chinese Medical View and Treatment of Endometriosis
Endometriosis and Static Blood Endometriosis is not a disease category in
Traditional Chinese Medicine. However, our Eastern healers have recognized this
disease for far longer than its identification in Western medicine. It is known
by its symptoms and is referred to as menstrual movement pain. It is also very
amenable to natural forms of treatment.
The Jin Gui Yao Lue (Essentials from the Golden Cabinet), "Women's
Miscellaneous Diseases' Pulse, Pattern & Treatment" chapter, has this
description: "The menstrual blood is inhibited and there is (resulting)
lower abdominal fullness and pain."
Chinese medicine categorizes endometrial lesions as static blood, or blood
which is not flowing as it should, and thus causes problems. This is not so
different from our Western understanding of the same disease. Since the
maligned blood is located in an vicinity where normal blood flow is often
absent or minimal, our body has a tougher time resolving it. The Chinese
therefore say that these conglomerations of static blood have entered the
network vessels, which are more difficult to reach. This is one important
aspect in how we will approach this syndrome.
Other countries throughout the rest of the world recognize endometriosis as an
autoimmune disease. The famous gynecologist Dr. Ni reported that in her
experience as a M.D. gynecologist in China, most women upon whom she performed
laparoscopies had some degree of endometrial tissue outside of the uterus,
which was found at various locales throughout the abdominal category. What sets
aside women with fertility impaired endometriosis is the "osis" or
inflammatory reaction which has resulted from the presence of the endometrial
tissue outside its original intended site.
The inflammatory reaction which the body has set up in response to the
endometrial tissue in an attempt to "clean it up", makes the immune
system reactive to the cells that make up the uterine lining. The fault then
begins to reside in the immune system, which is unable to eradicate the
misplaced tissue. The immune system then loses its discriminatory control, and
can't distinguish between self and non-self. As far as fertility is concerned,
this creates a toxic environment in the uterus, not conducive to an implanting
embryo.
An immunopharmacological study of an antiendometriotic herbal medicine known as
Gui Zhi Fu Ling Wan, was conducted by four researchers at the Osaka City
University Medical School in Japan.
The patients with endometriosis were found to have elevated serum levels of
Immunoglobulin M antibody titers. A control group was treated with leuproride
acetate therapy to suppress hormonal production (a common western approach for
endometriosis is to suppress the hormonal stimulus). The treated group was
given the antiemdometriotic herbal formula Gui Zhi Fu Ling Wan, which consists
of Ramulus Cinnamomi Cassiae, Sclerotium Poriae Cocos, Radis Paeoniae, Cortex
Moutan Radicis, and Semen Persicae. This formula was historically used in China
to treat bleeding during pregnancy due to blood stasis in the womb, or to
prevent miscarriage. Later indications include the treatment of immunologic and
inflammatory conditions of the uterus including dysmenorrhea, leiomyomas
(uterine fibroids), ovarian cysts, chronic pelvic inflammatoy disease and
salpingitis, and endometriosis.
The lupron treated group had lowered levels of estradiol, but no change in the
IgM antibody titer. The treated group had no changes in estradiol levels, but
the levels of IgM antibody titer were decreased and the patients were kept
symptom free for months.
From, "A Study on the Treatment of Primary Dysmenorrhea with Jia Wei Mo
Jia Tang (Added Flavors Myrrh & Dragon's Blood Decoction) and Its Affect on
Prostaglandins and Related Factors" by Zhu Nan-Sun, Huang Hui, & Chen
Hui-Lin, Ahong Yi Za Zhi (The Journal of Traditional Chinese Medicine), #2,
1994, p. 99-101:
This article reports on the treatment of primary dysmenorrhea in 95 women who
were divided into two groups. One group received the herbal formula Jia Wei Mo
Jie Tang as treatment for their dysmenorrhea and the other group, which acted
as a control group, received indomethacin. In addition, serum levels of various
prostaglandins were compared before and after treatment with 30 women who were
considered normal. The authors begin this report by stating that the disease
mechanism related to primary dysmenorrhea is stasis. Therefore, Jia Wei Mo Jie
Tang's intended purpose is to invigorate the blood and transform stasis, break
the qi and move stagnation. However, from a modern Western medical point of
view, this treatment achieves its effect by regulating serum prostaglandins.
All 95 of the women in this study who received treatment suffered from primary
dysmenorrhea. The 30 women who were considered normal did not have any period
pain and had normal, biphasic basal body temperatures. Of those suffering from
painful periods, 87 cases had menstrual cycles which lasted from 25-35 days,
while eight cases had menstrual cycles lasting from 35-45 days. Four cases had
scanty menses, 56 medium menses, and 35 cases had excessively heavy menses.
Ninety women's periods lasted seven days or less and fivce cases lasted more
than seven days. In terms of the disease course, 31 cases had dysmenorrhea for
less than five years, 47 cases for five to ten years, and seventeen cases for
more than ten years. In addition, 20 cases experienced pain before the onset of
their periods, 89 during their periods, and two after their periods. Five had
previously had children and 90 had not been able. In terms of the severity of
their pain, 61 suffered from severe pain and 34 from moderate pain. And as for
their pattern discrimination, there were 49 cases of qi stagnation with blood
stasis, 17 cases of qi stagnation with blood stasis and accompanied by cold, 19
cases of qi stagnation with blood stasis and accompanied by heat, and 10 cases
of qi stagnation and blood stasis accompanied by vacuity.
Jia Wei Mo Jie Tang consisted of uncooked pollen typhae, Feces Trogpterori Seu
Pteromi, Pericarpiuym Citri Reticulatae Viride, Rhizoma Sparganii, Rhizoma
Curcumae Zedoariae, Fructus Crataegi, Resina Olibani, Resina Myrrhae, and
powdered Sanguis Draconis.
The 63 women in the group which received Jia Wei Mo Jie Tang were given 50 ml
of this decoction orally two times per day beginning two weeks before the due
date of their period as calculated by the rise in their basal body temperature.
Since administration was continued through the first day of their period, the
total number of days this decoction was administered each cycle was 15, and one
course of treatment equaled three months.
The 32 women in the group which received indomethacin were given this
medication beginning three days before the onset of their period or 12 days
after their basal body temperature went up. They took 25 mg. of indomethacin
orally, three times per day. Since they also took this medication during the
first day of their periods, they took imdomethacin for a total of four days per
cycle, and one course of treatment also lasted three months. The 30 normal
women did not receive any medication during the course of this study.
In the Jia Wei Mo Jie Tang group, before treatment, 39 had severe pain and 24
moderate pain. After treatment, two cases still had severe pain, 17 experienced
moderate pain, and 18 cases slight pain. In the indomethacin group, 22 had
severe pain and 10 moderate pain. After treatment 1 had severe pain, 9 moderate
pain, and 17 slight pain. Thus the amelioration rate for the Jia Wei Mo Jie
Tang group was 80.4% as compared to 73.3% for the indomethacin group.
In terms of serum analysis, there was a positive correlation between the
severity of dysmenorrhea and PGF 2a and PGE contents in the menstrual blood.
Jia Wei Mo Jie Tang substantially decreased the blood contents of and the ratio
between PGF 2a and PGE 2. Further, it markedly lowered the content of medium
phase E 2 ( a type of estrogen) secreted by the corpus luteum and found in the
peripheral blood but markedly increased the content of late phase progesterone
secreted by the corpus luteum. Indomethacin, on the other hand, demonstrated no
marked effect on estrogen or progesterone.
Categories for treating endometriosis, or dysmenorrhea are further divided as:
1. Qi
Stagnation
2. Damp heat
stasis and stagnation
3. Spleen qi
vacuity
4. Kidney
yang vacuity
5. Blood
vacuity
6. Mixed
Heat & Cold; Vacuity and Repletion - includes qi and or yang vacuity, blood
stasis and qi stagnation. [For this category, if it includes digestive
complaints and presentation includes a patchy tongue coating (geographic
tongue), the Prescription Wu Mei Wan has been found to be emperically
effective.]
In each case, the pattern must be treated, using dietary principles, herbal
categories and acupressure treatments based upon the diagnostic presentation.
Endometriosis is an enduring disease; stasis entering the deeper, network
vessels. When an enduring disease enters the network vessels it is wise to
employ the use of resins like frankincense and myrrh with treatment.
The Jing Yue Quan Shu ([Zhang] Jing-yue's Complete Writings), "Women's
Regulation: Blood Conglomerations" chapter states:
Static blood which is retained and stagnates eventually becomes concretions.
This pattern may be casued during the period or postpartum and may be due to
internal damage engendering chill, external invasion of wind cold, rage and
anger damaging the liver, qi counterflow and blood stagnation, long-standing
taxation, long-standing weakness, and qi weakness not moving [the blood.]
Therefore, sometimes the blood stirs and sometimes it has almost nothing. It
may also counterflow, thus leading to retention and stagnation which
accumulates for days, gradually becoming concretions.
The Zheng Zhi Zheng Sheng (Patterns & Treatments Proven Restraing),
"Blood Conglomerations" chapter states (paraphrased):
If there is gathering of blood conglomeration, there will be low back pain and
inability to bend, accumulation of qi below the pubic bone, stone-like
hardness, tension inside the lower abdomen, bitter pain, upper back spine pain
penetrating to and reaching the low back and abdomen, spasms within the vagina,
a secluded cervix, menstruation behind schedule. This disease is found in
people with infertility. If treatment precipitates the conglomerations, it can
be cured.
The above literary cites and endometriosis all share the same symptoms. In
endometriosis there is the production of nodulations and lumps within the body.
In TCM, this is related to blood gathering becoming stasis, and stasis
accumulation becoming concretions and conglomerations. Most often, the greatest
method for treating endometriosis is to quicken the blood and transform stasis.
In all cases, the underlying pattern must be treated as well.
Endometriosis is also correlated with a scenario of estrogen dominance.
Estrogen feeds endometriosis. Many women with endometriosis also have lower
levels of progesterone as well. It is therefore important to help the body
clear itself if excess estrogens. The liver metabolizes estrogen; therefore
using methods which resolve liver qi stagnation will assist the body in
clearing excess estrogen. Use stimulation on the acupuncture points Joining
Valley, located between the bulge between the base of the thumb and first
finger bone on each hand, and Great Rushing, found in the depression on the
foot approximately one inch up from the web between the big and second toes.
Uterine Fibriods
Uterine Fiboids or myomas are benign tumors found in approximately 20% of
women over 35 years of age. Uterine myomas are the most common neoplasm of the
female reproductive organs, and are associated with menstrual pain, heavy
menstrual bleeding, and fertility problems.
Fibroids may impair conception if they obstruct the uterine cavity or the
entrance into the uterus from the fallopian tubes.
One chinese study conducted by Zhongli and Shurong used Traditional Chinese
Medicinals to treat 223 cases of uterine fibroids. All patients had conspicuous
symptoms and were diagnosed clinically by pelvic examination and confirmed by
ultrasonography.
·
Treatment
was provided according to the diffentiation of the pattern of imbalance,
involving the principles of invigorating the blood and eliminating blood
stasis, clearing heat, and suftening the induration.
·
Those
diagnosed with yin deficiency and liver fire were also given herbs to supplement
the yin and clear liver fire.
·
Those
diagnosed with spleen qi vacuity were also given herbs to supplement the spleen
qi such as codonopsis and astragalus.
·
Medicinal
herbs were added for qi and blood stagnation.
·
The herbs
were administered after menstruation. The authors reported a 72% reduction in
the quantity of menstrual blood. Symptoms like abdominal pain, leukorrhea, and
backache were improved in 58.8%. The overall effectiveness rate was 92.4%.
Myomas completely disappeared in 13% of the cases, were markedly diminished in
29%, slightly reduced in 19%, and unchanged in 28%.
Acupuncture and acupressure are also recommended in the treatment of fibroids,
using those points recommended for blood stasis and the uterus. The stimulation
provided by the acupuncture has been found to induce the regression of
pathologic proliferating cells locally. Humoral factors at a distally
stimulated acupoint which control and prevent local overgrowth of regenerating
and proliferating cells (those that invigorate the blood) also systemically
affect the growth of distant tumors.
As with all Chinese Medical treatments, however, the most efficacious results
will result from treating the pattern. I treated a woman for a large fibroid
(the size of a grapefruit), and the tumor shrunk, only in response to tonifying
her spleen and resolving dampness. When I tried to invigorate the blood, I got
no effect at all.
Other Natural Treatments for Endometriosis and Uterine Fibriods
·
Rest and
wear loose, comfortable clothing
·
Perform
deep breathing exercises and meditative practices
·
Take warm
baths (with aromatherapy if you wish.)
·
Use
essential oils like frankincense, myrrh, clary sage, peppermint, lavendar,
rosemary, juniper and thyme.
·
Use a
heating pad or hot water bottle on your abdomen
·
Apply
warm castor oil packs on your abdomen to invigorate the blood, assist the
lymphatic symptom and balance hormone levels. Apply warm castor oil to the
lower abdomen and cover with plastic wrap two to three times per day during the
premenstrual and menstrual period.
·
Take
herbal supplements that invigorate the blood (and those for resolving
concomitant patterns as applicable.)
·
Avoid all
foods which have been treated hormonally.
·
Consume
soy and soy products like tofu.
·
Buy only
organic fruits and vegetables.
·
Avoid
refined, rancid and hydrogenated oils.
·
Use only
unprocessed plant sources of essential fatty acids.
·
Use oils
rich in both linoleic and alpha-linolenic fatty acids such as flax-seed,
pumpkin-seed and chia-seed oils, but only if they are recently cold-pressed and
refined.
·
Include
dietary spirulina, evening primrose oil, and oil from black currant and borage
seeds.
·
Avoid
sources of arachodonic acid, which comes from animal meats, dairy products,
eggs, peanuts and seaweed.
·
Decrease
the amount of dietary animal products, except fish.
·
If you do
consume meat, make sure it is at least organic, and not hormonally treated.
·
Eat
walnuts, dark greens, saffron and cold crimate crops.
·
Foods
which are especially good for resolving blood stasis include: Kelp, lemons,
limes, onions, irish moss, and bladderwrack.
Supplement your diet with antioxidants (vitamins C, E, beta carotene, selenium,
zinc) Include super-antioxidants (grape seed extract, pine bark extract, red
wine extract, bilberry extract), which contain procyanidins, caffeic and
ferulic acid, with demonstrated antiinflammatory and spasmolytic activity
(Kohama, M.D., and Suzuki, M.D.)
Fibroids and endometriosis benefit from the use of Omega-3 fatty acids in the
diet. Fish oil and linseed oil are good sources of these Omega 3 fatty acids.
Fish oil prevents abnormal blood clotting. If your menstrual blood contains
clotty tissue, supplement with fish oil, linseed oil and evening primrose oil
(which also contain gamma linolenic acid or Omega 6).
Meditation and Visualization for Blood Statis in the Uterus
Exercise 1 - for the follicular phase
Perform this exercise daily, between the first day of menstruation until
ovulation only.
Step 1. Lay down, on your back, with your eyes closed. Relax and breathe
deeply. Notice any areas of tension you feel in your body from your head to
your neck, down your arms and hands, through your torso, down your abdomen,
buttocks, thighs, calves and feet. Tense the tight areas in your body even
more, one by one. Breathe in, inhaling deeply down into your lower abdomen.
Push your stomach out as you breathe in. Focus your attention on the tension in
your body, then tighten the muscles in the area even more, and relax them fully
as your exhale. Exhale all the way, deflating your abdomen when you breathe
out. Breathe the tension in your body out through the breath.
Focus your attention on the tension, the breath, and the relaxation. Nothing
more. When the tension in that particular part of your body is gone, move on to
the next part. When you feel relaxed throughout your body, and your mind is
clear, begin the visualization. Continue the deep breathing exercise, breathing
deep into your abdomen and relaxing with each exhalation.
Step 2. Now focus the breathe down into the pelvis. Breathe into your
uterus. Let the uterus draw the breath in itself. Let these breaths be cleansing.
The uterus has one energetic function. It is downward. It takes the blood and
the breath in through the top, and lets them out downward through the bottom.
Think of the uterus as a receptive, sponge-like organ. It draws in blood and
energy through the breath to prepare a garden-like home for implantation.
Picture a lush, green, mossy garden. With every breath in, you bring purifying
energy in through the top of the uterus. With every exhalation, breathe out any
impurities downward through the bottom of the uterus. Any pain, any toxins, any
impurities are released downward, with each breath. You are helping to prepare
these luxurious surroundings for implantation. This is a pure, flourishing,
abundant home. It is open, receptive, and fertile. It cannot afford to foster
toxins. Release them. When your uterus feels pure, open and receptive, you are
finished.
Exercise 2 - for the luteal phase
Practice this meditation and visualization from ovulation until menstruation
begins.
Perform Step 1 as above.Practice this meditation and visualization from
ovulation until menstruation begins.
Step 2. Breathe in very deeply, and concentrate on bringing your breath
from your nose and down the midline of your body, between the breasts, down the
abdomen, and eventually focusing your breath down to the region two inches
below your navel. This is called the Dan Tien. Let the breath energy pool here.
At the end of inhalation, bring the focus from the area below your navel down
to the uterus. Breathe in cleansing, purifying breaths to the uterus and then
down to the perineal muscles. Perform a kegel exercise, tightening the perineal
muscles. This should be a smooth, continuous movement, with cleansing breaths
inward. Concentrate on the uterine lining. It is pure, lush, and fertile. It is
receptive. Each breath brings fresh, clear energy into the uterus, reviving it
with healthy, fertile lining. When you release the kegel, begin exhalation.
During exhalation, turn the focus of your attention from the uterus back to the
tip of your tailbone, then up the spine to the top of the head. Your
concentration now is on the upward movement. Exhalation should end focusing
your attention down the midline of the head and out the nose. Repeat from the
beginning of step 2 with each new inhalation, until the process becomes one
smooth, continuous movement.
About the Author
Randine Lewis, MSOM, L.Ac., Ph.D., a licensed acupuncturist and herbalist, has
studied both Eastern and Western medicine. After suffering from
"infertility" herself, she earned her graduate and post-graduate
degrees in Acupuncture and Oriental Medicine, always focusing on fertility
enhancement. In addition to resolving her own fertility issues, she has helped
thousands of women throughout the world - with natural, health enhancing
methods. She lectures, and publishes articles for RESOLVE, the American
Infertility Association, and medical organizations, and is a medical expert on
numerous online fertility boards.
Dr. Lewis authored "The Infertility Cure, the Ancient Chinese Wellness
Program for Getting Pregnant and Having Healthy Babies", and has appeared
on multipe radio and television shows throughout the country, all featuring her
successes in helping women conceive with Traditional Chinese Medicine.
She now offers her phenomenal treatment methods, combined with the mind-body
medical program for overcoming infertility in her fertility enhancing retreats,
which take place in Austin, Texas at The Crossings in 2006. Each patient
receives a thorough Eastern medical evaluation, and dietary, nutritional and
herbal plans based upon this individual diagnosis.
For details regarding retreats or Dr. Lewis' speaking availability, please
visit www.thefertilesoul.com or call 713-869-8842.
