Endometriosis: Can Acupuncture Help End The Hidden Suffering Of MillIions Of Women
On Tuesday the Guardian published an interesting article on endometriosis. Often dismissed as ‘women’s troubles’, it affects one woman in 10 of reproductive age, yet a lack of research and funding means sufferers can live in severe pain, unable to work or socialise.
The Guardian reveals the hidden toll and extraordinary neglect of a disease that affects an estimated 176 million women around the globe, causing many to suffer a life of pain and debilitation and sometimes infertility.
It is estimated that one woman in 10 of reproductive age has endometriosis, and yet often their primary care doctors do not know what it is and the specialists to whom they are sent are ill-informed.
Vast numbers of women are under-treated or badly treated. It can take years to get a diagnosis and during that time women may suffer severe pain and are unable to work, socialise or maintain a sexual relationship.
So What Is Endometriosis?
The disease does not always have symptoms and may be the cause of half of all unexplained infertility. It occurs when tissue similar to the lining of the womb is found elsewhere – most commonly in the abdomen, ovaries, in the recto-vaginal septum, bladder and bowel. That tissue behaves like the lining of the womb, bleeding every month, and can cause cause severe and chronic pain .
The lack of research and funding for a disease that affects so many women is “a major scandal”, said Lone Hummelshoj, who heads the World Endometriosis Research Foundation and the World Endometriosis Society.
“Endometriosis affects women in the prime of their life. It is not a lifestyle disease. It is not a disease you get later in life. It attacks teens, young women when they should be out being active, working, having children, having sex – 50% of them are struggling with sex because it is too painful,” she said.
The Guardian article includes 20 things every woman (and every doctor) should know about endometriosis. In brief it has exacted a massive social cost in broken marriages and depression as well as being a huge economic burden, partly because of the large number of women who have to drop out of the workforce. The numbers are comparable with diabetes- and yet there is only a fraction of the awareness of the condition and help for those afflicted.
Endometriosis can be mild or so severe that it takes over a woman’s life. Former Spice Girl Emma Bunton, Dolly Parton and Anna Friel all have endometriosis. So does Booker Prize-winning author Hilary Mantel and actors Susan Sarandon and Whoopi Goldberg. Marilyn Monroe is thought to have become addicted to the painkillers she took for endometriosis, which resulted in her death.
Experts say the disease is little known. “The people we have polled have never heard of it,” said Jane Hudson Jones, chief executive of the charity Endometriosis UK. “I have never come across anybody in the general public who knows about it. Yet it can be absolutely devastating.” Surveys of their own membership showed that 25% had felt suicidal because of it. “It can affect pretty much every area of your life – your work, career, income, relationships and fertility. And many are constantly in pain.”
The article describes the experiences of sufferers having to give up successful careers after extensive surgeries did not heal well. In one case it took 20 years to get a diagnosis, by which point the disease was advanced.
Women who are lucky enough to have a primary care doctor who recognises the symptoms are referred to a gynaecologist. The only way to diagnose the disease is through a laparoscopy – keyhole surgery that allows the clinician to view the endometriosis.
But most gynaecologists do not have the specialist training to remove the tissue they see, which in severe cases is often very difficult to access. It often involves the bowel or bladder, which are not parts of the body gynaecologists usually deal with. Organs can be fused together. Women tell of having hysterectomies and the wholesale removal of ovaries and parts of the bowel and bladder, and yet some diseased tissue remains stuck to nerves and the pain continues.
Geoff Reid in Australia, one of the leading experts, believes the disease may be getting more aggressive.
How Does It Affect Fertility?
IVF has meant that women with endometriosis who want children have a good chance of having them.
But a study in 2008 by the Belgian gynaecologist Thomas D’Hooghe suggested that endometriosis may be a huge factor in infertility. D’Hooghe’s team carried out laparoscopies on 221 infertile women who had no obvious symptoms. “These were women who regarded their period pain as being normal and 47% of them had endometriosis and 40% of those had stage three and four disease,” said Reid.
“I find that extraordinary. You can have women with really quite bad endometriosis who are essentially asymptomatic, which means putting a handle on the prevalence of endometriosis very difficult.”
Reid says it is really important that women facing surgery for endometriosis on their ovaries are warned of the danger it could affect their fertility, because it can cause their levels of a critical hormone called AMH to fall by between 50% and 70%. “Perhaps they should consider freezing some embryos or eggs,” he said. If asked, he said, “women almost universally want to do that.”
How Can Acupuncture Help?
The Pacific College of Oriental Medicine have written an excellent blog on how TCM can treat Endometoriosis. Have a read here
In addition to the acupuncture the blog gives some useful advice on how positive outlook, diet, exercise and herbal medicine can complement treatment.
Acupuncture can manipulate and therapeutically adjust the qi, or energy pathways flowing through the body. The needles stimulate the nervous system and cause the release of neurochemical messenger molecules.
It has been shown that acupuncture treatment may specifically be of benefit in people with endometriosis by:
- providing pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Zhao 2008, Han 2004, Zijlstra 2003, Pomeranz 1987).
- reducing inflammation – by promoting release of vascular and immunomodulatory factors Kavoussi 2007, Zijlstra 2003).
- regulating levels of prostaglandins (Jin 2009
Patients may experience the slightest pinch upon insertion and then any of several sensations as the needle touches the point that is below the skin. These sensations can include tingling, heat, distention, heaviness, soreness, or an electrical, nervy feeling. Typically patients will relax deeply and may even fall asleep.
Acupuncture and herbal medicine treat effectively: painful menstruation , menstruation which is too little or too large in volume, menstruation which is either too early, too late, or which occurs at no fixed schedule, amenorrhea, PMS, lower abdominal pain, any endometriosis symptom and infertility.
Most menstrual problems can be treated by Chinese medicine within three to six months. However, the duration of therapy depends to some extent on the length of time the disease process has been in motion. Patients should expect it to take at least one month of treatment for every year there has been some problem with their period or in their pelvis in general.