This is part two of the discussion on endometriosis. To know what endometriosis is or what the symptoms of the disorder are if you have been wondering whether your menstrual symptoms and period pain may finally find an explanation, click here to read part one.
How is Endometriosis Diagnosed?
Endometriosis can take years to diagnose and a female may end up seeing her family physician multiple times over a number of years before a formal diagnosis is obtained. It is said that it can take 10 years for a formal diagnosis [1]. This is because there are no blood tests to formally diagnose it and an ultrasound may detect tissue but can’t diagnose it as endometriosis. A minimally invasive laparoscopic procedure, the gold standard, is required for diagnosis to obtain the tissue and perform a biopsy of the tissue to assess if it is endometrial tissue.
Recently, there has been research showing that measuring CA-125 via a blood test has high specificity (93%) to act as a non-invasive measure and a high normal result can provide a presumptive diagnosis in symptomatic women to begin medical management without having to wait to obtain the gold-standard laparoscopy for a confirmed diagnosis [2]. Due to poor sensitivity of 52% for CA-125, a negative result cannot rule out endometriosis as many with ‘endo’ may have levels within normal [2]. CA-125 should never be used alone to assume ‘endo’ and a pelvic ultrasound should also be done to assess and rule out conditions like ovarian cancer and fibroids which can raise CA-125.
Conventional Medical Management
Conventional medical management typically involves anti-inflammatories like ibuprofen (Advil or Motrin) and Tylenol to manage the pain [1]. Hormonal medication, most commonly, the birth control pill is prescribed to “regulate your hormones” which essentially shuts your own production of estrogen and progesterone off and relies on exogenous hormones. The IUD may be a better option but read more about birth control here.
The laparoscopic procedure used for diagnosis can be used for treatment to remove the endometrial lesions.
Naturopathic Medical Approach to Treatment / Management
From a naturopathic medical standpoint, we are always offering natural options to reduce inflammation, pain and other symptoms while we focus on identifying and treating the root cause and where the inflammation is coming from. This may be addressing an autoimmune condition that is generating inflammation, gut inflammation (very common), or a chronic infection. It may also be correcting a vitamin D deficiency. Due of inflammation, there is often an increase in histamine in endometriosis and histamine-mediated or allergy-like symptoms can be common and many of the symptoms can be related to higher histamine. Histamine can increase estrogen levels and vice versa. Therefore, addressing histamine intolerance is often needed as well.
Depending on the individual and if it appears their immune system is skewed to one side, endometriosis protocols may also involve immune balancing.
In short, as you can see, treating endometriosis from a naturopathic angle isn’t just about balancing estrogen and progesterone but it also looks at getting to the root cause of the inflammation, reducing histamine and possibly even one step further and re-balancing the immune system. This is achieved through dietary support, herbal and nutritional supplements, and even acupuncture to help with pain.
References:
[1] The Endometriosis Network Canada (2022). Retrieved on April 4 2022 from https://endometriosisnetwork.com/ [2] Speer L, MD. CA 125 relatively specific for diagnosing endometriosis. Am Fam Physician. 2017 Jan 15;95(2):122.
