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The Ins and Outs of Endo

By Lynne Gidish


Originally published in Longevity, September 2001. Reproduced with permission. The patient's name has been changed for privacy purposes.

For fellow endometriosis sufferers, Tracy's words say it all: "A pain so great that I was left feeling trapped and helpless."


From the age of 22, she lived with excruciating period pains which she tried to combat with a steady supply of painkillers. During the day, she took "enough to numb the effects of the pain without affecting my ability to function - although there were days when I could barely drag myself to work." Her bedtime regimen was a much stronger dose, "which knocked me out for a good 13 hours".

Finally plucking up the courage to see a gynaecologist five years later, she maintains she was extremely fortunate as her endometriosis was immediately diagnosed. "I had a laparoscopy and was told that I had Grade Four endo - the worst. Endometriosis is graded according to the amount of surface area covered - mine covered most of the area outside the uterus and had even grown on the ureter (the duct that conveys urine from the kidney to the bladder).

"My specialist was worried about bladder and kidney damage and was concerned that no one in South Africa was experienced enough to operate and clear out the endo without damaging the colon. He talked about sending me to London for micro-surgery, then suggested fall pregnant instead!"

Endometriosis is a painful, chronic disease that occurs when tissue normally found in the uterus appears in other areas such as the outer surface of the uterus, the lining of the pelvic cavity or on the ovaries. The misplaced tissue develops into growths or lesions which then respond to the menstrual cycle in the same way that the tissue of the uterus lining does.

However, unlike menstrual blood that flows from the uterus and out of the body through the vagina, the blood and tissue shed from the endometrial growth has no way of leaving the body, resulting in intemal bleeding, breakdown of blood and tissues from lesions, and inflammation.

While pregnancy does not cure endometriosis, it certainly can - and often does - improve the condition. Because women have no periods when pregnant and oestrogen levels are low, pain from endometriosis can decrease or cease.

Yet while many women discover that their symptoms improve after their babies are born and they start menstruating again, Tracy wasn't so fortunate. After the birth of her daughter last year — was lucky to carry her to seven and a half months because my uterus was literally patched together with endo - her pain returned, worse than ever.

"I went back to my doctor in agony. I was so bloated that I looked pregnant again. He immediately suggested a hysterectomy, but being only 32, I felt I was far too young and wanted another alternative. The Endometriosis Society then told me about a homeopath, Dr Caron Cole, who had done her thesis on endometriosis, so I contacted her."

Dr Cole put Tracy onto a series of natural medication specific to her symptoms, including her own endometriosis composition, which she said would help shrink the endo and heal the scar tissue. It seems to have worked: after six weeks, Tracy started feeling relief and today she is completely pain-free.

Approximately one in 10 women of child-bearing age suffers from endometriosis worldwide. Although the condition is common, it's not readily diagnosed, which is unfortunate because the sooner the diagnosis, the better the outcome.

Endometriosis can only be confirmed by laparoscopy (surgical insertion of a scope through the abdominal wall). The advantage of this procedure is that surgical treatment - the removal of endometrial tissue and the repair of old, damaged tissues - can be performed at the same time. The procedure takes about one hour and women are often able to go home the same day.

It's vital, says Joy Margolis, chairlady of ESSA (Endometriosis Society of South Africa) to choose your endometriosis specialist with care. "The right gynaecologist will assist you in selecting the most effective treatment option," she says. "This is important since endometriosis, if left untreated, can cause pain, infertility, scar-tissue formation, adhesions and bowel problems.

"Unfortunately, even with surgery, endometriosis can return, so it’s important for sufferers to gain knowledge about this debilitating disease in order to make informed decisions and manage the pain without compromising their health."

Causes

Although doctors have been able to diagnose endometriosis for more than a century, the exact causes are unknown.

In nearly all women, small amounts of endometrium are found inside the pelvic cavity and abdomen during a normal period, but not all women have endometriosis. It is unclear why this tissue becomes attached permanently in the pelvic cavity of some women and not others.

Symptoms

The most common symptom of endometriosis is pelvic pain, which may be constant and interfere with the ability to perform daily activities. This pain is felt in the lower part of the abdomen or deep in the pelvic cavity.

Pain during intercourse may be felt as a deep ache within the body and may be more severe if sexual activity is vigorous or if it occurs just before a period.

Other signs of endometriosis could include irregular periods or heavy menstrual bleeding, bladder problems and bowel trouble like diarrhoea, constipation, stomach bloating or painful bowel movements during menstruation.

Treatment

According to specialist gynaecologist Lawrence Gobetz of Vitalab Fertility Clinic, the choice of treatment depends upon factors such as age, fertility plans, previous treatment, nature and severity of the symptoms, and the anatomical location and severity of the disease.

Approximately one in 10 women of child-bearing age suffers from endometriosis worldwide. Although the condition is common, it's not readily diagnosed, which is unfortunate because the sooner the diagnosis, the better the outcome.

An Alternative Option

Dr Caron Cole is a registered homeopath who obtained her Masters degree in homoepathy after completing her thesis on endometriosis. This was a double-blind, placebo-controlled clinical trial evaluating the efficacy of a homoepathic combination medication (Endometrium Comp) on laproscopically diagnosed endometriosis sufferers.

A single constitutional remedy is usually prescribed, based on each persons symptoms, as well as herbal medication, vitamins, minerals and dietary advice. Symptomatic relief depends on severity, lifestyle and how acute or chronic the condition is.

One of the benefits of homeopathic treatment is that it is safe, causes minimal to no side-effects and may be taken in conjunction with medical drugs.