Endometriosis – what is it and how can Acupuncture assist with Endometriosis.
Endometriosis is a common disease in which the tissue that is similar to the lining of the womb grows outside it in other parts of the body. More than 830,000 (more than 10%) of Australian women suffer from endometriosis at some point in their life with the disease often starting in teenagers. Symptoms are variable and this may contribute to the 7 to 12-year delay in diagnosis.
Common symptoms include pelvic pain that puts life on hold around or during a woman’s period.
It can damage fertility. Whilst endometriosis most often affects the reproductive organs it is frequently found in the bowel and bladder and has been found in muscle, joints, the lungs and the brain. (1)
Endometrial tissue can lodge on any organ present in the abdominal cavity and can also cause adhesions – this is where parts of the organs become stuck to the abdominal cavity – it is very common for the ovaries and bowel to be adhered to the lining of the abdominal cavity and this can cause extreme pain and issues with bowel movements.
Many women with endometriosis have common symptoms such as severe period pain, long heavy periods and some may have constant bleeding throughout a cycle. Other women do not have any symptoms at all, and it may be only when they are trying to conceive that they are diagnosed.
One of the many complaints that I see in my clients is the pain that is caused by the endometriosis. Western Medicine aims to prevent the pain and further inflammation in the body by using hormone therapy – continuous use of the progesterone only pill to prevent the endometrial lining from growing and building up or using an IUD to aid with the pain and stop menstruation.
Diagnosis of endometriosis is done by a laparoscopy – where a small incision is made in the lower abdominal wall and a camera is placed into the abdominal cavity. If endometriosis is present, the tissue can be seen sitting on the organs – it is mainly found on the ovaries, fallopian tubes, bowel and bladder, but it can spread to any organ in the pelvic region.
Western medicine – can perform surgery and remove the endometrial tissue from the organs – this generally will increase your fertility as well. I find that after surgery, my clients have conceived a lot easier.
Approximately 10% of reproductive age women suffer from endometriosis. Additionally, approximately 50 per cent of infertile women have endometriosis. Biomedical approaches to controlling endometriosis include surgery, oral contraceptives and anti-inflammatory drugs. GnRH agonists are also used as a treatment modality. However, GnRH agonists lower estrogen levels and may lead to endometrial atrophy and amenorrhea. TCM (Traditional Chinese Medicine) including acupuncture and herbal medicine has a documented history for the treatment of dysmenorrhea related pain for over 1,000 years and is now the subject of modern research. (2)
In Chinese Medicine – there are 5 main patterns which cause endometriosis these include:
- blood stasis
- qi stagnation
- kidney yang deficiency
- spleen qi deficiency
- damp-heat stagnation and stasis
Quite often, clients will have a few of these patterns. Qi and blood stagnation are very common, and it accounts for the stabbing and constant pain that women experience in the pelvic area. This pattern, as well as spleen qi deficiency, often leads to long and heavy periods as well. If the Spleen Qi deficiency is severe, women may experience bleeding constantly, even after their cycle has finished. This bleeding long term can lead to anaemia, so it is important that we stop the bleeding quickly and also check your iron stores to rule out anaemia.
Many women may also experience lower back pain, and stiffness through the lower back – this is a sign of Kidney yang Deficiency. Heat signs – can be prone to hot flushes, thirsty a lot of the time, feeling hot at night and in the afternoon, as well as having pain in the lower abdomen.
Pain – is mainly caused by qi stagnation – in which case the complaint will be constant “dull pain”. If a client complains of stabbing pain and dull pain it is a mixed pattern of qi and blood stagnation within the pelvic region,
Endometriosis can affect your fertility. This is due to the endometrial tissue adhering to other organs and the ovaries and fallopian tubes can become blocked. Adhesions also create issues with ovulation and scar tissue and inflammation in the pelvic area also reduce fertility.
If you have endometriosis – it is important to get a pelvic ultrasound and hysteroscopy performed so that we can see if there is a blockage in the fallopian tubes or any issues with the ovaries. This is performed under ultrasound and it uses contrast dye to show the reproductive organs. If there is – a surgeon can flush the fallopian tubes, and surgery can remove the endometrial tissue from the abdominal cavity.
The diagnosis in TCM always takes into consideration the symptoms that manifest in every individual, as we understand that not everyone is the same and therefore TCM can be a great way to tailor each treatment to every single individual person. What works for one person may not work for another and no two people are the same. We treat the root cause in TCM and not just the condition or the symptoms.
How can Acupuncture help?
Recently, research has shown the many possible mechanisms behind the effectiveness of acupuncture for multiple conditions. Listed below are some possible explanations about how acupuncture works.
- When a needle is inserted into a point, the needle stimulates sensory (afferent) nerves (nerves which send signals from the peripheries to the brain), triggering a cascade that causes changes in the brain and the internal organs. One of the chemical reactions that occur after the insertion of an acupuncture needle is the release of adenosine, which is a neurotransmitter. It is an inhibitory neurotransmitter, which means that is can depress the central nervous system and promote sleep. Adenosine also decreases heart rate, improves blood circulation to the heart, improves heart rate variability and acts as a local anti-inflammatory.
The signals sent to the brain via adenosine then regulate functions like digestion, cardiovascular function, immune responses etc. and in higher brain centres, modulates pain.
2) Acupuncture stimulates the release of the body’s own natural painkillers, known as endogenous opioids. It also stimulates the release of molecules associated with tissue healing.
3 Acupuncture produces antihistamine effects and down-regulates pro-inflammatory cytokines and pro-inflammatory neuropeptides. It also down regulates neurotrophins, which contribute to hypersensitivity and prolong the inflammatory response.
4)Acupuncture regulates the HPA axis and balances the sympathetic/parasympathetic nervous systems (the sympathetic nervous system is often overstimulates when disease/illness is present).
5) Chinese medicine will also address other issues such as high stress, low energy levels, digestive issues, inflammation and poor sleep. TCM recognizes that endometriosis is different in every induvial and it is multifaceted. By addressing other symptoms we are also providing a better environment for your body to heal itself.
Many women use TCM and acupuncture in combination with Western medicine treatment plans and the most common complaint that my clients have is with pain.
What to expect with treatments?
If you are planning on seeing an acupuncturist you will be assessed, and a diagnosis will be determined.
For gynaecological conditions weekly acupuncture sessions are generally recommended to support your body. You should allow yourself a period of up to 4 months or more to help regulate your body, you must remember that you have had this condition for years and hormonal conditions cannot be regulated overnight.
For some clients with more severe pain – I do recommend 2 sessions a week for about 4 weeks. We then go to weekly sessions.
I use a combination of Acupuncture, Chinese Herbal medicine and diet to assist with endometriosis. Moxabustion is also used regularly, especially on the lower abdomen. Moxabustion is a warming herb which is used over acupuncture points, as it has a great warming effect, we use it to assist with pain and put warmth into the lower abdomen. This assists with blood flow and reducing pain.
From my experience, I have found that the combination of these treatments enables the body to rebalance itself out a lot quicker. We use diet therapy to assist with reducing inflammation in the body alongside the acupuncture.
Acupuncture’s main role in endometriosis is assisting with pain relief, reducing inflammation and regulating the nervous system – this reduces stress levels. In cases of blood stagnation and qi stagnation – acupuncture is used to reduce the stagnation so that eventually it breaks down into smaller pieces, which can then be removed naturally by your body, As we focus on breaking down the endometrial tissue (stuck blood) we begin to reduce pain. For women with heavy and long periods – we focus on reducing the amount of blood lost and shortening the length of a period. Supplements may be given as well. This is performed by placing needles along different points in the body that correspond to different channels and organs. In endometriosis – needles will typically be placed in the lower abdominal area, the legs, arms and sometimes head.
Your acupuncturist will help to explain what is happening for you and provide you with tools to support your health outside the treatment room. These may include moxibustion, acupressure, diet and lifestyle changes.
Current Research and Acupuncture
The most recent research conducted around acupuncture for endometriosis was conducted very recently, with the study run by Dr Mike Armour from Western Sydney University’s NICM Health Research Institute (NICM). The study has found that the women in the acupuncture group experienced a 42% reduction in pelvic pain after eight weeks of treatment. They also found reductions in the EHP-30 (endometriosis health profile questionnaire). This is amazing information! Imagine less pain and better quality of life scores.
Understanding and listening to your body is vital for a good outcome. Your body is your most important asset. At times your body sends you signals that something isn’t right, and when you have a better understanding of your condition things start to make more sense and you can directly relate all your symptoms that you have been experiencing to your diagnosis of endometriosis.
Maintaining good health is essential to all aspects of your wellbeing and I will provide you with simple tips and lifestyle changes that are easy to incorporate into your daily routine.
If you would like to find out more about endometriosis or find out more about how we can assist you on your journey please contact us firstname.lastname@example.org we would love to hear from you.
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- Evidence Based Acupuncture. (2019). Acupuncture: An Overview of Scientific Evidence. [online] Available at: https://www.evidencebasedacupuncture.org/acupuncture-scientific-evidence/ [Accessed 15 Aug. 2019].
- Cochrane S et al, March 2014 Volume 2014: 6 Pages 313—325 International Journal of Women’s Health
- Kong S et al, Volume (2014), Article ID 146383, 16 pages Evidence-Based Comp and Alternative Medicine
- Armour M, Dahlen HG, Zhu X, Farquhar C, Smith CA (2017) The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial. PLOS ONE 12(7): e0180177.https://doi.org/10.1371/journal.pone.0180177
- McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition). Brisbane: Australian Acupuncture and Chinese Medicine
- Lim CED et al, Aust J Acupunct Chin Med 2009;4(2):12-17. Australian Journal Acupuncture and Chinese Medicine
- MSD Professional version Endometriosis http://www.msdmanuals.com/en-au/professional/gynecology-and-obstetrics/endometriosis/endometriosis (accessed 20 November 2016)