While the causes of endometriosis are still unclear, here is a valuable list of the current medical thoughts on the condition:
> Deficienq? in the immune system
> Family history of endometriosis
> Menstrual cycle length of 27 days or less
> Early onset of menstruation
> Periods lasting seven or more days
> Reported mostly by women who have never been pregnant
The symptoms of endometriosis can be difficult to evaluate. In the beginning, many women do not have any symptoms. Others who have severe buildup of tissue have no pain, while some women with only small adhesions have disabling discomfort. Although endometriosis is usually diagnosed between the ages of 2b and '5b, the condition could begin about the same time that menstruation starts. Many of these symptoms are frequently ignored or thought of as a normal part of the cycle. Have a conversation with your healthcare provider if you experience any of these symptoms:
> Increasingly painful periods
> Severe pelvic cramps or abdominal pain one to two weeks before the menstrual period
A laparoscopy is an outpatient surgical procedure most commonly used to diagnose endometriosis. A tiny, lighted tube is inserted through a small incision in the navel, so that your surgeon can look inside the abdominal cavity.
> More frequent or irregular menses
> Pelvic or low-back pain felt at any time during the cycle
> Pain during or following sexual intercourse
> Pain with bowel movements
> Infertility (approximately 25-50 percent of these cases are due to endometriosis)
If you have symptoms of endometriosis, make sure you use a pad and not a tampon during menstruation. Tampons can increase pain and cramping duringyour cycle and may make reflux menstruation (the tissue backup) more likely.
Endometriosis can be a stubborn and frustrating condition because of the complex interplay of hormones and unknown scarring and adhesions. Dr. Joel Hargrove, of Vanderbilt, Tennessee, has spent many years studying the effects of endometriosis. He states that PMS is reported by 80-90 percent of women with endometriosis. Conventional medical treatment is controversial and must be individualized. Medications are often prescribed to suppress ovarian function. Oral contraceptives may also be used in an attempt to prevent the proliferation of endometriosis. Side effects of suppressive medications, such as danazol, are often unpleasant and include weight gain, fluid retention, fatigue, decreased breast size, acne, hot flashes, and muscle cramps.
In my experience, Oriental Medicine can significantly improve a woman's menstrual cycle (see Chapter 17, "The Disappointment Down Under"). If adhesions are too numerous, surgery may be recommended, but reoccurrence of endometriosis is very high. So even if you have the tissue removed by laser surgery, it may very well grow back. I have found that acupuncture and herbal medicine have brought satisfactory relief to many of my patients for whom surgery is not indicated, not wanted, or has already been done.
In addition to treatment, I advise women to follow the PMS diet discussed in Chapter 17 and to exercise regularly. According to a report in The Journal of the American Medical Association, strenuous exercise lowers the levels of estrogen in the body, which may help the symptoms of endometriosis.
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