To Your Health

Q. For years my periods have been getting worse, but I'm afraid if I go to the doctor he would find endometriosis, and I don't want to use hormones. Are there any alternatives?

A. Endometriosis is the presence of the tissue that lines the uterus, endometrial tissue, outside the cavity of the uterus. It may occur anywhere in the body, but is most commonly found in the pelvic region, for example on the ovaries, the fallopian tubes, or the exterior of the uterus. Endometriosis occurs almost exclusively in menstruating women, so is rarely seen in prepubertal girls or postmenopausal women. One theory suggests that functioning endometrial tissue reaches the abdomen through the Fallopian tubes but there are other possibilities.

Endometrial tissue outside the uterus responds to ovarian hormones the same way normal endometrial tissue does, with repetitive cycles of bleeding, except that outside the uterus this leads to inflammation followed by the development of scar tissue and adhesions between adjacent tissues. Severity of symptoms can vary tremendously and doesn't seem dependent on the severity of the disease. Symptoms often include abnormal bleeding and pelvic pain, especially during a period and sometimes with bowel movements and urination. Infertility is common among women with endometriosis.

The symptoms of endometriosis frequently subside during pregnancy, at a time when the production of progesterone increases dramatically. This observation led Dr. John Lee to recommend nonprescription natural progesterone cream, one-quarter teaspoon of cream twice a day for three weeks of the cycle, stopping just before a period is expected. He has reported successfully treating a number of women with endometriosis, some after failed surgeries. There is generally a gradual improvement in symptoms over three to six months as the inflammation subsides and the tissues heal. Some women may not recover completely, but the condition usually becomes much more tolerable. You will find more information about natural progesterone cream in his book What Your Doctor May Not Tell You About Pre-Menopause.

Endometriosis and the accompanying inflammation generate damaging free radicals that deplete antioxidants. Supplemental vitamin E might be helpful in reducing some of the pain and inflammation associated with endometriosis, plus additional antioxidant nutrients (vitamin C, vitamin A, and selenium would be the minimum) should work in concert with vitamin E.

Supplementation, in the proper balance, of omega-3 essential fatty acids, from fish oils, and one omega-6 fatty acid, gamma linolenic acid from borage or evening primrose oil, decreases inflammation by inhibiting the formation of the mediators of inflammation. Modern diets tend to be lacking these fatty acids and overly abundant in other fatty acids that enhance inflammation.

Several herbal remedies for menstrual problems have been used traditionally by Oriental, European, and Native American cultures. Some, like chasteberry, provide "phytoestrogens," substances that have estrogen activity in the body. Although these compounds are weak estrogens, they apparently block estrogen receptors and prevent the more potent estrogens from operating. Cat's claw has substances that reportedly reduce inflammation and edema. Recently, a proprietary standardized extract of red clover has garnered a great deal of attention in the management of endometriosis and related symptoms.

You can become a consumer of medical expertise and, with a few phone calls, select a physician who applies the principles of "complementary medicine" that would help you find alternatives to prescription hormones.