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Endometriosis - a Modern Healing Technique
A symptomatic treatment plan for the pain of endometriosis
What is endometriosis (en-doh-mee-tree-oh-suhs)?
Endometriosis is a common health problem in women. One in ten women of reproductive age in the UK suffer from it. 176 million worldwide. The prevalence of endometriosis in women with infertility is as high as 50 per cent.
Statistics are difficult to gather because it can't be diagnosed without surgery. Nevertheless, endometriosis is the second most common gynaecological condition (after fibroids) in the UK.
Its name comes from the word endometrium, the tissue that lines the uterus or womb. During the menstral cycle the endometrial cells from the inner lining of the uterus become implanted elsewhere in the body. The peritoneal cavity, the visceral cavity, and may even develop above the diaphragm. Obviously, that's not supposed to happen.
Endometriosis may have no symptoms and so it is possible that the numbers and prevalence are understated. But when it does, they generally include heavy, painful menstruation, pelvic and abddominal pain, difficulties with urination or defecation, painful intercourse, and other problems, depending on which tissues have been affected.
Symptoms are usually worst during menstruation, but sometimes the week before, or the week after, can also be painful. Infertility is a frequent complication of endometriosis.
(As this article is really about a treatment plan for endometriosis, I'd just like to point out, that the pre and post cycle weeks are proving to be the best times for treatment.)
During a woman's regular menstrual cycle, tissue lining the uterus builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis (ovaries, fallopian tubes) or in the abdominal cavity (among the visceral organs).
Each month, the tissue receives a hormonal signal to break down and shed from the body, resulting in bleeding. Thus, the uterine lining which is now waste, is removed.
However, the cells that have escaped the uterine build-up and ventured out on their own, also receive the same signal and have no choice but to decay and break down. They do NOT have the same natural opening to leave the body and so become trapped inside the pelvis and abdominal cavities. These cells then start to decay.
The broken down tissue can't leave the body and can form cysts or scartissue. Your tissues and organs can begin to stick together. The natural abdominal fluids that allow all the organs and tissues to slide over one another in a graceful comfortable movement, like apples bobbing in a bucket, can now cause tissue and organs to pull against each other because they are no longer detatched. These organs and pipes pull on each other like they've been spot glued together. This leads to inflammation, swelling, scarring and pain around the sites affected.
Does the treatment hurt, especially when it is recommended to come so close to my menstrual cycle?
I can see why it may be imagined that the work involves deep abdominal or pelvic palpation, and this could of course, be quite painful, especially close to your menstrual cycle. This is NOT how the treatment is performed. Light strokes that stimulate lymphatic drainage and engage the lymph ducts and nodes are the secret to success with this treatment. Deep tissue massage is left for another time and place.
So what are you trying to achieve with this treatment?
A painfree menstrual cycle is the ultimate goal. Many women have menstrual cramps, abdominal pain, vaginal and back pain, who don't have endometriosis. This treatment can help them too, but I designed it to help with patients who have the added complication of endometriosis.
Let me try to explain how I understand endometriosis from a non-scientific point of view.
Ok, endometriosis is the implantation and growth of endometrial cells anywhere outside of the uterus. The endometrium is the inner cellular layers and mucous membrane of the uterus. It has a base (basal) layer and a temporary (functional) layer; the functional layer thickens and then is shed during menstruation due to the influence of the hormones estrogen and progesterone.
If this endometrial tissue stayed in the uterus, there wouldn't be a problem; but in some women (perhaps all women, they just don't all develop endometriosis), it doesn't.
There are several theories why errant cells find their way into the body cavities and organs outside of the uterus. The uterus has tubes coming out of it called Fallopian tubes, and these are how eggs which leave the ovaries reach the uterus.
It is suggested that endometrial cells backflow up these uterine tubes into the peritoneal cavities. These cavities are bound by thin membranes and are where you park your organs; intestines, stomach, liver, spleen, first and fourth parts of the duodenum, jejunum, ileum, transverse and sigmoid colons.
These invading cells essentially set up camp and colonize the space, attaching themselves to anything they can, including the uterine tubes, ovaries, broad ligaments, the bladder, colon or the pelvic organs.
Normally, the immune system would see these cells as being 'off campus' and erradicate them. Your body has killer T-cells and natural killer cells that are part of the lymphatic system. Sometimes it seems that the antibodies produced to kill off these cells don't work very well and the cells can remain and create scar tissue. The bodies response is to secrete unusually high levels of prostaglandins which develop at sites of tissue damage or infection to deal with injury or illness. (More on this later).
Part of the problem is the endometrial cells are designed to stimulate the growth of supply blood vessels for the uterine wall, obeying the hormonal command to proliferate. So, whenever they attach themselves to a body outside the uterus, their first priority is to establish a blood supply and grow. They don't get long to do this thankfully.
Once the uterus receives the 'decay' signal because no egg has been detected, all the other endometrial cells respond to the same signal and decay wherever they are inside the visceral and peritoneal cavities, from which there is no exit. The decay process stimulates an inflammatory response. The body tries to isolate and contain the rotting cells by surrounding them with fibrous connective tissue. And remember those prostaglandins? They control processes such as inflammation, blood flow, a severe cramping response and pain sensitization.
The endometrial growths look like blisters, or vesicles, attached to whatever structure they have colonized and can eventually become thick, black and scarred. The consequence of which is pain, discomfort and cramp.
It appears there may be some hereditary likelihood of developing these permenant growths as women who's mothers and sisters who have been diagnosed with endometriosis have a much higher chance of being diagnosed themselves. Also, interestingly, the size of endometrial growths have little bearing on the severity of pain, as many women with microscopic growths report more pain and discomfort than someone else with more advanced deposits.
It is likely that a lot of women don't seek help initially because it is assumed that painful periods are 'normal' and just something that women go through. For many this is true, but nowadays women are much more proactive about their healthcare and are willing to explore the causes and possible solutions for their pain.
Those are the women that seem to find their way here.
What treatments are available in mainstream medicine?
There is only one diagnostic test for endometriosis and that is laparoscopic surgery. A Laparoscopy is a type of surgical procedure that allows a surgeon to look inside the abdomen and pelvis without having to make large incisions in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery (MIS).
Birth control pills and hormones that change, reduce or stop the menstrual cycle are often used first to see how you respond, as they can be quite successful in the early days.
Even a complete hysterectomy is no guarantee of a cure as microscopic deposits can remain to carry on the symptoms during other treatments like hormone replacement therapy (HRT).
Nonsteroidal anti-inflammatory drugs (NSAID's) and other analgesics may be prescribed to limit pain and discomfort, but with long term use they can come with a hefty list of side effects that are not pleasant. Other surgical interventions can include laser or electrocauterization to cut out visible growths and to reduce adhesions between the pelvic organs.
Should I join a support group?
It is important to get support for your condition, because long term pain and discomfort can mess with your emotions. Sadness, depression, anger, anxiety, fright, confusion and loneliness can creep up on you over time and bring you down. You probably know this already. There are a plethora of groups and communities online that you can join. I am not a big fan of group therapy. It seems mostly that everyone is talking about the same symptoms, theirs is always worse than yours, and this can create a feeling of collective hopelessness. But it will help you learn as much as you can about the condition and the odd tip of how to cope will be forthcoming and beneficial.
So what made you look at lymphatic drainage as a possible way of treating endometriosis?
Before I answer that, many massage therapists claim to be able to do lymph drainage. They can't. They have a tendency to work too deep. The 'more is better' approach. This is totally wrong. Lymph drainage, proper lymphatic drainage, is a specialist treatment, and different training is necessary for this work to be successful. Deep abdominal massage is NOT APPROPRIATE for patients with endometriosis. Please don't be tempted to go to one and ask for 'light' massage, its not the same.
It's important to understand what the lymph system does. It is our internal drainage system. In its simplistic form, it collects debris from around the body, both liquid and solid, kills anything that is a danger to you, recycles what it can, and dumps the rest. It flushes the body of unwanted waste and stimulates the immune system to recognize what is likely to be a problem for us later on, to mop it up, destroy it and remove it from the body.
Part of the problem with endometriosis is the cells ability to hide from the immune system. Afterall, it is part of us and therefore not alien. The antiogenic potential is high (the ability to tap into and create new blood supply vessels), and the increased neurogenesis (the abnormal growth of nerve fibres), is thought to contribute to the generation of pain symptoms. Both of these things enhance an endometrial cells ability to remain viable, escape immune surveillance, to implant and survive in ectopic locations throughout the abdomen.
We have already established that the errant endometrial cells are like weeds. Wrong cells, wrong place. Once they become established and send out chemicals to demand a blood supply, they are part of us, unrecognizable as not wanted or necessary. During the hormonal breakdown and subsequent decay, our immune system is blind to their destruction.
By stimulating the lymph system to pick up these cells and run them past the lymph nodes, it is perhaps possible to trigger the immune system to recognize them as dangerous and to absorb them, render them harmless and remove them. The best thing about the immune system is it has a good memory. The next time it detects one and the same, it knows what to do.
In just the same way that stripping out adhesions and scar tissue in a muscle from a sports injury using massage enables the muscle to repair and grow back stronger, it is my considered opinion that softly disrupting the endometrial cells, both floating and attached, and sending them towards the lymph nodes, will encourage the immune system to recognize them as diseased and destroy them.
The pathogenesis (progression of a disease) of endometriosis remains undefined, despite extensive investigations. Multiple theories have been proposed, but surprisingly little practical study. There is some research that suggests it is the lymphatic system that causes endometriosis in the first place.
If this is true, it is likely the sheer proliferation of endometrial cells that build up prior to the menstrual cycle overwhelms the lymph system causing clogging of the lymph channels and impairing the immune clearance of endometrial products following menstrual shedding.
If endometrial lymphatic vessel density is highest during menstruation, these cells are far more likely to overwhelm the immune system and get past all the check points that would otherwise put up a better fight on our behalf. Isn't this how we become ill with other illnesses?
It's possible the immune system doesn't recognize an invader, but even if it does, if the invader is in sufficient numbers and overwhelms the immune system, we can become dangerously ill. Antibiotics wipe out huge populations of bacteria, both good and bad, but enough to give the immune system a chance to once again gain the upper hand. We get better.
The lymphatic drainage treatment is designed to gently present the decomposing endometrial scar tissue to the lymph system now as something alien, a little at a time, so it can deal with the dead and diseased cells by destroying them in the lymph nodes. And, therein lies the basis of this new treatment.
Living with Endometriosis can be very challenging. Feelings of helplessness and hopelessness are not uncommon. My flavour of lymphatic drainage will be unique to you, based on your symptoms and timing of the month. I put a lot of focus on making you feel comfortable, dignified, happy and special. The treatment doesn't hurt. If you have any questions, it's best to ask them when you make the appointment, but if you're anything like me, things pop into your head after you put the phone down, and so you can bring up any points or questions you need answering before we start. I hope you have found this information useful and feel encouraged to give this treatment a try. Please contact me if you want to find out about appointments and prices. It is likely you will need a course of treatment and so there is an option to book several unspecified dates in advance to receive a sizeable discount. I look forward to welcoming you soon. Phil.
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Important Note: DISCLAIMER: This information is not presented by a medical practitioner and is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read.
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