An Alternative Approach to Endometriosis Treatment How Acupuncture Can Relieve Endometriosis Symptoms

Endometriosis pain can take over your life. And while medication or surgery is standard, could stainless-steel needles and herbal teas offer relief? Yes, according to some experts. Learn how one woman eased endometriosis symptoms naturally and how physical therapy, Chinese medicine and supplements may help you... When Lisa Cirando was an adolescent, she had such painful periods that she “literally couldn’t see straight,” she says. “There were many times that I fainted from the pain,” Cirando recalls. The cause: endometriosis, a condition in which tissue similar to the lining of the uterus grows in other parts of the body, causing swelling, inflammation and scarring. It can also lead to adhesions, fibrous bands that grow between tissues and organs and limit movement in the pelvic area. They can bind the uterus to other pelvic organs, such as the bladder and bowel. At first, Cirando’s doctor prescribed birth control pills to limit production of the female hormone estrogen, which feeds the growth of endometrial tissue. Cirando stopped that endometriosis treatment because “I didn’t like the way the hormones made me feel, and they didn’t stop the heavy bleeding,” she says. Her next step: Surgery to remove endometriomas, ovarian cysts that sometimes develop in women with endometriosis. But her endometriosis symptoms returned within a month, Cirando says. That’s when she took a new direction: complementary medicine. For the past 15 years, Cirando has used a combination of acupuncture, Chinese herbs, exercises and dietary changes to stay pain-free. After a 7-hour operation that uncovered extensive cysts, fibroids and scar tissue, “my doctor couldn’t believe that I wasn’t having any pain,” she says. “I attribute that to the acupuncture and herbs.” Recently, she had a second surgery to remove more areas affected by endometriosis – including her appendix. “My acupuncturists prepared me with twice-weekly visits for several weeks before surgery, and they helped speed recovery with twice-weekly visits afterward,” she says. Complementary medicine techniques are now being recommended for pain control, along with classic medical endometriosis treatment, by specialists, including Iris Orbuch, M.D., director of the Advanced Gynecologic Laparoscopy Center in New York City. That’s because medications used to treat pelvic pain – hormones and nonsteroidal anti-inflammatory drugs – can cause unpleasant side effects such as hot flashes, weight gain, irregular cycles, acne and stomach upset. They can also lead to elevated blood pressure and an increased risk of stroke, and may not be safe for women trying to get pregnant. Complementary methods are safe and can help control pain by reducing inflammation, Orbuch says. But first talk to your ob-gyn or endometriosis treatment specialist, says Mike Berkley, a licensed acupuncturist, herbalist and director of the Berkley Center for Reproductive Wellness in New York City. “I’d never treat a patient with endometriosis unless she was under the care of a specialist,” Berkley says. “You can’t treat endometriosis solely with complementary medicine, because complementary medicine can’t eliminate the endometriosis. The only thing that can do that is surgery.” “Eventually, if you’re symptomatic, it’s best to have excision surgery” to remove adhesions, Orbuch adds. Complementary therapies can work both before and after surgery to break down scar tissue and reduce endometriosis pain and inflammation, she says. Here’s what you need to know about the three complementary techniques doctors recommend for dealing with endometriosis pain. Endometriosis Treatment #1: Physical Therapy Physical therapists use hands-on treatments and prescribe exercises to help cure endometriosis pain in your back, knees, hands or shoulders. They also can help with endometriosis symptoms. After getting a prescription from your doctor, visit a physical therapist with expertise in treating pelvic pain. The therapist will evaluate your symptoms in a private treatment room and recommend the best combination of techniques to treat your endometriosis symptoms. They include: Manual therapy. The severe cramping you have with endometriosis can make your body tense up, says Amy Stein, M.P.T., a physical therapist at Beyond Basics Physical Therapy in New York City, and author of Heal Pelvic Pain (McGraw-Hill). “If you roll up into a ball because of pain, your muscles can change,” she says. “If you’re hunched over from pain, your posture can change too.” Your physical therapist can use massage, myofascial release techniques and trigger point therapy to relax the muscles. Manual therapy can also make supple the tissue around scars and adhesions. Stretches. If you’ve had children, you’re probably familiar with Kegel exercises, which strengthen the pelvic floor muscles. But for women with long-term endometriosis, these muscles may also need to be relaxed, Stein says. That’s because years of endometriosis pain have caused them to contract – in turn, leading to even more pain and discomfort. Your physical therapist can teach you exercises that will help. Strengthening. Changes in posture may have weakened your back and abdominal muscles. Strengthening your core helps alleviate this pain. Besides teaching specific exercise moves, some therapists recommend that you make core-strengthening exercises, such as yoga or Pilates, a part of your workout routine. It’s best to work with a physical therapist trained in treating pelvic pain, Stein says. One source is the Herman & Wallace Pelvic Rehabilitation Institute in New York City, which offers a practitioner directory. Endometriosis Treatment #2: Chinese Medicine Little clinical research backs up the efficacy of Chinese medicine as an endometriosis treatment. But anecdotally, many women, like Cirando, report that acupuncture and Chinese herbal medicine help them control the endometriosis pain. “If my patient is interested in trying acupuncture and herbs, I will tell her to try it,” Orbuch says. “It won’t hurt and may help.” Acupuncture helps relieve endometriosis pain by improving blood flow and reducing inflammation, says acupuncturist Berkley. It also inhibits the body’s production of prostaglandins, hormone-like substances that increase pain, he says. Here’s what to expect from acupuncture: A lengthy introductory session of up to 90 minutes. Your practitioner will take a comprehensive list of your symptoms and conditions. Treatment sessions – either once or twice a week – during which 10 to 20 extremely thin needles are inserted into strategic points on your body. Your acupuncturist also may prescribe a regimen of Chinese herbs. These premeasured doses, usually taken twice daily, contain substances that regulate your hormones and fight inflammation. (Make sure your doctor knows what herbs you’re taking.) For a listing of licensed acupuncturists, visit the National Certification Commission for Acupuncture and Oriental Medicine. Endometriosis Treatment #3: Diet and Nutritional Supplements Can changing your diet reduce endometriosis symptoms? For many, the answer is yes, Orbuch says. As with the other kinds of endometriosis treatment, you’ll need to experiment to determine which foods help and which don’t. But don’t go to extremes. “I always tell people that moderation is the key,” she says. Among the dietary changes that Orbuch recommends: Try an anti-inflammatory food plan. This diet is high in fresh fruits, vegetables, whole grains, lean proteins and oily fish (like salmon or tuna) – which are rich in omega-3s, fatty acids found in fish and some plants that help reduce inflammation. Avoid these foods. Refined oils, sugars and carbohydrates as well as saturated and trans fats. Reduce gluten intake. Some women – especially those with digestive symptoms – find that gluten (hard-to-digest proteins found in foods processed from wheat and other grains) aggravates endometriosis symptoms. Avoid gluten-rich foods such as wheat, barley and rye and see if you feel better. Avoid estrogenic foods. It’s a controversial subject in medical circles, but soy products are believed to stimulate the production of estrogen, a hormone that feeds your endometriosis. You don't have to avoid these foods altogether, but you may want to limit your consumption of soy-based foods. If you like them, it’s OK to have tofu, soy milk or edamame once every 7-10 days, Orbuch says. Go organic. Factory-produced meats often contain hormones, which are fed to animals to encourage growth. You can avoid these by buying organic meats and dairy products. Avoid packaged foods. Plastic containers and canned food liners often contain hormone-disrupting chemicals called BPA, or Bisphenol A, and DEHP, or Bis (2-ethylhexyl) phthalate, a plastics softener. These chemicals can be absorbed into packaged food. Avoid them by eating fresh food. A March 2011 study of 20 San Francisco residents found that they had 66% less BPA in their urine after only three days of a diet of fresh, organic, unpackaged food. Their levels of DEHP fell by 53%. The study, published in the journal Environmental Health Perspectives, was conducted by researchers from the Silent Spring Institute in Newton, Mass., and the Breast Cancer Fund in San Francisco. Consider supplements. Some nutritional supplements can relieve endometriosis pain, says Deborah Coady, M.D., clinical assistant professor of obstetrics and gynecology at NYU Langone Medical Center in New York City, and co-author of Healing Painful Sex (Seal Press). She recommends them for her patients with endometriosis to combat inflammation. Ask your doctor whether the following supplements could help you: vitamin D3, omega-3 fatty acids, methylsulfonylmethane (MSM, a sulfurous substance found in meat, dairy, fruit and vegetables), and either borage seed, black currant seed or evening primrose oil, Coady says. For more information, visit our Women’s Health Center. Do You Have Endometriosis? Has your period always been troublesome? Can’t figure out your female problems? You may have endometriosis, a common gynecological condition in women that occurs during their reproductive years.