Endometriosis
Endometriosis is described as the abnormal growth of endometrial tissue outside the endometrium. Endometrial cells are those that are found in the uterine lining. When those cells are found in areas outside of the uterus, the diagnosis of endometriosis is made. Although the disease has been present throughout history, it was first identified in 1860. In 1960 the disease mechanism was first described because of the discovery and use in France of the laparoscope. Endometriosis is therefore a surgical diagnosis. Modern science does not know why endometrial cells are found elsewhere. One theory of its origin is explained by retrograde menstruation. When a woman is supposed to menstruate and blood should be discharged vaginally, it backs up through the tubes and into the abdominal cavity. Yet this happens in most women, and most women do not have endometriosis. Another hypothesis is that anatomic abnormalities such as retroverted uteri and small cervical openings do not allow the blood to pass through freely, and it therefore backs up into other areas of the pelvis.
 
Another theory of the causative origins of endometriosis is that other cells outside of the uterus are transformed by some unknown stimulus into endometrial cells. Whatever the etiology, the misplaced endometrial cells then respond to hormonal stimulus just like the endometrium is supposed to. But, during menstruation there is no way for this menstrual blood to leave the body. Pain, sometimes very severe, is the result. Prostaglandins are said to be the causative factor in menstrual pain. Painful periods are an indication of possible endometriosis, and women with endometriosis have higher levels of certain of the prostaglandins. The bleeding tissue may also cause adhesions and scar tissue.
 
Common sites of endometriosis include the cervix, the vaginal-rectal space, ovary, fallopian tubes, colon and bladder wall.
 
Common accompanying symptoms include dysmenorrhea, pathological uterine bleeding, and bleeding at sites other than the endometrium during menstruation. Some women bleed at sites as distant as the nasopharynx during menstruation and get nosebleeds during the menses. Endometriosis is classified as to its severity.
 
Mild endometriosis - implants are small, flat patches of endometrial tissue growing outside of their normal location.
 
Moderate endometriosis - includes "chocolate cysts" of endometriosis may be smaller than a pea or larger than a grapefruit, located within the ovary.
 
Severe endometriosis - in some cases, bands of fibrous scar tissues (adhesions) bind the pelvic organs together.
 
Interestingly enough, except for the obvious mechanical obstruction found in severe endometriosis, there seems to be no real correlation between the severity of endometriosis and its impact on fertility. However, as many as half of the women who have been diagnosed with infertility are found to have endometriosis on laparoscopic examination.
 
Some women, in fact, have no symptoms at all, and diagnosis is only made through laparoscopy. Symptoms which may accompany endometriosis include abnormally heavy bleeding, associated with back pain or severe abdominal cramping, painful intercourse, painful intestinal upset or urination during the menstruation, and the inability to become pregnant.
 
Western medical treatment usually includes pain relieving medication, laparoscopy and laser removal of the endometrial tissue. Other drugs may be used to control the hormonal stimulation of the endometriosis. As menstruation ceases each month, the misplaced endometrial tissue will be starved of hormonal stimulus, and thus mollify the endometriosis response. Of course, ovulation is also halted in this process, which defeats our present purpose.
 
The Traditional Chinese Medical View and Treatment of Endometriosis
Endometriosis and Static Blood Endometriosis is not a disease category in Traditional Chinese Medicine. However, our Eastern healers have recognized this disease for far longer than its identification in Western medicine. It is known by its symptoms and is referred to as menstrual movement pain. It is also very amenable to natural forms of treatment.
 
The Jin Gui Yao Lue (Essentials from the Golden Cabinet), "Women's Miscellaneous Diseases' Pulse, Pattern & Treatment" chapter, has this description: "The menstrual blood is inhibited and there is (resulting) lower abdominal fullness and pain."
 
Chinese medicine categorizes endometrial lesions as static blood, or blood which is not flowing as it should, and thus causes problems. This is not so different from our Western understanding of the same disease. Since the maligned blood is located in an vicinity where normal blood flow is often absent or minimal, our body has a tougher time resolving it. The Chinese therefore say that these conglomerations of static blood have entered the network vessels, which are more difficult to reach. This is one important aspect in how we will approach this syndrome.
 
Other countries throughout the rest of the world recognize endometriosis as an autoimmune disease. The famous gynecologist Dr. Ni reported that in her experience as a M.D. gynecologist in China, most women upon whom she performed laparoscopies had some degree of endometrial tissue outside of the uterus, which was found at various locales throughout the abdominal category. What sets aside women with fertility impaired endometriosis is the "osis" or inflammatory reaction which has resulted from the presence of the endometrial tissue outside its original intended site.
 
The inflammatory reaction which the body has set up in response to the endometrial tissue in an attempt to "clean it up", makes the immune system reactive to the cells that make up the uterine lining. The fault then begins to reside in the immune system, which is unable to eradicate the misplaced tissue. The immune system then loses its discriminatory control, and can't distinguish between self and non-self. As far as fertility is concerned, this creates a toxic environment in the uterus, not conducive to an implanting embryo.
 
An immunopharmacological study of an antiendometriotic herbal medicine known as Gui Zhi Fu Ling Wan, was conducted by four researchers at the Osaka City University Medical School in Japan.
 
The patients with endometriosis were found to have elevated serum levels of Immunoglobulin M antibody titers. A control group was treated with leuproride acetate therapy to suppress hormonal production (a common western approach for endometriosis is to suppress the hormonal stimulus). The treated group was given the antiemdometriotic herbal formula Gui Zhi Fu Ling Wan, which consists of Ramulus Cinnamomi (Guizhi), Poria (Fuling), Radix Paeoniae Alba (Baishaoyao), Cortex Radicis (Mudanpi), Semen Persicae (Taoren). This formula was historically used in China to treat bleeding during pregnancy due to blood stasis in the womb, or to prevent miscarriage. Later indications include the treatment of immunologic and inflammatory conditions of the uterus including Dysmenorrhea, leiomyomas (uterine fibroids), Ovarian Cyst, chronic pelvic inflammatoy disease and salpingitis, Endometriosis.
 
The lupron treated group had lowered levels of estradiol, but no change in the IgM antibody titer. The treated group had no changes in estradiol levels, but the levels of IgM antibody titer were decreased and the patients were kept symptom free for months.