Endometriosis occurs when endometrial cells—the cells that make up the lining of your uterus—travel outside the uterus to other parts of your body. These misplaced cells are stimulated by hormones, just like the cells within your uterus, and bleed during your period (menstruation). Blood from these cells must be absorbed by your body. With each period, deposits build up and form scar tissue, which can be painful. Endometriosis affects 10 to 20 percent of American women of childbearing age. It is found in 30 percent of infertile women.

One-third of women with endometriosis have no symptoms. The most common symptoms include the following.

• Pelvic pain, especially when you have your period
• Heavy or irregular menstruation
• Pain during sexual intercourse
• Infertility or miscarriage
• Pain with bladder or bowel function, or intestional pain

The cause is unknown, but there are three theories.

• Abnormal functioning of your immune system
• Retrograde (or reflux) menstruation, in which some menstrual blood flows backward through your fallopian tubes
• Genetic or heredity factors

A physical examination may include gentle pushing on your abdomen and an internal examination. Definitive diagnosis is made with laparoscopy.

Because there is no cure, treatment is to relieve symptoms.

The following drugs can relieve the symptoms of endometriosis.

• Nonsteroidal anti-inflammatory drugs (such as ibuprofen)
• Oral contraceptives
• Hormone-suppressing drugs (which stop menstruation)

Laparoscopic laser techniques help shrink lesions. Total hysterectomy (removal of your uterus and ovaries) is recommended only when necessary but does not guarantee an end to your symptoms.

Providing liver support is the backbone of alternative treatment.

• Eliminate all known food allergens.
• Eliminate alcohol, caffeine, chocolate, refined foods, food additives, sugar, and saturated fats (meats and dairy products).
• Eat only organic poultry and produce.
• Increase intake of whole grains, fresh vegetables, essential fatty acids, and vegetable proteins. Include liver-supporting foods such as beets, carrots, onions, garlic, leafy greens, artichokes, apples, and lemons.
• Vitamin C (1,000 mg three times per day) decreases inflammation.
• Zinc (30 to 50 mg per day) and beta-carotene (50,000 to 100,000 IU per day) support immune function and enhance healing.
• Vitamin E (400 IU per day) is necessary for hormone production.
• Selenium (200 mcg per day) is needed for fatty acid metabolism.
• Iron supplementation may be necessary if bleeding is severe.
• Calcium (1,000 to 1,500 mg per day) and magnesium (200 mg two to three times per day) are needed for hormone metabolism.
• Essential fatty acids (1,000 to 1,500 mg twice a day).

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts).

Chaste tree (Vitex agnus cactus) taken long term (12 to 18 months) for maximum effectiveness. Combine 2 parts of chaste tree with 1 part of two herbs from each category below. Drink 3 cups of tea per day or take 30 to 60 drops of tincture per day.

For liver support (include milk thistle and one other herb): Milk thistle (Silybum marianum), dandelion root (Taraxacum officinale), vervain (Verbena officinalis), or blue flag (Iris versicolor).

For reducing pelvic congestion: Squaw vine (Mitchella repens), motherwort (Leonurus cardiaca), red root (Ceonothus americanus), red raspberry (Rubus idaeus).

For management of severe pain and extensive endometriosis, Turska's formula is the preferred combination and should be used only under a health care provider's supervision.

Some of the most common remedies are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours.

• Belladonna for menstruation with sensation of heaviness and heat
• Calcarea phosphoricum for excessive periods with backache
• Chamomilla for heavy menses with dark clotted blood and pains
• Cimicifuga racemosa for unbearable pain radiating from hip to hip

Do not perform these therapies during menstrual flow.

• Contrast sitz baths. You will need two basins that you can comfortably sit in. Sit in hot water for three minutes, then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets per day, three to four days per week.
• Castor oil pack. Apply oil directly to abdomen, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes. Use for three consecutive days.
• Kegel exercises (contracting and releasing the pelvic muscles).

Acupuncture may be helpful for endometriosis.

Therapeutic massage may help resolve pelvic congestion.

Endometriosis often resolves during pregnancy.

Facts About Endometriosis. U.S. Department of Health and Human Services. National Institutes of Child Health and Human Development. NIH Publication no. 91-2413.

Hudson T, Lewin A, Gerson S, et al. Endometriosis (modality specific condition reviews) Protocol J Botan Med. 1996;1:30-46.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:112-114.

McQuade CA. Women's health workshop: endometriosis, fibroids, PMS and HRT. Medicines from the earth: exploring nature's pharmacy (official proceedings). Harvard, Mass: Gaia Research Institute; 1997:182-183.

Tureck RW. Endometriosis: diagnosis and initial treatment. Hospital Physician Obstetrics and Gynecology Board Review Manual. April 1997;3:1-8.