Julia Chang, MSc
Endometriosis symptoms, treatment and liver health
Endometriosis is the most common cause of pelvic pain in women of reproductive age. It afflicts millions of women in America. Yet the medical profession has a limited understanding of this disease. Endometriosis occurs when endometrial cells which normally line the uterus somehow grow on other pelvic organs such as the outside of the ovaries, the fallopian tubes, the uterus, etc. The mislocated cells can develop into cysts, scars or adhesions which may lead to infertility. Symptoms may include chronic pelvic pain, severe menstrual pain, painful bowel movements during menstruation, constant fatigue, allergies and infertility. It usually ends with menopause as the estrogen level decreases, but estrogen replacement therapy can reactivate the disease because it raises the estrogen level.
Various medical therapies may temporarily relieve the symptoms of endometriosis by suppressing estrogen level but they often lead to the absence of menstruation and decreased fertility. Surgery is not the answer because endometrial cells grow back in different areas sooner or later unless the root of the problem is addressed. Pregnancy and birth control pills can temporarily control the symptoms but are also incapable of eradicating the disease.
My experience with endometriosis
As an endometriosis sufferer for more than 15 years, I hope my experience can help other sufferers. Other than juvenile arthritis which started at the age of 14, hay fever and allergy to dust and pollen, I was never bothered by my period (except feeling fatigue) until my early 30's. I started having pain and experienced fainting with every period. The pain increased over the years. In 1984 I passed out one day during my period in a subway train (fortunately I wasn't driving). The ambulance took me to a hospital where I was examined by a woman doctor. She told me that I had a thick and hard uterine wall for unknown reasons. A gynecologist was then called in. He told me that I had a big fibroid in my uterus and should be checked with ultrasound as soon as possible. The ultrasound "confirmed" the big fibroid. He suggested a hysterectomy immediately but I refused. Half a year later my family moved and I went to see a top gynecologist in Toronto. He told me that my fibroid was actually very small and should cause no concern but that I had endometriosis which was my real problem. When I told him that my big fibroid was confirmed by ultrasound, he simply said "they must have mistaken water for fibroid". Unless the pain became unbearable, he would not advise me to take any medication. I accepted the chronic pain as part of my life and tried to live as normally as I could. During those years constant fatigue and allergies also bothered me, but I did not know that they were all related. As I advanced in years, all the above problems became more severe and new problems continued to appear. By my late 30's, I had problems sleeping, frequent urination, and my skin became dull, grey and yellowish with constant breakouts. In 1989, my thyroid problem started and my fingers sometimes felt numb in the morning.
I decided to see a traditional Chinese doctor. He correctly diagnosed that I had liver congestion by reading my pulse. From my experience working for more than 6 years in the medical laboratory of a large hospital in Toronto, I recognized that unlike liver inflammation or infections which show elevated liver enzyme levels in blood due to enzymes released from ruptured liver cells, liver congestion or weakness cannot be detected in blood tests. This is due to the fact that the liver cells are still intact and therefore do not release liver enzymes into the blood. In fact I had two blood tests done prior to my visit to the Chinese doctor and they were both normal. In general, blood tests will not reveal liver congestion or weakness.
How I overcame endometriosis
Unfortunately Chinese medicine does not understand hormones or endometriosis. As a matter of fact, there is no term for hormones in Chinese medicine. The Chinese doctor who diagnosed my liver congestion gave me two products for my liver. They contained Don Quei, ginseng, licorice and royal jelly. I was feeling better for about two weeks because they did help my liver and improve my circulation. Then my pain came back worse than ever. I realized that the above herbs have estrogenic activities, which took a little while to have an effect on me. I later found out from other peoples' experiences that the sicker a person is, the shorter is the time needed to have negative effects from plant estrogens.
Realizing that Chinese medicine does not address hormone problems and conventional medicine does not address liver congestion problems, I decided to start my own journey of self-healing, using my combined knowledge of western science and Chinese medicine. I made some mistakes at the beginning which delayed my recovery. I tried Swedish Bitter which contains fennel, anise, angelica and licorice all of which have estrogenic activities. Again I was feeling better for about 3 weeks before I got into more pain and extreme fatigue. Following a lengthy research into the estrogenic activities in different herbs, I developed my own remedies which help liver functions but without estrogenic activities. I used these remedies in conjunction with regular exercise and diet control. It took me about 7 to 8 months before my symptoms disappeared completely. The regimen that I followed is described below:
Take 2 cups of warm water first thing in the morning.
Do Y-Dan exercise for 20 to 30 minutes.
Take Chinese Bitters. 45 minutes to 1 hour should have passed since taking the water (to ensure that most of the water has left your stomach).
Have my breakfast about 20 to 30 minutes after taking Chinese Bitters.
Take Coptis at bed time on an empty stomach.
Avoid or minimize foods [french bean, date palm, dates, garlic, pomegranate, apple, soyabean, chick pea, cherry, alfalfa, soya sprouts, cow pea, green beans, red beans, split peas, flaxseed, raspberry, carrot and squash - both have beta carotene] or herbs [anise, hops, fennel, black cohosh, milk thistle, clover, red clover, Don Quai, licorice, ginseng, royal jelly, peony, nettle, sage, fenugreek, evening primrose oil, burdock, chamomiles, rhubarb] with estrogenic activities and foods that weaken our organs, especially the liver, kidney and spleen.
The warm water taken in the morning is intended to stimulate intestinal movement and activate the kidneys. Exercise stimulates blood circulation and reduces estrogen production. It also activates the liver. Chinese Bitters helps to cleanse and decongest the liver. Coptis is very effective in stimulating bile flow and eliminating excess estrogens since the liver eliminates estrogens through bile and urine. "A Significant route of excretion of estrogens is the bile, and undue accumulation of these hormones may occur in circumstances of a decreased flow of bile or a diminished excretion of estrogens in the bile" .
Once the bile is flowing properly, Coptis may not be needed any more. It usually takes 1-2 bottles of Coptis. Indications of proper bile flow include better quality sleep and normal bowel movements with good bile color in the stool.
I also used Taheebo (a Brazilian tree bark) and vitamin B, C and minerals for liver strengthening. An essentially vegetarian diet with no refined food or deep-fried foods also helped to restore my liver health. Along with the endometriosis pain, every other problem (skin problems, sleep disorder, allergy and overactive thyroid and arthritic pain) was gone. During that year, I noticed that my pain reduced gradually with improvement in my liver and my complexion. When most of my problems disappeared and my complexion improved, I realized how important the liver was to endometriosis.
The importance of diet
During those years of suffering, I found that many foods bothered me during my menstruation even though they didn't seem to cause obvious negative reactions when I was not menstruating. Those foods include tomato, orange, lemon, grapefruit, banana and cold foods cold drinks in general, basically most foods classified by Chinese medicine as "Yin". Pain is the result of blood stagnation. According to Chinese medicine, "Yin" means inactivity which aggrevates blood stagnation and makes pain worse. One day during my menstruation, I did not eat anything and was resting in bed the whole day. I felt weak but no pain. Then I decided to eat some light dinner which consisted of rice, boiled egg and a few slices of tomato. Within an hour, I had the worst cramp in months. I believe it was the tomato that did it because I never had problem with rice or egg before. I found that physical exertion also aggrevated my pain. One of my clients had similar experience with tomato. One day during her menstruation, she was feeling fine in the morning while at work. After lunch which consisted of spaghetti with tomato sauce, she had such a bad cramp that she had to go home.
Relationship between endometriosis, estrogen levels and liver health
Studies have shown that chronic exposure to dioxins (TCDD) is directly correlated with an increased incidence in endometriosis in rhesus monkeys . Unfortunately, we all live in an environment contaminated with dioxins (90% of it in fish, meat and dairy products according to a report from the World Health Organization). Why do some women get endometriosis but not others? Apart from genetic factors, the difference may lie in the state of their liver health. The book Chemical Scythe  states: "the liver is a major target organ for TCDD (2,3,7,8 Tetrachlorodibenzo-p-dioxin) and is severely affected by the chemical"; "TCDD will cause extensive necrosis (tissue decay or death) of the liver in rabbits"; "one of the main toxic effects of TCDD in the rat and rabbit is damage to the liver". Studies and observations also showed that up to 50% of the nearly 1000 persons who may have had exposure to dioxins since 1949 in industrial accidents have enlarged liver and impairment of liver function .
Substantial evidence exists that endometriosis is dependent on estrogen for continued growth and proliferation . Estrogen therapy has been shown to worsen gynecological conditions such as fibroids and endometriosis , and to have a pronounced effect upon the endometrium and induce endometrial mitosis (hyperplasia) . Research also suggested that regular exercise may help to protect against endometriosis by decreasing the rate of estrogen production . Endometriosis can even occur in men who are castrated and treated with estrogen .
Medical therapies for endometriosis try to lower estrogen levels either by suppressing estrogen production or suppressing the serum estrogen level by derivatives of testosterone. A better alternative however is to strengthen the liver so that it can more efficiently inactivate and remove estrogen. The liver regulates estrogen by inactivating it through oxidation and conjugation with sulfate or glucuronide. The conjugated estrogens are excreted mostly in the bile with a small amount excreted in the urine. The fact that hyper-estrogenism accompanies certain types of liver disorders confirms the important role of the liver in estrogen inactivation. "The hyper-estrogenism occurs as a result of failure of hepatic (liver) removal of estrogen from the circulation" . As a matter of fact the symptoms often associated with endometriosis such as chronic fatigue, allergy, emaciation and poor complexion are not caused directly by endometriosis but are signs of liver disorders.
According to Chinese medicine, the liver is the most emotion sensitive organ. It serves important regulatory functions which affect emotional and mental activity. When the liver is affected by stress, it becomes tense and its vitality is repressed, the bowels may become constipated or sleep is disturbed, accompanied by nightmares or insomnia .
After I was first diagnosed as having endometriosis in 1984, I came across a publication from the Mayo Clinic which called endometriosis a "career woman's disease" because most women with this disease were career women. It didn't explain the reason so it made me wonder how my body knew that I was a career woman. It is clear to me now that "career woman" simply means "stressed woman". As we all know, "stress" is damaging to every part of our body especially to the liver. In my case, a long period of stress resulted in liver congestion which led to restricted bile and blood flow. The weakened liver was too weak to inactivate and remove my estrogens, resulting in their accumulation.
Other than stress, liver weakness can also be caused by taking too much medication as most of them are damaging to the liver or kidneys, or intakes of toxins such as dioxins from various sources. It may also be caused by eating too many liver weakening foods such as refined flour, refined sugar, deep fried foods, caffeine or ice cold foods or drinks which chill the liver and kidneys especially if the liver is already genetically weak. Overall however, I still think stress is the most common factor because most endometriosis sufferers including myself are over-sensitive emotionally. My stress started from my childhood.
Many endometriosis sufferers take painkillers regularly to control their pain. Since painkillers are damaging to the liver and kidneys, they actually make their problems worse in the long run. I feel lucky that I only took painkillers less than 10 times during my years of suffering. Too many painkillers may make the liver disorder irreversible. My own and other people's experience showed that calcium in an easily assimilable form such as calcium gluconate or calcium ascorbate can be substituted for painkillers. Magnesium oxide is also recommended to be taken to balance calcium.
I was pain-free for almost 5 years (1989 - 1994) except once in early 1994 after taking another Chinese herb, Lycium berries, daily for a few months. My pain albeit mild did come back. When I stopped taking this herb, the pain disappeared. I later found out from the book Planetary Herbology  that Lycium berries tonifies liver and kidney but also "helps reproductive secretions" which means that the berries probably raised my estrogen level again. This personal experience led me to believe that endometrial cells do not necessarily cause pain unless the estrogen level reaches a certain threshold that make the endometrial cells swell or congest thereby causing pain. Finally at the end of 1994 my long awaited menopause came and a new stage of life began. I am now healthy and energetic. I still watch my diet, do exercises , cleanse and strengthen my liver periodically.
Since Vitality Magazine in Toronto published my article entitled "Endometriosis" in its December 1994 issue, many sufferers who read the article contacted me and were willing to try my approach. Among the endometriosis sufferers that I have helped, one of them has been suffering severely for 26 years. She tried practically everything including 10 surgeries, acupuncture, herbs, Danazol and Provera. She told me that my program of liver cleansing and strengthening with Chinese herbs is the first treatment that ever helped her in 26 years. After only a few months of treatment, her ovarian cyst was gone and her pain and feeling of tightness in her abdominal area reduced substantially. She was sleeping much better and only had to get up once to go to the bathroom through the night in the second half of her menstrual cycle. Before the treatment she had to urinate every 15 minutes throughout the day and night. Her heart palpitation disappeared after 8 months of liver cleansing and strengthening. She told me that she is totally convinced that her endometriosis is caused by liver disorder. Otherwise the liver cleansing and strengthening treatment couldn't have helped so many of her problems at the same time. Another sufferer whose problems were not as severe was almost completely out of pain after a few months of treatment.
Among all of the published articles that I have read, endometriosis is still considered to have no known cause or effective medical therapy. There was not a single reference to liver disorders being related to endometriosis. However, my personal experience and that of others have shown that liver plays a central role in this and many other conditions.
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