There would be no human life on our planet without the reproductive power of the uterus. When my children were younger, I described the uterus as a warm and cozy nest. When the egg is fertilized, it is gently dropped into the nest to be protected and nurtured. It was a few more years before I explained exactly how the egg is fertilized, but that is another story entirely, and was a little more embarrassing to explain!

The lining of the uterus is called the endometrium. It changes sizes throughout the menstrual cycle, first thickening to prepare a soft and secure nest, and then, if there is no egg to nurture, it is shed through menstruation and the whole process starts over the next month. This is a singular capability to increase and decrease in size depending upon the needs of the body. Our human existence is incredibly complex and often downright mysterious.

Sometimes diseases are mysterious, too, and endometriosis is near the top of the list. For some reason, endometrial tissue starts to grow outside the uterus! Most of the time, this growth is on other parts of the structures in the pelvis, like ligaments that hold the uterus in place, the fallopian tubes, the ovaries, sometimes even the rectum and/or bladder. But on rare occasions, this tissue will grow even to the lungs and brain. Can you imagine if your heart tissue suddenly started to grow on your knee, or your brain tissue started growing on your elbow? Well, the places where endometrial tissue will grow is weird. I suspect that the reason endometrial tissue can grow in abnormal places compared to other tissue is because of its strength and flexibility in being able to grow larger and smaller to suit the body’s needs. The very brilliance of its unique capability is also the core problem when tissue growth is out of control.

Women with endometriosis may have mild to no symptoms, and some women suffer miserably with this condition. About a third of women struggling with infertility have endometriosis. That does not always mean they will never be able to conceive, but it does mean that it may be harder and take longer. A common symptom of this disease is pelvic pain, ovulation pain, and/or menstrual pain. Weirdly, the endometrial tissue outside the uterus responds to menstrual signals and bleeds during menstruation, which can cause pain and trigger inflammation in other areas of the body, such as the intestines, bladder and low back.

Endometriosis can also increase the risk for ectopic pregnancies because the fertilized egg cannot get into the uterine nest and implants outside the nest, usually in the fallopian tube. Sadly, these pregnancies are not survivable for the mistakenly implanted egg and will also cause mortality to the mother if it is not addressed, because eventually the fallopian tube will rupture and cause internal bleeding. It is a very sad situation, especially in women already struggling with fertility.

Traditional treatments include surgery and hormone therapy—often estrogen blockers. Estrogen blockers may decrease the pain and proliferation of the endometrial tissue, but they put young women in premature menopause. Their bones can become thinner, and they can experience mood, hair and skin changes. I don’t judge anyone who is led to these decisions because of their pain and suffering, but I have to think there are better ways of helping women with endometriosis.

Inflammation and Curcumin

Whenever we talk about a chronic disease, we always end up talking about inflammation. Endometriosis can cause massive amounts of inflammation, and the best all-around natural anti-inflammatory is curcumin.

There are several studies on using curcumin to decrease inflammation and pain in endometriosis, but there are also a surprising number of studies that indicate that it does much more than that. Some research has shown that curcumin can reduce the abnormal blood vessel growth that can become entangled with endometrial tissue, while others have shown it can reduce cellular signaling that tells the endometrial tissue to grow in the first place.

If you choose to use curcumin, you should look for a clinically studied, enhanced absorption version. Otherwise, you may not be getting nearly the amount of curcumin on board to make a difference.

Grape Seed Extract and Aromatase

Grape seeds have some marvelous compounds, the most important of which are oligomeric proanthocyanidins (who names these things?), better known as OPCs. OPCs help with issues of excessive estrogen exposure, because estrogen is like dumping gas on a fire when it comes to endometriosis. Of course, we need our body’s own healthy estrogen, but we have exposure to very negative estrogens in environmental toxins (bisphenol-A [BPA] in plastics is one dangerous example), endocrine disrupting pesticides, and even our own fat cells. I am not saying you must be overweight to struggle with endometriosis, but it is true that women with obesity have higher risk rates of more severe disease. The OPCs in grape seed don’t bother our healthy estrogen. Instead, it reduces a process by which other compounds in our body are turned into estrogen. Some have described this activity as aromatase inhibition, and that is partially true. But drug aromatase inhibitors are quite strong and can have serious side effects, and quality grape seed extracts do not. I would rather call them aromatase modulators, because they do not block anything, they merely slow it down if it is overactive.

Please note that not all OPCs are absorbable. Only the smallest are beneficial. The largest, called tannins, are not dangerous but not absorbed, so you may want to look for a tannin-free grape seed extract for better absorbability.

Diindolylmethane (DIM) and Estrogen Safety

Again, who names these plant compounds? That is a very long name for an incredibly beneficial compound the precursor of which is found in cruciferous vegetables like cauliflower, cabbage and broccoli. So, eat a healthy diet, but note that you would have to consume two pounds or more of broccoli to get a therapeutic dose of DIM. That is why supplementation can be much more beneficial in this situation.

The research on DIM has been more on breast and cervical cancer, as well as cervical dysplasia, with preliminary studies on endometriosis. I include it because there are similarities in how estrogen metabolites can have a deleterious impact on health. Dysfunctional estrogens and pollutant estrogen lookalikes (called xenoestrogens) wreak havoc on our cell’s response to estrogenic signals. Just as dysfunctional estrogen exposure can cause breast cancer cells to proliferate, it can do the same for endometrial tissue in this disease.

DIM does not increase or decrease estrogen. It helps keep estrogen in the safest form, and assure it is metabolized down healthier pathways. I always say it is like the traffic police, waving cars around deep potholes and sending them down safer streets. Adding a quality DIM to your protocol can gradually turn the needle away from dysfunctional and more toward healthy and functional estrogen.

DIM is not well absorbed, and the most clinically studied form is BR-DIM (previously called BioResponse DIM). This form has enhanced absorption for more consistent benefits. But don’t forget to eat your broccoli and bok choy, too.

Circadian Rhythm, Endometriosis, Melatonin

This last suggestion is surprising, as we think of melatonin as an effective sleep aid, and it is. However, more importantly, it is the major driver behind the circadian rhythm that rules our bodies, including the cycles of endometrial growth and proliferation.

In a recent randomized, placebo-controlled trial, women ages 18 to 45 diagnosed with endometriosis pelvic pain took either placebo or 10 mg of melatonin for eight weeks. The results were excellent. Women in the melatonin group had an average 40 percent reduction in pain scores, significant improvements in sleep quality, 38 percent reduction in painful menstruation, and were 80 percent less likely to have to take pain medicine.

Melatonin is an antioxidant, and there is always oxidative stress with this disease. It also upregulates and downregulates several pathways that can reduce the amount of abnormal endometrial tissue being produced or even already produced. Remember when I said the body is so complex? It turns out that melatonin is pretty complex itself, and capable of much more than previously thought.

Conclusion

These are dietary supplements that are able to help women with endometriosis. These products should not be used only around menstruation, when pain is often peaking, but every day as part of a healthy supplement regimen. If you are struggling with endometriosis, or you know someone with this condition, please know that while there is not yet a cure, there are so many choices that can make you feel much better, and slow or maybe even reverse some of the tissue overgrowth. Switch to organic whenever possible and do some reading on hidden xenoestrogen chemicals in our plastics, nail polish, baby toys, make up and more. Avoiding further exposure to these damaging chemicals can only mean good things for you! VR

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Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.