By Jack Handlin L.Ac., Dipl OM

Basic Facts

Endometriosis is defined by the presence of endometrial tissue (normal lining of the uterus) somewhere in the pelvic cavity but outside the uterus. Laparoscopy is the gold standard for diagnosing endometriosis. This can show the presence of small areas of tiny spots or large lumps, which can affect the organs of the pelvis. Brown colored endometriosis formed from the blood lost during the menstruation that has nowhere to go gets trapped, often causing pain. Chocolate cysts are cysts that form on the ovaries from encapsulated blood and tissue that becomes thick and dark brown.

Clinical research has shown the depth of attachment of endometrial tissue can influence the effect on the body, where the superficial endometriosis seems to affect fertility, the deeper endometriosis causes pain.

Common symptoms are painful periods, pain during intercourse, spotting before periods and infertility. Other symptoms can be painful bowel movements, urinary urgency, and frequency. One theory of the cause of pain is that the endometrial lesions react to hormone stimulation and bleed during the time of menstruation. The blood accumulates which can lead to swelling triggering the inflammatory process (including cytokines and prostaglandins), causes pain and disrupting fertility.

How Endometriosis Affects Fertility

If the endometriosis is located in places such as fallopian tubes or ovaries this can affect the fertility and ability to conceive. One way endometriosis may affect fertility is due to the increased activity of macrophages when the lesions are present. One of the functions of these macrophages is to destroy the sperm swim out of the tubes into the abdomen. The macrophages can at times enter the tubes and destroy the sperm before there is a chance to fertilize the egg. Other ways this tissue can decrease fertility is decreasing the function of the fimbriae preventing transfer of the egg, decreasing the flexibility of the fallopian tubes, and decreasing progesterone levels in the luteal phase.

Many theories about the cause of endometriosis, focus on the possibility that endometriosis represents a state of an impaired immune system, which allows the endometrial implants to invade and proliferate. Biopsies of endometriosis will contain large levels of macrophages, which include cytokines and prostaglandins. These factors will produce inflammation and damage the surrounding tissues and cells.

In patients who are suffering from infertility problems, it is important to care for and regulate the  menstrual cycle before trying to conceive naturally our with ART therapies.  Although endometriosis will cause symptoms such as pain and discomfort during the menstrual cycle it is important to think about the broader aspect of fertility as well.

How Acupuncture Can Help

One of the main goals of acupuncture treatment for endometriosis is to regulate the smooth flow of blood from the uterus and to decrease the body's immune response. Providing the optimal environment for conception to occur.

Although laparoscopy is an effective treatment for endometriosis, many women experience recurring symptoms and can suffer from additional symptoms from adhesions caused by multiple surgeries.  For many women, laparoscopy is not cure because  the endometriosis returns over time.  This is where acupuncture and alternative treatments become a great addition to conventional medicine care.   

Acupuncture is an effective treatment for decreasing pain, and regulating the menstrual cycle in women with endometriosis.  The benefits of acupuncture for endometriosis and infertility are not usually seen right away, it often takes several treatments before signs of improvement becomes significant and visible.  For this reason, it is important to choose your practitioner carefully. 

Patients can assist their reproductive endocrinologist by regulating the menstruation and optimizing fertility in preparation for IVF & IUI cycles.  This can take between 3-6 months of treatments to get the body to the optimal state in preparation to conceive.  Although this may seem like a long treatment course, from experience we have found that this is often is the quickest path to achieving and sustaining a healthy pregnancy.    

Although conventional medicine often offers viable treatments for endometriosis, acupuncture may offer a less invasive approach with more sustainable results.  The acceptance of acupuncture by conventional medicine doctors is growing significantly, and practitioners often recommending acupuncture as an effective treatment for endometriosis and infertility.

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