I love to support women with information that honors a womans body, mind and agency to choose what is right for her on her health and wellness journey. Please note: THIS IS GENERAL INFORMATION ONLY. THIS IS NOT ADVICE. IT IS NOT INTENDED TO DIAGNOSE OR TREAT. PLEASE DISCUSS ALL INFORMATION WITH YOUR PROFESSIONAL HEALTH TEAM OR SEEK PROFESSIONAL SUPPORT FOR SYMPTOMS.
A heavy period sucks, but if you are getting them regularly and you suffer a lot of cramping and pain and maybe even pain during sex you may be suffering from Adenomyosis or Endometriosis. This article looks at Adenomyosis (Cousin to Endometriosis) its Risk Factors, Holistic and Surgical Treatments.
A thorough article by Endometriosis Australia on Adenomyosis can be found here. But just so we know what we’re talking about:
“Adenomyosis is a condition of the uterus that is diagnosed when there are glands and supporting structures of the endometrium found inside the muscular layers of the uterus. It is a common cause of pain and abnormal (heavy) bleeding in women and its features often overlap the symptoms of endometriosis and in fact the two may co-exist in the same woman.” “For a disease that is suggested to affect 20-35% of women (3, 8-11) we still don’t know what the causes of adenomyosis are.” Risk factors are: “surgical instruments being used in the uterus that may push the lining cells into the muscle. Other risk factors include longer oestrogen exposure such as an early time of first period, short duration between the menstrual cycles and obesity” - Endometriosis Australia.
RISK FACTORS - LINKED TO HORMONE IMBALANCE?
So, Adenomyosis is related to Endometriosis and medically has been identified with ‘no known causes’ and this might be what your local Dr might say to you. Now although the old medical world says that it has no clinically known causes, we do know that excess estrogen (in particular estradiol which is a cell-proliferator) is a contributor to cancer and fibroid symptoms. Note:
“Women who take estradiol need to be aware that they have an increased risk for uterine and ovarian cancer” says breast cancer educator Phylis Johnson.
“The labeling of estrogen-only products in the U.S. now includes a warning that unopposed estrogen, without progesterone, therapy increases the risk of endometrial cancer and breast cancers”... from Adenomysios Advice Association, 2003.
And it is common practice to treat the symptoms of Adenomyosis with hormones (the most successful being the Mirena with a synthetic progesterone and it is common practice to also use the pill). However your local Dr won't be asking you about whether you have too much Estrogen and offer suggestions of how to lower it. Australian fertility expert Nat Kringoudis claims about estrogen (again the estradiol sort):
“There’s a lot to love, but it must be said that oestradiol is mostly responsible for our gynaecological issues like endometriosis, adenomyosis, fibroids and reproductive cancers.” Her full article about excess estrogen can be found here: Healthy Hormones - Estrogen Explained - Nat Kringoudis
So unopposed Estrogen and its risks is supported by varied health professionals and research and the Adenomyosis Advice Association (which was set up by a woman who had a long journey with the condition and eventually had a hysterectomy), wishes women could have estrogen testing as a normal thing to detect reproductive issues early.
Mayo Clinic has these listed as risk factors for Endometriosis:
Never giving birth
Starting your period at an early age
Going through menopause at an older age
Short menstrual cycles — for instance, less than 27 days
Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
Low body mass index
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
So you may be able to look at hormonal balancing for treatment, but what if its really severe? Your doctor will likely suggest medical or surgical intervention.
TYPICAL MEDICAL TREATMENTS
The treatment for Adenomyosis is often surgery (depending on severity of symptoms). It may be suggested to have a hysterectomy although a more conservative surgical intervention is Uterus-sparing operative treatment which removes the nodules - also called excision surgery. You can read more about that if you scroll down to Surgical Treatment in the first article I pointed to: Eendometriosis Australia - surgical options These options have success in maintaining fertility and lowering symptoms, including pain.
The American Society for Reproductive Medicine reviewed systematically the literature on uterus-sparing surgical treatment options for Adenomyosis. What they found about complete excision of Adenomyosis was an improvement in pain of up to 82%. And a pregnancy rate of 60%. (Full Article here.)
There is informaion available about other non-hysterectomy and non-surgical treatment of heavy bleeding at Womens Health.org.au in their Non-hysterectomy Options for Treating Heavy Bleeding. This also mentions the treatment types of blocking blood supply and ablation, but health expert Jessica Drummond from Integrative Womens Health Institute suggests that excision surgery has been known to have the best results if the client is seeking this sort of medical intervention.
There is also the much less conservative treatment of removing the uterus with a hysterectomy. This seems to be recommended less. If excision surgery is an option, excision seems preferred. You can read all about hysterectomy on this Hysteretomy Fact Sheet Womens Health.org.au .
The hormonal fix is another typical approach from Doctors. Altering the hormone balance so that Estrogen is not unopposed by Progesterone helps the situation. The Mirena is commonly prescribed as an Intra Uterine System that uses a progestin to alter hormonal balance to treat Adenomyoisis ( Progestins are synthetic progestogens, medications that have effects similar to those of progesterone ) “Where there are studies to show that this medical option may be of equal benefit to hysterectomy (and clearly the reversible nature of the Mirena for future fertility is often desirable). Overall, satisfaction with Mirena for adenomyosis is reported to be about 70% (17)” - Endometriosis Australia
Why might satisfaction be at 70%? There is growing evidence of womens dissatisfaction with being dependant on the progestin in Mirena and bad side effects coming off of it, as well as poor health implications like migration of the actual device. You can read more about the negative implications for the Mirena here from a law firm who are concerned about the negative effects of its use in women.
NATURAL OR COMPLIMENTARY THERAPIES/APPROACHES TO SUPPORT
Complimentary therapies have been shown by health professionals to have an impact on womens symptoms with Adenomyosis and Endometriosis. Hormonal balancing through diet, reducing environmental estrogens, increasing progesterone, reducing stress, looking at ways that help eliminate excess estrogen through the liver are all relevant approaches to assist the body to balance hormonally. I would recommend working with a womens health professional to establish if this route is possible for treating your case. Below is a list of resources and notes on ways that complimentary treatment has been shown to effect change for some women.
For hormonal imbalance Dr Northrup recommends a natural progesterone cream here without the Mirena Crash symptoms:
Use transdermal 2% bioidentical progesterone cream: Many of the symptoms of estrogen dominance can be relieved with natural, bioidentical progesterone, - Click to See more.
Nina has recorded her personal experience in treating and curing Adenomyosis with progesterone cream here.
Dr Northrup also mentions in this article on menstrual cramps that she has had success with dietary change to effect period pain. “I’ve seen many women get rid of their menstrual pain altogether (even in cases of severe endometriosis) by eliminating dairy foods”
“Poor digestive health can inhibit excretion of unwanted oestrogen from the body and promote its re-absorption which often stores in fat cells.
-Ensure you are eating a diet rich in vegetable/fruit fibre and avoid gut irritants such as wheat.
-Balance blood sugars. High insulin levels stress the endocrine system which inhibits estrogen metabolism. Cut out the processed sugars and opt for alternatives”
All those above tips are from digestion expert Laura Knowles in this great simple article on Estrogen:
For more natural healing options for Adenomyosis this Natural Fertility specialist site recommends - herbs, abdominal massage, castor oil packs.
There is also another informative post here from former teaching staff of the University of Westminster who are practitioners at BeWell Integrative Health service on treating Endometriosis with abdominal therapy, castor oil, herbs and Traditional Chinese Medicine.
Melissa is an expert on endometriosis and women’s health. Having overcome stage 4 endometriosis, she is a guiding light for women with endometriosis who are keen to use a natural and holistic approach. There might be something useful on her EndoEmpowered site to inspire and educate.
If you’d like to hear about hormone balancing, testing and herbal treatments with a Womens Health Specialist, Dr Bridget Danner. Take a listen to this podcast recording with Dr Carrie Jones. She mentions Adenomyosis at about 40mins.
Womens Wellness Radio - Natural Solutions for Hormonal Problems
Eliminating Estrogen through the LIver
Detoxing the liver is what internationally acclaimed womens health expert Dr Northrup writes as one thing to help with estrogen dominance in peri-menopause:
“The liver acts as a filter, helping us screen out the harmful effects of toxins from our environment and the products we put in our bodies. When the liver has to work hard to eliminate toxins such as alcohol, drugs, caffeine, or environmental agents, the liver’s capacity to cleanse the blood of estrogen is compromised”. - See more here.
Naturopaths seem to recommend similar approaches about making sure we are detoxing our estrogen. “ Estrogen is metabolized by the liver and cleared out of the body through the bowel, if this process is not working optimally it can lead to either high levels of potentially toxic estrogen or reabsorbing estrogen back into circulation.” Says Michael from Planet Naturopath He also suggests doing the DUTCH hormone test because it measures how you are eliminating estrogen and which types, not just your general levels.
Reducing alcohol consumption can help to reduce estrogen levels and help liver function.
So making sure that the liver is getting rid of estrogen properly lets look at lowering alcohol and coffee... Does this spell Detox to anyone? Here is a good article about effects of detox and estrogen. You may like to seek support from a naturopath for liver cleansing herbs too like Milk Thistle and look into what foods support getting the excess estrogen out too.
Environmental Impacts on Estrogen
Yep our environment is impacting us in so many ways...
Something we might not ordinarily think about is our electronic environment and Electro Magnetic Fields however Dr Mercola states “Compared to measurements taken in the presence of negligible background fields, overnight exposure of women to 200-mG EMFs in the laboratory significantly elevated estrogen; other studies have shown that elevated exposure to estrogen over many years can increase a woman's breast cancer risk.” So make sure your'e not lying next to your electricity meter!
Another huge topic is xenoestrogens. "Xenoestrogens are found in a variety of everyday items. Many of us don’t think twice about the makeup we wear each day or the plastic container we use to pack our lunch. Unfortunately, all of the above may be altering the way our body naturally functions because they all contain endocrine disruptors called, xenoestrogens - a sub-category of the endocrine disruptor group that specifically have estrogen-like effects." Thanks Women In Balance Institute. You can find their great article here that lists specific xenoestrogens and how you can avoid them. And Here is a blog post about how to lower estrogen in the environment from Fertility Friday. The worst offenders - insecticides of normal food produce, plastic packaging and skincare preservatives and sunscreen lotions. So make sure you take a look at one of these lists if you feel like your'e abit behind in getting natural and organic.
Stress and Hormone Imbalance
And of course I couldnt talk about balancing hormones without making a mention of stress. Laura Knowles says succinctly “Progesterone, the partner hormone to oestrogen, is used by the body to create the stress hormone cortisol. If women are under a lot of stress it is common that her progestrone levels are low and her cortisol levels are high. Reducing stress will help balance progesterone / oestrogen / cortisol levels.” How straight forward does that sound? Of course there are many reasons why meditation, mindfulness, stress reduction and pursuing things you love are great. Now you can add hormone balancing to your list! You might even find a great Yoga for Hormone Balancing class in your local neighbourhood.
Check out Mindfulness Based Stress Reduction or get an app like CALM or MINDFUL on your phone to be your meditation buddy.
Laura is also a counselor and is an advocate for healthy boundaries. If you feel that your boundaries could help you drop some stress you can see her work here on this topic: www.reclaimyourlifewithease.com
Lastly, and most radically, yes there is sometimes an emotional or mysterious component to our pain. Deanna L’am works with womb healing on those mental/emotional/spiritual areas. “Within 3 month Susan went down from 5 to 1 pain killer a day. The following month she didnt need any painkillers anymore. ”
I myself worked with a spiritual healer (alongside hormonal cycle awareness) and I was healed of the suffering from PMS that I had suffered for over 25 years, without other changes of diet or supplements. In no way do I make claims that this will work for you and the severity of symptoms for Endometriosis and Adenomyosis are certainly different to the painful periods I suffered. Each woman must be assessed properly by a health professional to help with her condition, but it is a piece of the health and wellness puzzle that may be meaningful to some women to explore. This type of exploration of health is linked to the territory of psycho-neuroimmunology - how the mind effects the body's health through stress or it might suit those that see the body as a map of the spiritual or etheric body. Whenever symptoms persist you should consider all options available.
I hope this information is helpful for you to choose what treatments and/or lifestyle change you may feel called to try if you have been diagnosed with Adenomyosis or if it has made you want to find out more about how you can improve your hormone balance and optimise yourself as a woman. I recommend you research all options thoroughly, ask as many questions as you need to understand your options from your health care professionals, both western medicine and holistic. The complimentary, holistic or integrative approaches may help with on-going support for your health and wellbeing, alongside surgical methods if they are necessary. Naturopathy, Traditional Chinese Medicine, Functional Nutrition all have something to offer hormonal health.
Again, this is general information and in no way is this writing a diagnosis or recommendation of treatment. You must see registered health practitioners to get a health plan tailored to your needs.
I always aim to support your health and wellness in a whole person way, where you are driving the ship. I look forward to supporting you in your next steps.
Dominique is a Womens Wellness Coach who aims to empower women so they can be the best version of themselves. You can find out more about her coaching programs at templewellwoman.com.