Endometriosis, Fibrocystic Breasts, Uterine Fibroids Flashcards
Endometriosis
The presence of endometrial like
tissue outside the uterus.
* Endometrial tissue located in the pelvis (e.g., ovaries, fallopian
tubes, rectum, Pouch of Douglas ). Extra pelvic deposits can occur
(e.g., lungs) but are
* Tissue responds to the natural hormonal cycle causing it to grow, break down and bleed. The blood has no outlet, leading to
inflammation, pain, and the formation of scar tissue and adhesions.
Endometriosis: Signs and symptoms
- Dysmenorrhoea, heavy menstrual bleeding and deep dyspareunia
- Chronic pelvic pain (minimum of 6 months) and lower back pain.
- Period related or cyclical GI (e.g., painful bowel movements) / urinary symptoms (e.g., dysuria).
- Migraines, anxiety and depression.
Endometriosis: Complications
Infertility, endometriomas (ovarian cysts containing blood and endometriosis like tissue), bowel
obstruction, ovarian cancer.
Endometriosis, oestrogen and histamine
- Endometriosis is often associated with a high O:P ratio.
- Oestradiol (E2) is central to the endometrial tissue growth.
- Mast cells contain
oestrogen and progesterone receptors.
Oestrogen triggers histamine degranulation, but histamine itself
is also able to induce ovarian E2 synthesis (a two way process). - High histamine drives inflammation and angiogenesis, and hence endometriosis proliferation.
- Progesterone has an inhibitory effect on histamine secretion following mast cell
binding but is overridden by oestrogen.
Endometriosis: Causes and risk factors
- Prolonged oestrogen exposure (e.g., early menarche, nulliparity and OCP).
- Low birth weight, prematurity and formula feeding.
- Obesity
- Poor oestrogen detoxification and clearance.
- Environmental toxin exposure
- Emotional trauma
- Microbial infections
- High consumption of fats ( trans / saturated )
Natural approach to endometriosis
- CNM Naturopathic Diet with a hormone balancing approach adopted to be low histamine.
- Normalise the immune response and reduce histamine load.
- Reduce exposure to hormone disruptors
- Optimise liver function
- Support the elimination of oestrogen metabolites.
- Promote optimal transit time and optimal intestinal microflora
- Reduce inflammatory processes and oxidative stress.
Fibrocystic breasts (FB)
A common, benign condition characterised by swollen and tender breasts.
* Common among premenopausal women aged 20-50 years old.
* A minority can progress to a high risk and malignant phenotype
due to genetic mutations and differing breast microbiome.
Fibrocystic breasts (FB): Symptoms
- Cyclical breast cysts; ‘ diffuse lumpiness’.
- Breast pain (often bilateral) often during
the luteal phase; improves post menses. Dull / heavy in nature. - Some experience nipple discharge.
Fibrocystic Breasts: Causes and Risk Factors
- Oestrogen dominance / elevated O:P ratio with low progesterone. Stress may be a contributing factor.
- Reproductive history ― nulliparity and late menopause .
- Obesity and T2DM are both associated with breast changes.
- HRT ― increased incidence with oestrogen replacement therapy.
- Iodine deficiency ― shown to contribute to
- Methylxanthines ― substances found in coffee, tea, cola,
chocolate and some drugs that have been linked with FB. - Low fibre ― ↑ dietary fibre = ↓ risk of benign breast disease.
Natural approach to fibrocystic breasts:
- CNM Naturopathic Diet with a hormone balancing approach
- Evening primrose oil 1000 mg 3 x daily )
- Vitex Agnus castus
- Seed cycling
Uterine fibroids
Benign tumours that originate from the myometrium and connective tissue.
* Affect approximately 30% globally. Occur between menarche and menopause but are most common in women aged 35-49 years.
Uterine Fibroids: Signs and symptoms
- 50-80% are asymptomatic.
- Heavy / prolonged menstrual bleeds.
- Pelvic discomfort / pain.
- Abdominal bloating.
- Depending on location: Frequent urination and constipation.
Uterine Fibroids: Complications
Iron deficiency anaemia, infertility, miscarriage, pre term labour, obstructed labour, foetal anomalies, postpartum haemorrhage.
Uterine fibroids and oestrogen
- Uterine fibroids are oestrogen dependent.
- Oestrogen receptors are over expressed in fibroid tissue.
- Oestradiol concentration increases, which increases progesterone receptor availability. Progesterone completes fibroid development.
- Excess aromatisation is also seen.
- IGF and cytokines (e.g., TNF, IL 8) can also promote fibroid growth.
Uterine Fibroids: Causes and Risk factors
- Genetics
- Hypertension
- Poor oestrogen metabolism / clearance
- Chronic stress
- Heavy metals
- Diet / lifestyle
- Vitamin D deficiency
