NATURAL TREATMENTS FOR ENDOMETRIOSIS.PROGESTERONA NATURAL.Very complete publication, based on scientific studies

NATURAL PROGESTERONE

NATURAL TREATMENTS FOR ENDOMETRIOSIS

by Jeffrey Dach MD:

Comprehensive publication based on scientific studies

Endometriosis is a chronic, incurable gynecological disorder that causes pelvic pain, menstrual irregularities, infertility, and misery that affects 10.6% of women in the United States. (1) (7) The global incidence of endometriosis is estimated to be between 0.1 and 0.3% , or approximately 150 to 200 million women. (17)

Medical treatments are largely ineffective. Surgical treatment with laparoscopy is used as a last resort to restore fertility and relieve pain. (2) In this article we will discuss natural treatments for endometriosis

What is endometriosis?

In this condition, cells from the lining of the uterus called the endometrium are found in distant locations outside the uterus, with deposits of tissue scattered throughout the peritoneal cavity. The mechanism, confirmed in animal experiments, is thought to be the retrograde passage of menstrual endometrium through the fallopian tubes. These cells then seed the surface of the ovaries as well as the entire peritoneal cavity. (3)

“The principal theory of the pathogenesis of endometriosis… (is) the retrograde” regurgitation “of endometrial cells that pass through the oviducts in the peritoneal cavity and proliferate at ectopic sites”. Quote from Dr. Ceccaroni (4)

Abnormalities of host immunity required to allow abnormal implantation of endometrial tissue are also found. (1)

When physicians view the ovaries or peritoneal lining with the laparoscope instrument, they may find small, dark nodules of endometrial tissue implanted (see image below). Microscopic examination of the endometrial implants shows the induction of blood and innervation of the implants,

Above image: Shows laparoscopic view of endometrial implants in the peritoneal cavity (dark spots denoted by red arrows) courtesy of Dr. Yahya Kamal

Shared functions with cancer

Although endometriosis is a benign disease, it shares many of the characteristics of cancer cells, and can be viewed as a neoplastic process. (5) There is extensive clinical, pathological, and molecular evidence suggesting that endometriosis is a neoplastic process with a potential for malignant transformation. (5) Endometriosis can appear on cancer images with PET scans giving a false positive. (6)

Resveratrol and EGCG, fish oil and melatonin

If this is true, that endometriosis is a neoplastic process, then one might expect endometriosis to regress in response to natural substances that have anti-cancer activity, such as resveratrol, ECGC (green tea), fish oil, and melatonin. These have been studied in animal models.

Resveratrol is a natural substance obtained from red wine, which has anti-proliferative and anti-inflammatory properties. (11) EGCG is a green tea extract. A 2013 study by Dr. Riccifound both Resveratrol and EGCG had a potent inhibitory effect on the development of endomeriosis in a mouse model. (7)

A 2011 study by Dr. Brune-Tran showed that resveratrol inhibits the development of experimental endometriosis in vivo and reduces the invasiveness of endometrial stromal cells in vitro. (8) In this study, naked mice were implanted with human endometriosis cells. (8) The authors found that resveratrol reduced the number of endometrial implants by 60% and the decrease in total implant volume by 80%. (8) This is a great result for a naturally occurring supplement.

Fish Oil

The omega-3 fatty acids in fish oil are known to have anti-inflammatory properties. A 2014 study by Dr. Jennifer L. Herington using an experimental mouse model of endometriosis, showed that in mice with a 10% fish oil diet to be completed, adhesion scores and disease burden were significantly reduced. (9) The authors concluded, “an anti-inflammatory diet that includes fish oil supplementation may be a beneficial adjuvant in reducing the development of adhesions in women undergoing surgical treatment of endometriosis. (9)

Melatonin

Melatonin has anti-cancer and anti-inflammatory properties and was studied by Dr. Guney in 2008 in a mouse model of endometriosis. (10) The authors found that melatonin causes regression and atrophy of endometriosis lesions in experimental mice. (10)

Adenomyosis

Adenomyosis is similar to endometriosis with similar ectopic implantation of endometrial tissue, in this case, the ectopic tissue resides inside the uterus itself, in the muscular layer of the uterine wall where no endometrial glandular tissue should be found. Induction of adenomyosis in mice results in progressive hyperalgesia (increased sensitivity to pain), uterine hyperactivity, and the elevated plasma corticosterone levels (stress) that it indicates. (13-14)

EGCG, a green tea extract has been found to possess anti-cancer activity (12). Two publications treat EGCG as a natural beneficial treatment for adenomyosis. (13-14) In a 2013 study, Dr. Chen found that EGCG suppressed myometrial infiltration, improved overall hyperalgesia, reduced uterine contractility, and decreased plasma corticosterone levels in experimental adenomiosis-induced mice. (13-14)

Cyclic Natural progesterone for endometriosis

Another natural treatment that has been used successfully in recent years is cyclic progesterone, 20-40 mg twice a day applied as a topical cream for days 8 to 26 of the menstrual cycle. It was started by John R Lee MD and is described in his book, Natural Progesterone: The Multiple Functions of a Remarkable Hormone

Patients have reported good results with this regimen with relief of pain and other symptoms of endometriosis.

Dr. Jeri Lynn previous protocol with oral Prometium 300 mg BID.

Dr. Lam protocol for endometriosis – 20 mg BID topical progesterone days 26.8 .

Women in balance in progesterone cream for endometriosis.

Medicinal Cannabis Beneficial for endometriosis

While it is true that endometriosis is a benign disease that responds to natural substances with anti-cancer activity, then one would expect cannabis sativa extract to have beneficial effects. This is exactly what was found in multiple studies. (15-19) An additional benefit, reduction in pain, was also reported. (15-19)

Pain from the endocannabinoid system and endometriosis

Dr. Dmitrieva studied endocannabinoid involvement in endometriosis and reported her findings in the journal Pain in 2010. He noted that previous studies of endometriosis in mouse models and in women showed:. “Sensory and sympathetic nerve fibers sprout branches that innervate” endometriosis implants “In the past, medicinal cannabis has been commonly used for the control of pain associated with endometriosis. Dr. Dmitrieva the theory that the endocannabinoid system is involved in both endometriosis and its associated pain. Using a mouse model of endometriosis, Dr. Dmitrieva found that cannabinoid CB1 receptors are expressed on the sensory and sympathetic nerves to endometriosis implants. (15)

Progesterone and the endometrium

Dioxin Interrupts cannabinoid signaling in the endometrium

In October 2012 Fertility and Sterility, Dr. Kevin G. Osteen, proposed that exposure to environmental endocrine disrupting chemicals, such as dioxin, can trigger changes that promote resistant progesterone endometriosis. He did a molecular study of the CB1 receptor messenger RNA in endometriosis. He analyzed messenger RNA receptor cannabinoids (CB1-R mRNA) in human endometrial tissues before and after exposure to dioxin, (TCDD) or a progesterone receptor antagonist drug, onapristone. (16)

Dr. Osteen found that in vivo exposure to progesterone during the secretory phase (days 12-26 of the cycle) was associated with positive regulation of endocannabinoid receptors in normal women. Dr. Osteen found increased gene expression of endocannabinoid receptor (CB1-R) messenger RNA in endometrial tissue samples harvested from normal healthy women during 12-26 days of the menstrual cycle. However, there was no positive regulation of gene expression in women with endometriosis. They found very little, or reduced, expression of CB1-R gene expression in similar endometrial tissue samples obtained from women with endometriosis.

In vitro studies revealed that acute dioxin exposure to normal endometrial cells produced this same abnormality, resulting in a failure of progesterone to maximally regulate the expression of the endocannabinoid receptor. The same results were obtained with a progesterone antagonist drug.

The authors concluded that the loss of normal progesterone responsiveness, i.e. progesterone resistance, is a striking feature of endometriosis. In addition, the endometrial progesterone-mediated endocannabinoid receptor system was profoundly dysfunctional in women with endometriosis. Exposure to the endocrine disrupting chemical, dioxins, replicated these abnormalities (16)

Endometrial-dependent progesterone regulation Cannabinoid ReceptorLeft Image: Top frame: Green arrow denotes normal increased expression of the endocannabinoid receptor gene in normal patients. The red arrow indicates endometriosis patients with low gene expression during the early phase and there is an increase in the secretory phase. Structure below: Histology slides of endometrial samples show normal brown staining of receptor proteins