Natural Family Planning: Endometriosis 

Natural Family Planning: Endometriosis 
On behalf of our Diocesan Marriage and Family Life team, Dr Amanda Buadi MBBS, MRCP(UK), a qualified Creighton Method Practitioner, brings us the latest instalment of her monthly series sharing information on the Theology of the Body; what the Catechism says about managing fertility, infertility, family planning; the health benefits of managing fertility naturally; the marital enrichment that can be achieved through using a natural method to plan a family as well as and other issues and talking points. This month she highlights endometriosis…

Endometriosis is a menstrual disorder in which endometrial deposits (tissue similar to the lining of the womb) grows outside of the womb. This tissue is most commonly found within the pelvic area – for example on the ovaries, fallopian tubes, bowel and bladder but it can also be found in a variety of other locations including the lung, renal tract, diaphragm, skin and liver. When the woman has her period, this tissue located outside of the womb also breaks down and bleeds. Unlike the lining of the womb, however, this tissue has no way of exiting the body and instead stays in the pelvic area or in whichever part of the body it is located. This blood and tissue causes irritation to those organs leading to scarring and adhesions (bands of scar tissue forming between organs and causing them to stick together). While there are many theories as to the cause of endometriosis, there is currently no consensus.

Endometriosis is thought to affect 1 in 10 women of childbearing age which is approximately 176 million women worldwide. It is likely, however, that these numbers are underreported as it can take up to 8 years for a woman to get a diagnosis. This is due to multiple factors such as endometriosis being not very well understood, the symptoms being non-specific and that many times women go to their doctors with pelvic pain and find that their symptoms are not taken seriously.

Symptoms include dysmenorrhoea (painful periods), pelvic pain, dyspareunia (painful intercourse), infertility, heavy or irregular bleeding, nausea at the time of menses, diarrhoea and/or painful bowel movements, dizziness, headaches at the time of the menses, fatigue, low grade fever and low resistance to infection. Endometriosis is also a leading cause of infertility affecting up to 50% of women who struggle to conceive. This is thought to be due to the inflammation caused by the trapped blood and tissue causing the release of toxins which create a hostile environment for conception.

Typical Endometriosis Treatment & Its Problems
Typically, when a woman goes to her doctor with heavy, painful periods, she is offered painkillers and some form of hormonal contraception as a way of managing her symptoms. These work by suppressing her menstrual cycles which means she no longer has heavy painful periods. However, endometriosis is a surgical condition and the gold standard for diagnosis and treatment is a laparoscopy and excision of the endometrial deposits under direct observation by the surgeon. Histological analysis of the endometrial deposit confirms the diagnosis. Hormonal contraception masks the symptoms rather than treating the endometriosis and this could also be a contributory factor in the inordinate length of time it can take to diagnosis. Once the woman stops taking the hormonal contraception, often after many years and often because she wants to try to conceive, the endometriosis is still there untreated. She thus faces the double impact of long untreated endometriosis and advancing age adversely affecting her fertility. Finally, there is no medical regime that can be used successfully in the treatment of endometriosis-associated infertility. It needs to be treated surgically.

The Restorative Reproductive Approach to Endometriosis – Naprotechnology
NaproTechnology uses a holistic approach to treating endometriosis. One of the theories of the cause of endometriosis is oestrogen dominance i.e. higher than normal levels of oestrogen. There are also studies to suggest a possible link between endometriosis and a post-ovulatory deficiency in progesterone which can lead to symptoms of PMS and miscarriage. By tracking her cycles using a fertility awareness-based method, a woman can learn the biological signs that can indicate a hormonal imbalance and this can then be corrected using bio-identical hormones taken in sync with her cycle. Tracking fertile windows and using these times for intercourse, will also help determine quickly if there is a problem with fertility. Either (or both) of these factors can help support a diagnosis of endometriosis. An anti-inflammatory diet (high in fresh fruit, vegetables, nuts and seeds and low in processed food, alcohol and caffeine) as well as exercise can help as natural means of managing pelvic pain. Exercise can also be used for weight loss – as excess body fat can cause excess oestrogen which may contribute to the endometriosis.

Surgical NaproTechnology uses a ‘near-contact’ excision technique for the endometrial deposits during the laparoscopy. This technique is shown to be superior to surgical ablation for lower recurrence rates and a longer duration of symptom resolution.

For more information please contact the diocesan Marriage and Family Life Team at mandfl@portsmouthdiocese.org.uk.