"Endometriosis is a serious condition in which tiny islets of endometrium (inner lining cells of the uterus) become scattered in areas where they don't belong: the fallopian tubes, within the uterine musculature (adenomyosis), and on the outer surface of the uterus and other pelvic organs, the colon, the bladder, and the sides of the pelvic cavity. With each monthly cycle, these islets of endometrium respond to ovarian hormones exactly as endometrial cells do within the uterus - they increase in size, swell with blood, and bleed into the surrrounding tissue at menstruation. The bleeding (no matter how small) into the surrounding tissue causes inflammation and is very painful, often disabling. Symptoms begin seven days to twelve days before menstruation and then become excruciatingly painful during menstruation. The pain may be diffuse and may cause painful intercourse or painful bowel movements, depending on the sites involved. Diagnosis is not easily established, as there is no lab test to identify endometrial islets, nor are they usually large enough to show on an X ray or sonogram. Laproscopy (a minimally invasive surgery enabling a doctor to look into the abdomen with a small scope) is very useful in this regard.

The cause of endometriosis is unclear. Some authorities argue that these endometrial cells wander out through the fallopian tubes. Others suggest they are displaced through some sort of embryological mix-up when an embryo is just forming its tissues. The fact is, however, that endometriosis seems to be a disease of the twentieth century. Given the severity of the pains and the association with monthly periods, it seems unlikely that earlier doctors would not have described the condition. Now that we know about xenoestrogens and the fact that the tissues of the developing embryo are especially sensitive to the toxic effects of xenoestrogens, it is tempting to speculate that our petrochemical age has spawned diseases we've never known before--and that endometriosis is one of them.

Mainstream treatment of endometriosis is difficult and not very successsful. Surgical attempts at removing each and every endometrial implant throughout the pelvis is only temporarily successful. Many of the tiny islets are simply too small to see, and eventually they enlarge and the condition recurs. Another surgical venture is even more radical: the removal of both ovaries, the uterus and the fallopian tubes, the aim being to remove or reduce hormone levels as much as possible--not a pleasant prospect.

When women with endometriosis delay childbearing until their thirties, they are unable to conceive. Pregnancy often retards the progress of the disease and occasionally cures it. With this in mind, other medical treatments attempt to create a state of pseudopregnancy, with long periods of supplemented progestins to simulate the high progesterone levels of pregnancy. Unfortunately, the high doses needed are often accompanied by side effects of the progestin and breakthrough bleeding.

As an alternative, I have treated a number of endometriosis patients, some after failed surgery, with natural progesterone and have observed considerable success. Since we know that estrogen initiates endometrial cell proliferation and the formation of blood vessel accumulation in the endometrium, the aim of treatment is to block this monthly estrogen stimulus to the aberrant endometrial islets. Progesterone stops further proliferation of endometrial cells. I advised such women to use natural progesterone cream from day six (6) of the cycle to day twenty-six (26) each month, using one ounce of cream per week for three weeks, stopping just before their expected period. This treatment requires patience. Over time (four to six months), however, the monthly pains gradually subside as monthly bleeding in the islets becomes less and healing of the inflammatory sites occurs. The monthly discomfort may not disappear entirely but becomes more tolerable. Endometriosis is cured by menopause. This technique is surely worth a trial, since the alternatives are not all that successful and laden with undesirable consequences and side effects."

"This treatment requires patience. Over time (four to six months), however, the monthly, the monthly pains gradually subside as monthly bleeding in the islets becomes less and healing of the inflammatory sites occurs. The monthly discomfort may not disappear entirely but becomes more tolerable."

John Lee, M.D.