This month’s case study is 35 year old ‘Abigail’ who came to the Clinic with a diagnosis of endometriosis.

I had been suffering with painful periods from the age of 30 and they had become increasingly debilitating. Having relied on painkillers, which I think I was becoming resistant to, I thought it was time to seek help. I suppose I was putting off going to my GP because I was scared of what the outcome would be. He talked me through the options and recommended that I get referred to a gynaecologist for further investigation.

My appointment came through fairly quickly and when I saw the gynaecologist he recommended I have a procedure called a laparoscopy – an exploratory procedure to look at my ovaries and womb to see what, if anything, was causing my painful periods. I was very nervous because I hated going to hospital, but I had got to the point where I needed to find out why I was in so much pain. After the procedure the gynaecologist diagnosed endometriosis, (a condition where the womb lining migrates and grows outside of the womb). He said it was quite advanced and I had patches of endometriosis growing over my ovaries and around my bowel, which is why I would also experience pain with a bowel movement. During the laparoscopy, the gynaecologist removed the patches of endometriosis with a laser which would stop the pain, but he explained that this was not a guarantee that it would not grow back.

 

The first three periods after my operation were relatively pain free, which was amazing. But after that the pain returned, albeit less intense. I decided to research into endometriosis to see if there was anything I could do to support myself. I had heard that complementary therapies could be useful. I looked on the internet and came across the Dr Marilyn Glenville Clinic, which specialises in women’s conditions and endometriosis was one of them. I decided to download an ‘e-book’ on endometriosis. It was very useful as it explained what the condition is, how it can develop and both the medical and natural treatments available. Although the e-book was helpful, I knew I needed some more help so I called the number at the back to find out more about having a consultation.

 

I spoke to a very helpful receptionist at the Dr Marilyn Glenville Clinic who explained how the clinic worked and what I could expect from my first session with one of the nutritionists. It sounded exactly what I was looking for, so I went ahead and booked a consultation. I was sent a comprehensive questionnaire to complete and return before my consultation, which allowed me to write down what my main health concerns were, symptoms I was experiencing and my diet! After I had completed this I was appalled at how much alcohol I was consuming over the two days. (I thought it was better to be honest than to write down what the nutritionist wanted to hear!)

 

I met with the nutritionist 2 weeks later and we went through the questionnaire in detail together. I felt very encouraged by this because no one had ever taken so much interest in me and ‘my condition’. The nutritionist explained that endometriosis is a condition in which the lining of the womb (the endometrium) implants and grows outside the womb itself. These endometrial implants can grow in the pelvis, fallopian tubes, ovaries, bowel and bladder. More uncommonly, they can also crop up in the lung, heart, eye, armpit or knee. Wherever it grows, the womb lining responds to the natural hormone cycle and bleeds every time a period occurs. When women bleed normally throughout menstruation, blood leaves the body through the vagina. However, in the case of endometriosis the blood has no outlet and becomes trapped in the tissue, causing pain, inflammation, cysts and scar tissue.

 

Endometriosis is stimulated by excess oestrogen, so one of the main dietary principles is to keep this hormone under control. Oestrogen is found in meat, dairy products and the water supply and even in preservatives that are routinely put into our everyday skin creams and shampoos. Our liver is the organ that helps controls levels of oestrogen by detoxifying the hormone and ensuring elimination, so it’s important that it is functioning well. Liver function can be compromised by alcohol and caffeine, preservatives in our diet and taking drugs (painkillers etc). The nutritionist explained that we are more exposed to these ‘xenoestrogens’ (foreign oestrogens) than ever before because of the way our food is processed, pollution and increased use of chemicals.

 

The pain associated with the endometriosis is due to inflammation, so cutting out foods that are pro-inflammatory (causing inflammation) and eating plenty of foods that are anti-inflammatory was recommended. Pro-inflammatory foods include red meat and dairy products and anti-inflammatory include oily fish, nuts and seeds and avocados. I had been drinking a lot of milk and I loved cheese, but the nutritionist gave me plenty of alternative options. It was recommended that I eat a daily serving of dark leafy green vegetables because of the mineral magnesium, which is a natural muscle relaxant and has been shown to reduce cramps and spasms associated with endometriosis.    

 

To support the liver I was advised to cut back on my caffeine (I was drinking 3-4 cups of strong coffee daily), alcohol and processed foods – which can be a strain for the liver to process, which in turn reduces its ability to process the extra oestrogen that my body has to deal with. She explained that some food/drinks can naturally have a supportive effect on the liver. Broccoli and brussel sprouts are particularly useful because of a compound within them that promotes oestrogen detoxification. She also recommended I drink nettle and dandelion tea, which are good for the liver.

 

The nutritionist also explained to me the importance of using natural skin and hair products because they can contain ‘parabens’, which are synthetic preservatives that have been linked to oestrogen related breast cancer and may also be linked to endometriosis. She recommended specific brands, which made it easier than trawling through the shops!

 

I was also advised to take some specific nutritional supplements to address the high oestrogen, using a combination of herbs and liver support. I also took natural anti-inflammatory supplements like fish oil, ginger and magnesium, which was just amazing for the cramps! It is often known as ‘nature’s tranquilliser’ and this certainly was the case!

 

I booked a follow up consultation for 8 weeks time so the nutritionist could see how I was getting on. She decided on 8 weeks because I would have had 2 periods in that time and we could get a better idea of how I was getting on with the programme. I kept a food and symptom diary and even with my first period, I definitely had less pain. I only had to take 1 painkiller where I would usually take at least 6 over the duration of my period. By my second period I had virtually no symptoms! It was amazing. Not only had my menstrual symptoms disappeared I generally felt I had more energy, clearer skin and had lost weight, which wasn’t intentional but was certainly appreciated! The nutritionist did say it was a good thing that I had lost the weight because fat cells produce oestrogen.

 

Six months on and my diet consists mainly of fresh fruit and vegetables, some organic poultry, fish, beans, nuts and seeds, brown rice and oats. I also largely avoid dairy and wheat, which I really feel has helped enormously. I am disciplined with my diet but do have occasional lapses, which the nutritionist said was ‘ok’ every so often! But the truth of it is I actually don’t enjoy eating or drinking those foods when I do have them.  

 

I am so pleased that I decided to book the consultation and I feel so much more in control of my endometriosis, because I understand the condition. This is what I found frustrating about my gynaecologist – there was no explanation and I found it quite depressing to think my only option was surgery. The nutritionist did recommend that I go back to my gynaecologist in another 6 months to review, because endometriosis can ‘grow’ back, but with the change of diet she hoped this would not be the case or at least it would slow it down. All I can say is thank you so much to my nutritionist and all the team at The Dr Marilyn Glenville Clinic for their help and support.  

 

 

  

Marilyn’s Comment

 

This is a wonderful case of how powerful nutrition can be in dealing with hormone imbalance. It is not just endometriosis that can be supported with nutrition, but fibroids and PCOS too, which are also hormonally driven. Unfortunately we’re seeing so many more cases, especially in young women. It is important to always have painful periods checked by a medical practitioner for a diagnosis. With the case of Abigail her endometriosis was at a severe stage and required surgery, but if it is less aggressive, it may be that you have a 6 month ‘window’ to really focus on the nutritional approach rather than going down the medical route straight away. 

 

If you would like to find out more about our clinics and the products mentioned, then please see the Resources Page.

Most women are all too familiar with the pain of cystitis, a common bladder infection. An estimated 35 per cent of women between the age of 25 and 40 have had at least one bladder infection, frequently referred to as urinary tract infection or UTI. Men can get bladder infections too, but they are more common in women.

Women tend to suffer most from this condition because in women the tube (urethra) that runs from the bladder to the outside of their body is considerably shorter (about 5cm/2ins) than it is in a man (about 18cm/7ins) and this makes it easier for bacteria to make its way into a woman’s bladder. In addition, the opening to the urethra is much closer to the anus than it is in men, so the bacteria have easy access to the urethra and from there to the bladder. 

 

Cystitis is an inflammation of the bladder lining caused by infection, irritation or bruising, or a combination of all three. The inflammation makes you want to pass water more urgently and frequently, even if there is very little to pass, and there is typically a burning sensation on urination. You may also experience lower abdominal pain, nausea and vomiting, dark, foul-smelling urine (perhaps with traces of blood) and fever. Cystitis is not only painful it can progress to more serious infections of the kidney if not stopped in time.

 

The Causes

 

Bacterial cystitis is an infection responsible for about 50 per cent of cystitis cases. It is normally caused by E-coli bacteria (Escherichia coli – not the E-coli 0157 that causes food poisoning). E-coli is normally present in the bowels, but once this bacterium enters the urethra it sticks to the walls of the bladder and multiplies causing pain, inflammation and infection. If you regularly use tampons you are more susceptible to bacterial cystitis than women who use pads. This is because the chemicals from tampons can irritate the lining of the vagina and this irritation can encourage inflammation and infection. The string on the tampon used to pull it out can also provide bacteria easy access to the body.

 

There is another type of cystitis that is non-infectious and sometimes nicknamed ‘honeymoon cystitis.’ It is typically caused by bruising or irritation during sex, which causes inflammation and this inflammation can make infection more likely. Other triggers for non-bacterial cystitis include: wearing a sanitary pad for too long; tight underwear, tights or trousers and chemical irritants, including soaps and bubble baths. Some women are sensitive to chlorine from swimming pools.

 

The hormonal changes that take place at the menopause can also spur on the development of cystitis. When oestrogen levels drop the balance of bacteria in the vagina changes and the number of good bacteria declines, which may explain why the incidence of cystitis can increase by 2 per cent each decade after the menopause. In addition, vibrations from riding a horse, bike or motorcycle can also cause bruising, which can lead to symptoms of cystitis. Some women experience cystitis in pregnancy because the urethra is relaxed by high levels of progesterone.

 

Other causes of non-infectious cystitis include dehydration, which can make the urine more concentrated and more likely to cause irritation of the urethra and the bladder. Certain foods may also irritate the bladder and the urethra and these include spicy foods, alcohol, caffeine and fresh fruit juice.

 

Getting to the cause of the problem

If you’re plagued by bladder infections, here’s what you need to know to both prevent and treat the problem:

 

• Urinate after sex: It has been found to be helpful to urinate after intercourse. This can wash out any bacteria that might have worked their way up into the bladder.
• Drink fluids: If you feel symptoms coming on drink fluids to help dilute your urine.
• Stick with cranberry juice: You’ve probably heard that cranberry juice is good for bladder infections. This advice has been around a long time, but recent studies have given credence to the claim by showing that cranberry juice can significantly reduce the bacteria associated with urinary tract infections. This is because cranberries contain substances called tannins, which can stop bacteria like E-coli sticking to the walls of the urethra. If you are prone to bouts of cystitis I recommend cranberries and cranberry juice as a preventative natural medicine, but don’t ever buy cranberry juice with added sugar or artificial sweeteners. Sugar has a destructive impact on your immune system and will make it difficult for your body to fight infection.
• Use towels instead of tampons: Again, this will reduce the likelihood of infection.
• Don’t hold on. Urinate regularly and, if you feel the need to go, find a toilet rather than putting it off.
• Take showers instead of baths if you are prone to frequent bouts of cystitis and use natural soaps free from chemical irritants.
• Avoid wearing tight underwear, tights or trousers.
• Use sanitary towels instead of tampons, but make sure you change your pads every two hours.
• Avoid all sugar, including hidden sugar found in many refined foods and sauces, such as tomato sauce. Start reading labels to find out how much sugar you are actually consuming. Refined carbohydrates, such as the white flour found in pastries, cakes and pies, is also broken down into sugar (glucose) quickly so should be avoided.
• Acidic food and drink can trigger flare ups so avoid caffeine (in tea as well as coffee), alcohol, sugar, meat, spicy foods and undiluted fruit juices. Some, but not all, women with cystitis find that certain healthy foods, can aggravate the condition and these foods include strawberries, potatoes, tomatoes, spinach and rhubarb.
• Abstain from sex just before your period: If you are vulnerable to bladder infections during certain phases in your menstrual cycle you may want to avoid sex just before your period when levels of oestrogen, the hormone that maintains vaginal health, are low.
• Switch contraceptives: If you are using contraceptive jellies and foams and get recurrent infections talk to your doctor and consider using other methods of birth control. The jelly can make it easier for bacteria to get into the vagina.
• Get treated: Sometimes even if you do all the right things you can still get an infection. As soon as you suspect you have an infection visit your doctor. Your doctor will be able to tell you if your condition is infectious or not. This is important because it can spread from the urinary tract to the bladder and kidneys, where it can cause kidney infection. If bacterial cystitis is diagnosed it will be treated with antibiotics. If you take antibiotics you need to be aware that although they will eliminate the infection, they will also destroy beneficial bacteria in the gut, increasing the likelihood of recurrent infection and thrush. So if you need to take antibiotics make sure you always take a probiotic with them to help recolonise your gut with beneficial bacteria (the one I use in the clinic is called BioKult – see the Resources Page)
• Garlic: Often called ‘nature’s antibiotic’, research has shown that it can help eliminate bacteria associated with cystitis, such as E coli and staphylococcus. To get the full benefits of garlic you need to eat it raw. This sounds unpleasant, but just add raw garlic to salad dressings or crush it and use as a garnish. Alternatively, if you can’t bear the smell, you can take a garlic supplement – the most effective one I have found is called Aged Garlic, which is a concentrated form of organic garlic (see the Resources Page).
• Pineapple: This fruit contains a digestive enzyme called bromelain, which has anti-inflammatory properties. Studies have shown it can have a beneficial effect on cystitis. Take 500mg, 3 times a day, between meals (see the Resources Page for how to obtain bromelain).
• Live yogurt: Lactobacillus acidophilus (healthy bacteria) can be found in live yogurt but not at a therapeutic level, which is needed along with other beneficial bacteria when you have cystitis.  So you also need to take a probiotic. You need a probiotic containing at least 14 beneficial strains of bacteria with a 10 billion viable organisms per gram. (I have found BioKult to be an excellent probiotic.) 
• Echinacea: This herb has been shown to increase the white blood cell count and activity in order to effectively engulf bacteria and viruses, so it may be a helpful herb for cystitis treatment and prevention.
• Uva Ursi (Arctostaphylos uva-ursi) is a herb with antiseptic properties that may be effective against E-coli bacteria. Goldenseal (Hydrastis canadensis) is also anti bacterial. The best approach is to have a mix of both golden seal and uva ursi, but don’t take this tincture for any longer than two weeks. Both these herbs should be used in the short term only in order to try and prevent the need to take antibiotics. If you are pregnant or hoping to be or have a history of heart disease, glaucoma or diabetes, you should consult your doctor or practitioner before using goldenseal.
• D-mannose: This is a naturally occurring glyconutrient which sticks to the urinary tract. The E-coli adheres to the D-mannose, rather than the bladder wall, and the E-coli bug gets flushed out as your urinate. I have found D-mannose to be an excellent remedy for cystitis (in order to obtain it go see information on the Resources Page).

 

Self-help:

 

– Massage your stomach with two drops each of juniper and lavender oils in two teaspoons of warmed sweet lavender oil. Or add 1 to 2 drops each of tea tree, juniper, cypress and eucalyptus essential oils to your bath.

 

– To  help make your urine more alkaline and relieve the burning sensation try dissolving a teaspoonful of bicarbonate of soda (also called baking soda) in about half a litre of warm water and drink twice daily, or sip throughout the day.

 

– Barley water can act as an anti-inflammatory agent for the urinary system. Buy whole barley, put 1.5oz (40g) in 2 pints (1200 ml) water, boil and then simmer for 30 minutes. Add a slice of lemon, or the juice of one lemon, for the last 10 minutes of simmering. Sip the barley water during the day.

 

Note: If you get more than six bladder infections a year it is essential that you work with your doctor to identify the problem. Find a health professional who will outline a plan of diagnosis and treatment, including a review of your diary of activities.

Far from making you feel more tired, physical activity can actually give you more energy. If you don’t fancy going to the gym there are plenty of activities you can easily fit into your daily routine that will help to keep you fit and healthy and boost your energy levels at the same time. Here are some examples: 

• Increase your steps: Take the stairs instead of the lift, leave the car at home and get off the bus a stop before your own, use the upstairs toilet  rather than the downstairs one (if you have one), hide the remote controls and get up to switch your appliances on and off. Buy a pedometer to count your steps.
• Get out in the garden: Researchers at Kansas State University say gardening can strengthen limbs, help the cardiovascular system and develop flexibility. So get out there and start digging. Take the opportunity to have a good stretch after you’ve been kneeling down.
• Do it to music: Put on a lively CD and do your housework in time to it. You’ll be working out without even knowing it.
• Rediscover your sexual energy: Sex is a calorie burner and can be a good aerobic workout too. It also releases feel good hormones that increase your energy levels and put you in a good mood. So feel free to indulge yourself.