Helen O’Callaghan talks to Fiona Clancy about her battle with endometriosis.
PAIN that plunged her into semi-consciousness, drugs that gave her all the symptoms of menopause, fears about her fertility — at 32, Fiona Clancy has endured them all. But when, two years ago, Fiona was first diagnosed with endometriosis (a condition where tissue that normally lines the uterus is found outside the uterus or attached to other organs), she almost welcomed the news. Finally she had a “real condition” that explained why for two days each month she suffered stabbing pains.
At 17 she’d been put on the contraceptive pill for period pain. “Eight years later the pain came back. But not just period pain, I had pain with a bowel movement and urination. I had bloating and was generally very unwell. It got gradually worse and, during the two years before diagnosis, it progressed to the point where I felt like that all the time,” says the Dublin woman who now lives in Galway. “During my period, the pain was excruciating — I felt I wanted to be put down.”
An office administrator, Fiona missed a lot of work so her GP referred her for a laparoscopy, which detected severe endometriosis. “I had a lot of adhesions — my bowel and uterus were stuck together. Really it was a mess inside.”
She was prescribed a hormone treatment drug which propelled her into a reversible menopause. “One day I was a normal 30-year-old, the next day I was in full menopause, having hot flushes a few times an hour. And the tiredness was absolutely unbelievable — at work I’d go to the car to rest at lunchtime or I’d go to the ladies’ just so I could rest for a few minutes.”
Nine months after her diagnosis, Fiona had a laparoscopy to remove her endometriosis. Now, working part-time in NUI, Galway, she feels a lot better though she still suffers from diarrhoea and bloating during menstruation.
But she worries that endometriosis may have jeopardised her fertility. Married to Mattie, the couple have been trying for a baby for a year and a half. “Because my endometriosis was so severe, it has been indicated that I won’t get pregnant naturally, that I may need IVF.”
FOOD FIRST: One woman who believes nutrition is the key to combating endometriosis and helping fertility is Dian Shepperson Mills, director of the Endometriosis and Fertility Clinic based at The Hale Clinic in London. Examples of women who’ve fought the ‘endo’ battle and successfully become pregnant trip off her tongue. Firmly believing that we are what we eat, Ms Mills says specific nutrients can have a very direct effect on endometrial symptoms.
PAIN: Essential fatty acids: A Danish trial, using fish oils, led to a 37% drop in menstrual pain. “Women who have endometriosis have high levels of pro-inflammatory prostaglandins in the peritoneal fluid that bathes the uterus, ovaries, bowel and bladder. These cause pain. Evening Primrose Oil and fish oils (Omega 3 and 6) help by producing anti-inflammatory prostaglandins.” Eat oily fish two to three times a week: wild salmon, fresh tuna, halibut, herrings and mackerel. Take a palmful of nuts and seeds daily: almonds, pecans, walnuts, pistachio.
— Vitamins B1, B6 and B12 facilitate the body’s use of endorphins which help control pain.
— Magnesium helps the body relax smooth muscle (the uterus and intestinal muscle), thus stopping cramping. Research has also shown it prevents against miscarriage.
BLOATING: Acidophilus (get in a health food shop) helps balance gut flora, which can be put out of sync by the pill, certain drugs for endometriosis and stress.
— Berries: “Eat two pieces of fruit a day and berries if you can,” advises Ms Mills. Most women with endometriosis are distended and sore — blackcurrants, blackberries, blueberries, cranberries are anti-inflammatory and diuretic so they help reduce bloating and fluid retention. “But if they’ve got digestive problems, lots of oranges and grapefruit can act as gut irritants.”
— Complex carbohydrates: “80% of women I see find wheat triggers abdominal pain, bloating and constipation. We either reduce it or avoid it for the first month — after that you can eat it once or twice a week without a problem.” Eat complex carbohydrates like oats, corn, rye, brown rice, barley and legumes (peas, beans and lentils).
No need to be afraid of needles, says Helen O’Callaghan, who explores Acupuncture as a solution to infertility and talks to women for whom the treatment worked.
KAREN COSTIN describes herself as a kind of electrical engineer of the body. A Five-Element acupuncturist, she has been practicing for 16 years and has been helping couples conceive for the past eight years. Today, 90% of her client base involves people with fertility issues. Among those she’s helped are women:
- with Endometriosis,
- with Polycystic Ovarian Syndrome,
- in their 40s who’ve had repeated failed IVFs,
- with one ovary or who’ve been told by medics that they’re menopausal or have ovarian failure.
She also uses Acupuncture to treat male fertility problems.
The idea that a millennia-old treatment such as Acupuncture can help women conceive is reassuring, considering the warning issued by specialists attending the recent European Society of Human Reproduction and Embryology conference in Copenhagen: that infertility could soar in Europe over the next 10 years, rising from the present statistic of one in seven to about one in three in 2015. Contributing factors, the conference heard, were increasing levels of obesity and sexually transmitted infections, as well as the fact that many women are putting off having families ’til they’re older.
But Karen Costin points out that in addition to these factors there are very subtle influences affecting women’s hormones, which western medicine often doesn’t appreciate. “The emotional state of a woman has as much impact on her body as her physical state. Women need positive, creative information and an encouraging environment. If there’s a focus only on what’s wrong that’s not a holistic approach and won’t work”.
From the day women attend for Acupuncture, Costin encourages them to measure their basal body temperature each morning before getting up and to do this right through their cycle. By tracking their temperature and checking for cervical mucus, they can pinpoint ovulation. “Progesterone causes the temperature to rise in the second part of the cycle. Post-ovulation, women need 14 days of continuous high temperatures of 36.69 or above to conceive,” she says.
If progesterone is low, Acupuncture can help rebalance the hormones. “The medical profession says this is too subtle. I say that’s why conception works, because it is subtle. Taking their basal body temperature empowers women because it tells them about the natural rhythms of their body and, as I’m treating them, it gives information about the improvements in their cycle. They feel they’re claiming back control.”
Acupuncture is based on the premise that every cell in the body is made up of electro-magnetic energy and that there are 14 main channels of electro-magnetic energy (meridians) running through the body, each going through a specific bodily organ. Along these meridians are Acupuncture points, which are rather like fuse boxes. Basically, the body is like an electrical circuit board with junction boxes. If one of those electrical circuits fuses it has a knock-on effect — the rest of the system has to compensate, and this compensatory re-balancing manifests as disease on the physical, emotional, mental or hormonal level. Acupuncturists, says Costin, are rather like engineers who balance the electricals, ultimately allowing the body use its innate wisdom to fix itself.
Kerry-based acupuncturist Jill Tynan says Chinese medicine sees the kidney both as the organ in which we store our essential energy to reproduce and as the one which, psychologically-speaking, holds fear. When it comes to reproductive problems, the first thing Chinese medicine does is attempt to restore the maximum Qi (energy) to the kidney function.
“The kidneys have to be nourished. If we’re frozen with fear, that will manifest as blocks in the kidney area, with the person suffering urinary and bladder infections. “Fear blocks the ability of the woman’s Jing (life-force) to be harnessed by the partner’s sperm. As time goes on, if a woman doesn’t conceive, the fear can be compounded, so the sooner people attend for Acupuncture the better — that way, they don’t allow fear about not conceiving to build up to immobilising proportions.”
Acupuncture can help conception in a variety of ways, says Tynan:
it can boost the ability to produce eggs
it enhances ability to hold a pregnancy
it balances the woman’s hormone systems.
Conditions such as Polycystic Ovarian Syndrome (PCOS), Endometriosis, Amenorrhea (scant periods) and Dysmenorrhea (painful, heavy periods) all respond well to Acupuncture.
“If a woman realises early on that she has one of these conditions it’s much easier to treat — I’ve cleared PCOS in teens, using Acupuncture,” she says, adding that there’s no one Acupuncture treatment that cures every infertile woman. “The treatment is tailor-made to each woman’s individual changing cyclical needs.”
In terms of fertility, Tynan treats women in one of three scenarios and she cites the Acupuncture success rates in each context: women who have not yet gone down the IVF route and therefore have no extra chemicals in the body — 82% success rate (latest Chinese research) women who use it in tandem with IVF to strengthen their system — 46% success (German study) women who are taking a break from IVF but intend to resume it later — 52% success.
Obstetrician and gynaecologist Dr Mary McCaffrey says she would never discourage patients from seeking an alternative treatment, like Acupuncture. “It focuses women on time out for themselves. I’ve seen Acupuncture work in women with very irregular periods or who have a hormone imbalance.
“It does also seem to help relax the muscles of the uterus at the time of embryo transfer in IVF, but I would never advocate it in total isolation from other treatments. I would support it as a complement to the standard treatment, whether IVF or straightforward fertility medication like Clomid.”
Both Karen Costin and Jill Tynan emphasise Acupuncture’s holistic approach to fertility — it’s important that the acupuncturist builds up a total picture of the woman from the beginning, looking at everything from the physical to the psychological, the hormonal to the nutritional. Tynan — who says Acupuncture feels very relaxing though there may be “a slight tingle” when needles are first inserted — recommends an initial course of 12 sessions over a month. “It’s rather like jump-leading someone’s system — thereafter the person’s system works itself.”
Costin, who practices the Japanese Five-Element Acupuncture (the subtle needling means this type can also be used in pregnancy), recommends one session weekly or fortnightly, depending on the woman’s age and history. “People should give Acupuncture six months. If someone’s done a lot of hormonal treatments — been on the pill for ten years, been on Clomid, gone for IVF — the body has to relearn to function,” she says.