Endometriosis is a heterogenous, and oestrogen dependant inflammatory disease that is characterised by morphological and biologically active endometrium (composed of endometrial-type glandular tissue and stroma), that is present in sites outside of the uterine cavity. The disease is complex in nature with the implantation of tissue occurring due to phenomena known as retrograde menstruation. While this is considered central to the pathogenesis of endometriosis, 90% of women that experience this event do not have endometriosis, while the remaining 10% of this population do have endometriosis. The role of the immune system may explain why some women develop endometriosis and why others don’t. Alterations in the immune system (Increased TNF-α, PGE2 and reduced NK cells) have been proposed to play a key role in the establishment of endometrial implants and sustained its growth and development. In order to treat aspects of immunity, it is important to improve relative oestrogen excess which triggers a pro-inflammatory cascade and to regulate immune system abnormalities. With continued unopposed oestrogens, the immune system will not regulate, so this must be a primary treatment aim. Prostaglandin synthesis must be regulated to ensure normal uterine function, healthy flow of menstruation and reducing pain experienced. Key herbs that help address inflammation, immune alterations and oestrogen clearance include Turmeric, Echinacea, Green tea, Caledula and Gotu cola. These herbs have multi-factorial actions that address the underpinning pathology of endometriosis and help rectify and improve reproductive function.
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