In February 2012, I was twenty-eight years old and had been living with a diagnosis of endometriosis for over a year. I’d had a miscarriage a few months before my diagnosis but was unable to conceive again. Birth control pills and then Lupron Depot, a drug that mimics menopause, hadn’t helped control my increasing pain in the second halves of my menstrual cycles.
Unlike many patients, I didn’t seek out a naturopath from my own frustration or go behind my OB/GYN’s back. My OB/GYN suggested I see a naturopath because “they see things differently,” specifically hormone imbalances and lifestyle choices. I chose a naturopathic practice where a friend from my church worked as a nurse practitioner. I figured if a mainstream provider was on staff, the naturopaths couldn’t be too far out there.
So I spent the better part of 2012 as the patient of a naturopath. I was Britt’s patient.
If you do much online research on endometriosis, one of the first things you discover is that no one knows what causes it. The endometrial tissues that implant themselves into crevices and organs in the pelvic cavity rarely show up on any medical imaging devices, so laparoscopic surgery is the only reliable diagnostic tool. Because of this, many woman aren’t diagnosed for years. (I was lucky and received a diagnosis two months after the onset of symptoms.) Further, the implants behave differently for every patient. A woman I know has endo implants only on her ovaries, severely impairing her ovarian functions. Mine are spread thinly across my pelvic cavity nearly everywhere but my ovaries, so my ovarian function was right on par with my age (twenty-nine when most recently tested). Some women have implants on their intestines that give them symptoms of irritable bowel syndrome. All of this makes fertile ground for myriad theories as to why you have endo and how to treat it—and naturopathy and other types of alternative medicine thrive in this space.
One of the most persistent theories about endometriosis, especially in alternative-medicine land, is that there is some sort of emotional or psychological component. Because of course, a disease of the female reproductive system can’t be a physical, likely genetic, condition—sexist much? Practitioners all across the medical spectrum subscribe to this theory in varying degrees. In my case, symptoms of endometriosis coincided with the anguish of a miscarriage. Britt wasn’t the first healthcare provider to tell me that the pelvic region was a place where women “hold” tension, grief, anger, etc., or that the emotional trauma of my miscarriage probably initiated or exacerbated my endometriosis—that distinction belongs to an acupuncturist—but she seemed to allow this idea to guide her treatments. This seems to be par for the course for alternative medicine providers.
But also par for the course was that Britt really listened to me describe my symptoms, both in person and via email. Many healthcare providers assume they know how endo behaves and tune out symptoms that don’t match their notions, but Britt wasn’t that way. I appreciated her open-mindedness immensely, as would anyone with a complicated, individualistic disease.
In turn, she made sure to thoroughly explain all of her recommendations. She sent me home from my first appointment loaded down with herbal and vitamin supplements (some for cycle regulation, some for pain, some to boost my immune system) and suggested I adopt a temporary vegan diet so as to limit the amount of excess hormones entering my system. I didn’t love how much I was spending on the supplements (my husband and I were preparing for adoption, so money was tight), but giving up meat and dairy was downright hard. I have vegetarian and vegan friends who give up animal products happily, but all I could think about was what I couldn’t eat. The list was immense.
I would have kept at it, though, if my pain had improved in the slightest. But every month was more of the same, as though I were being stabbed from the inside out. Fortunately, Britt wasn’t the type to beat a dead horse. We adjusted the diet (vegetarian with organic dairy products), added more vitamins, and threw in homeopathic tablets. At one point, I had a daily pill intake in the double-digits, only two of which I’d taken before I saw Britt (Synthroid for hypothyroidism and Zyrtec for seasonal allergies). Still, I got no pain relief, and my cycles were all over the place.
Looking back, my body was probably having a hard time righting itself after the Lupron shots. Because I’d committed to natural healing, though, I did things like rush to buy more homeopathic tablets while on vacation to double my dosage or lay on the couch with a heating pad and castor oil instead of reaching for ibuprofen. (The castor oil plus heating pad approach actually did feel pretty good, as long as I stayed on the couch. Unfortunately, not practical for long.)
By the end of summer, my cycles fell back to their standard thirty or thirty-one days. I don’t remember why Britt had me buy ovulation testing strips at that point, but she did. My body gave every indication of ovulating except a positive sign on those strips. For some reason, this concerned Britt. She hypothesized several ways my body might be making some of the necessary hormones but not putting it all together—I remember one theory was that my progesterone levels were rising too slowly during my luteal phase. This might also be keeping me from getting pregnant, she thought. I had never asked her for fertility treatments per se, especially after we were approved to adopt, but that felt like the direction we were suddenly going. In our final email exchange that October, I distinctly remember her saying that I should make an appointment so that “we can get you ovulating.”
I never made the appointment. I was done. I’d tried all kinds of what felt like hacks and magic pills, and the only thing that made any dent in my pain was plain, cheap ibuprofen. The thought of taking more vitamins and tweaking my diet to show I was ovulating put my stomach in knots. I told Britt I was going to try a different type of birth control recommended by my OB/GYN and see a surgeon who specialized in using robotic surgery to remove endo. Shortly after that, Britt moved to another state. We didn’t talk again until I found her blog—by following a link from the Facebook page of the same friend who worked as a nurse practitioner in Britt’s naturopathic practice.
Words can’t describe how vindicating it has been to read Britt’s blog. A constant struggle of mine with endometriosis has been the nagging feeling that, while maybe I didn’t cause the disease, I must be hindering the treatment of it. After all, I couldn’t even train myself to pour almond milk on my cereal for more than a month! But that’s the burden placed on patients when a disease that is under-researched meets alternative healthcare providers who don’t spend enough time studying hard sciences or treating patients. The reproductive endocrinologist I saw for testing in 2013 spent years studying and interning just in her specialization so that she could analyze the changes in my hormones during my cycle. Britt was trying to do the same thing but without the benefit of that education or experience. Instead of using medications that truly do alter hormones by working directly with them, she was trying to achieve the same results with food and herbs, even homeopathy. For other conditions and diseases, there is a vast body of scientific literature to explain why those remedies don’t work. For endo, it’s still pretty much a dimly lit free-for-all, where naturopaths and other alternative providers use fanciful theories and treatments on desperate patients.
Image credit: By André Brouillet, via Wikimedia Commons
Emilie Bishop is not a healthcare professional, but after five years of battling endometriosis, she sometimes feels like her specialty is “all the treatments that haven’t worked for Emilie Bishop.” She blogged about her journey with endo and becoming a mom at emiliebishop.wordpress.com. She also writes fiction and nonfiction for children. She lives in the greater Seattle area with her software engineer husband, their adorable (and miraculous) one-year-old son, and two quirky cats.