What you need to know about endometriosis
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Endometriosis affects one in 10 people with a uterus who are of reproductive age. This condition occurs when tissue similar to the endometrium—the inner lining of the uterus—grows on organs outside of the uterus, causing severe pain that impacts patients’ quality of life.
Read on to learn more about endometriosis: What it is, how it’s diagnosed and treated, where patients can find support, and more.
What is endometriosis, and what areas of the body can it affect?
The endometrium is the tissue that lines the inside of the uterus and sheds during each menstrual cycle. Endometriosis occurs when endometrial-like tissue grows outside of the uterus.
This tissue can typically grow in the pelvic region and may affect the outside of the uterus, fallopian tubes, ovaries, vagina, bladder, intestines, and rectum. It has also been observed outside of the pelvis on the lungs, spleen, liver, and brain.
What are the symptoms?
Symptoms may include pelvic pain and cramping before or during menstrual periods, heavy menstrual bleeding, bleeding or spotting between periods, pain with bowel movements or urination, pain during or after sex or orgasm, fatigue, nausea, bloating, and infertility.
The pain associated with this condition has been linked to depression, anxiety, and eating disorders. A meta-analysis published in 2019 found that more than two-thirds of patients with endometriosis report psychological stress due to their symptoms.
Who is at risk?
Endometriosis most commonly occurs in people with a uterus between the ages of 25 and 40, but it can also affect pre-pubescent and post-menopausal people. In rare cases, it has been documented in cisgender men.
Scientists still don’t know what causes the endometrial-like tissue to grow, but research shows that people with a family history of endometriosis are at a higher risk of developing the condition. Other risk factors include early menstruation, short menstrual cycles, high estrogen, low body mass, and starting menopause at an older age.
There is no known way to prevent endometriosis.
How does endometriosis affect fertility?
Up to 50 percent of people with endometriosis may struggle to get pregnant. Adhesions and scarring on the fallopian tubes and ovaries as well as changes in hormones and egg quality can contribute to infertility.
Additionally, when patients with this condition are able to conceive, they may face an increased risk of pregnancy complications and adverse pregnancy outcomes.
Treating endometriosis, taking fertility medications, and using assistive reproductive technology like in vitro fertilization can improve fertility outcomes.
How is endometriosis diagnosed, and what challenges do patients face when seeking a diagnosis?
A doctor may perform a pelvic exam and request an ultrasound or MRI. These exams and tests help identify cysts or other unusual tissue that may indicate endometriosis.
Endometriosis can only be confirmed through a surgical laparoscopy (although less-invasive diagnostic tests are currently in development). During the procedure, a surgeon makes a small cut in the patient’s abdomen and inserts a thin scope to check for endometrial-like tissue outside of the uterus. The surgeon may take a biopsy, or a small sample, and send it to a lab.
It takes an average of 10 years for patients to be properly diagnosed with endometriosis. A 2023 U.K. study found that stigma around menstrual health, the normalization of menstrual pain, and a lack of medical training about the condition contribute to delayed diagnoses. Patients also report that health care providers dismiss their pain and attribute their symptoms to psychological factors.
Additionally, endometriosis has typically been studied among white, cisgender populations. Data on the prevalence of endometriosis among people of color and transgender people is limited, so patients in those communities face additional barriers to care.
What treatment options are available?
Treatment for endometriosis depends on its severity. Management options include:
- Over-the-counter pain medication to alleviate pelvic pain
- Hormonal birth control to facilitate lighter, less painful periods
- Hormonal medications such as gonadotropin-releasing hormone (GnRH) or danazol, which stop the production of hormones that cause menstruation
- Progestin therapy, which may stop the growth of endometriosis tissue
- Aromatase inhibitors, which reduce estrogen
In some cases, a doctor may perform a laparoscopic surgery to remove endometrial-like tissue.
Depending on the severity of the patient’s symptoms and scar tissue, some doctors may also recommend a hysterectomy, or the removal of the uterus, to alleviate symptoms. Doctors may also recommend removing the patient’s ovaries, inducing early menopause to potentially improve pain.
Where can people living with endometriosis find support?
Given the documented mental health impacts of endometriosis, patients with this condition may benefit from therapy, as well as support from others living with the same symptoms. Some peer support organizations include:
- Endometriosis Coalition Patient Support Group (virtual)
- MyEndometriosisTeam (virtual)
- Endo Black, Inc. (Washington, D.C.)
- endoQueer (virtual)
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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What Teas To Drink Before Bed (By Science!)
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Which Sleepy Tea?
Herbal “tea” preparations (henceforth we will write it without the quotation marks, although these are not true teas) are popular for winding down at the end of a long day ready for a relaxing sleep.
Today we’ll look at the science for them! We’ll be brief for each, because we’ve selected five and have only so much room, but here goes:
Camomile
Simply put, it works and has plenty of good science for it. Here’s just one example:
❝Noteworthy, our meta-analysis showed a significant improvement in sleep quality after chamomile administration❞
Also this writer’s favourite relaxation drink!
(example on Amazon if you want some)
Lavender
We didn’t find robust science for its popularly-claimed sedative properties, but it does appear to be anxiolytic, and anxiety gets in the way of sleep, so while lavender may not be a sedative, it may calm a racing mind all the same, thus facilitating better sleep:
(example on Amazon if you want some)
Magnolia
Animal study for the mechanism:
Human study for “it is observed to help humans sleep better”:
As you can see from the title, its sedative properties weren’t the point of the study, but if you click through to read it, you can see that they found (and recorded) this benefit anyway
(example on Amazon if you want some)
Passionflower
There’s not a lot of evidence for this one, but there is some. Here’s a small study (n=41) that found:
❝Of six sleep-diary measures analysed, sleep quality showed a significantly better rating for passionflower compared with placebo (t(40) = 2.70, p < 0.01). These initial findings suggest that the consumption of a low dose of Passiflora incarnata, in the form of tea, yields short-term subjective sleep benefits for healthy adults with mild fluctuations in sleep quality.❞
So, that’s not exactly a huge body of evidence, but it is promising.
(example on Amazon if you want some)
Valerian
We’ll be honest, the science for this one is sloppy. It’s very rare to find Valerian tested by itself (or sold by itself; we had to dig a bit to find one for the Amazon link below), and that skews the results of science and renders any conclusions questionable.
And the studies that were done? Dubious methods, and inconclusive results:
Nevertheless, if you want to try it for yourself, you can do a case study (i.e., n=1 sample) if not a randomized controlled trial, and let us know how it goes 🙂
(example on Amazon if you want some)
Summary
- Valerian we really don’t have the science to say anything about it
- Passionflower has some nascent science for it, but not much
- Lavender is probably not soporific, but it is anxiolytic
- Magnolia almost certainly helps, but isn’t nearly so well-backed as…
- Camomile comes out on top, easily—by both sheer weight of evidence, and by clear conclusive uncontroversial results.
Enjoy!
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The How Not to Die Cookbook – by Dr. Michael Greger
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We’ve previously reviewed Dr. Greger’s “How Not To Die”, which is excellent and/but very science-dense.
This book is different, in that the science is referenced and explained throughout, but the focus is the recipes, and how to prepare delicious healthy food in accordance with the principles laid out in How Not To Die.
It also follows “Dr Greger’s Daily Dozen“, that is to say, the 12 specific things he advises we make sure to have every day, and thus helps us to include them in an easy, no-fuss fashion.
The recipes themselves are by Robin Robertson, and/but with plenty of notes by Dr Greger; they clearly collaborated closely in creating them.
The ingredients are all things one can find in any well-stocked supermarket, so unless you live in a food desert, you can make these things easily.
And yes, the foods are delicious too.
Bottom line: if you’re interested in cooking according to perhaps the most science-based dietary system out there, then this book is a top-tier choice.
Click here to check out The How Not To Die Cookbook, and live well!
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Ageless Athletes – by Dr. Jim Madden
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This is an approach to strength and fitness training specifically for the 50+ crowd, and/but even more specifically for the 50+ crowd who do not wish to settle for mediocrity. In short, it’s for those who not only wish to stay healthy and have good mobility, but also who wish to be and remain athletic.
It does not assume extant athleticism, but nor does it assume complete inexperience. It provides a fairly ground-upwards entry to a training program that then quickly proceeds to competitive levels of athleticism.
The author himself details his own journey from being in his 30s, overweight and unfit, to being in his 50s and very athletic, with before and after photos. Granted, those are 20 years in between, but all the same, it’s a good sign when someone gets stronger and fitter with age, rather than declining.
The style of the book is quite casual, and/but after the introductory background and pep talk, is quite pragmatic and drops the additional fluff. In particular, older readers may enjoy the “Old Workhorse” protocol, as a tailored measured progression system.
In terms of expected equipment by the way, some is bodyweight and some is with weights; kettlebells in particular feature strongly, since this is about functional strength and not bodybuilding.
In the category of criticism, he does refer to his other books and generally assumes the reader is reading all his work, so it may not be for everyone as a standalone book.
Bottom line: if you’re 50+ and are wondering how to gain/maintain a high level athleticism, this book can definitely help with that.
Click here to check out Ageless Athlete, and go from strength to strength!
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Lucid Dreaming: How To Do It, & Why
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Lucid Dreaming: Methods & Uses
We’ve written about dreaming more generally before:
Today we’re going to be talking more about a subject we’ve only touched on previously: lucid dreaming
What it is: lucid dreaming is the practice of being mentally awake while dreaming, with awareness that it is a dream, and control over the dream.
Why is it useful? Beyond simply being fun, it can banish nightmares, it can improve one’s relationship with sleep (always something to look forward to, and sleep doesn’t feel like a waste of time at all!), and it can allow for exploring a lot of things that can’t easily be explored otherwise—which can be quite therapeutic.
How to do it
There are various ways to induce lucid dreaming, but the most common and “entry-level” method is called Mnemonic-Induced Lucid Dreaming (MILD).
MILD involves having some means of remembering what one has forgotten, i.e., that one is dreaming. To break it down further, first we’ll need to learn how to perform a reality check. Again, there are many of these, but one of the simplest is to ask yourself:
How did I get here?
- If you can retrace your steps with relative ease and the story of how you got here does not sound too much like a dream sequence, you are probably not dreaming.
- If you are dreaming, however, chances are that nothing actually led to where you are now; you just appeared here.
Other reality checks include checking whether books, clocks, and/or lightswitches work as they should—all are notorious for often being broken in dreams; books have gibberish or missing or repeated text; clocks do not tell the correct time and often do not even tell a time that could be real (e.g: 07:72), and lightswitches may turn a light on/off without actually changing the level of illumination in the room.
Now, a reality check is only useful if you actually perform it, so this is where MILD comes in.
You need to make a habit of doing a reality check frequently. Whenever you remember, it’s a good time to do a reality check, but you should also try tying it to something. Many people use a red light, because then they can also use a timed red light during the night to subconsciously cue them that they are dreaming. But it could be as simple as “whenever I go to the bathroom, I do a reality check”.
With this in mind, a fun method that has extra benefits is to try to use a magical power, such as psychokinesis. If (while fully awake) whenever you go to pick up some object you imagine it just wooshing magically to meet your hand halfway, then at some point you’ll instinctively do that while dreaming, and it’ll stand a good chance of working—and thus cluing you in that you are dreaming.
How to stay lucid
When you awaken within a dream (i.e. become lucid), there’s a good chance of one of two things happening quickly:
- you forget again
- you wake up
So when you realize you are dreaming, do two things at once:
- verbally repeat to yourself “I am dreaming now”. This will help stretch your awareness from one second to the next.
- look at your hands, and touch things, especially the floor and/or walls. This will help to ground you within the dream.
Things to do while lucid
Flying is a good fun entry-level activity; it’s very common to initially find it difficult though, and only be able to lift up very slightly before gently falling down, or things like that. A good tip is: instead of trying to move yourself, you stay still and move the dream around you, as though you are rotating a 3D model (because guess what: you are).
Confronting your nightmares and/or general fears is a good thing for many. Think, while you’re still awake during the day, about what you would do about the source/trigger of your fear if you had magical powers. Whatever you choose, keep it consistent for now, because this is about habit-forming.
Example: let’s say there’s a person from your past who appears in your nightmares. Let’s say your chosen magic would be “I would cause the ground to open up, swallow them, and close again behind them”. Vividly imagine that whenever they come to mind while you are awake, and when you encounter them next in a nightmare, you’ll remember to do exactly that, and it’ll work.
Learning about your own subconscious is a more advanced activity, but once you’re used to lucid dreaming, you can remember that everything in there is an internal projection of your own mind, so you can literally talk to parts of your subconscious, including past versions of yourself, or singular parts of your greater-whole personality, as per IFS:
Take Care Of Your “Unwanted” Parts Too!
Want to know more?
You might like to read:
Enjoy!
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JoyFull – by Radhi Devlukia-Shetty
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We haven’t done a recipe book in a little while, so here’s a good one!
The focus of this book is getting more plants and spices into your diet, and doing it deliciously.
Healthwise, there is nothing controversial here: the recipes are all plant-based, mostly whole-foods, and the items that aren’t whole foods are things like “vanilla extract”.
The recipes themselves (of which there are 125) are presented clearly and simply, one to a double-page (although sometimes there will be a suggested variation on the same double-page), ideal for use in a kitchen bookstand. For each recipe, there’s a clear photo of the end result, so you know what you’re working towards.
The ingredients are not too obscure, and can be acquired from more or less any large supermarket.
Bottom line: if you’re looking to expand your plant-based cooking repertoire in a way that’s not just substitutions, then this book provides an excellent variety.
Click here to check out JoyFull, and get a taste of Ayurvedic cooking!
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Does Ginseng Increase Testosterone Levels?
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❓ Q&A With 10almonds Subscribers!
Q: You talked about spearmint as reducing testosterone levels, what about ginseng for increasing them?
A: Hormones are complicated and often it’s not a simple matter of higher or lower levels! It can also be a matter of…
- how your body converts one thing into another
- how your body responds (or not) to something according to how the relevant hormone’s receptors are doing
- …and whether there’s anything else blocking those receptors.
All this to say: spearmint categorically is an anti-androgen, but the mechanism of action remains uncertain.
Panax ginseng, meanwhile, is one of the most well-established mysteries in herbal medicine.
Paradoxically, it seems to improve both male and female hormonal regulation, despite being more commonly associated with the former.
- It doesn’t necessarily increase or decrease testosterone or estrogen levels (but it can, even if indirectly)
- It does improve sexual function
- …and alleviates symptoms associated with conditions as varied as:
- Late-onset hypogonadism (common for men during the andropause)
- Benign prostate hyperplasia (again common for men during the andropause)
- …and also counteracts unwanted side-effects of finasteride. Finasteride is often taken by men as a hair loss remedy or, less often but critically, in the case of an enlarged prostate.
But it also…
- Alleviates symptoms of PCOS (polycystic ovary syndrome, which effects around 20% of women)
- May even be an effective treatment for PCOS (rat model only so far)
- It also may improve female reproductive fertility more generally (the studies are down to fruit flies now though)
Bottom line: Panax ginseng is popularly taken to improve natural hormone function, a task at which it appears to excel.
Scientists are still working out exactly how it does the many things it appears to do.
Progress has been made, and it clearly is science rather than witchcraft, but there are still far more unanswered questions than resolved ones!
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