- 1 Eclectic Specific Condition Review: Endometriosis
- 2 Cervical Dysplasia: Diagnosis
- 3 Cervical Dysplasia: Conventional Treatment Approaches
- 4 Staging of Cervical Dysplasia
- 5 Cervical Dysplasia: Botanical And Naturopathic Treatment
- 6 Cervical Dysplasia: Discussion Of Botanicals
Botanical And Naturopathic Approaches
Cervical dysplasia describes cervical cells with an atypical appearance, loss of uniformity in cell structure, and loss of their normal architectural orientation. Each year between 250,000 and 1 million women in the United States are diagnosed with cervical dysplasia. It can occur at any age, but the mean ages are 25 to 35 years old. Atypia and dysplasia can be caused by inflammation, cervical intraepithelial neoplasia (CIN), or carcinoma in situ (CIS) (see Staging). Atypical cervical cells can be a precursor to invasive cervical cancer. Mild dysplasia is the most common form of cervical dysplasia, and up to 70% of these cases regress on their own, the cervical tissue returning to normal without treatment. Moderate and severe dysplasias are less likely to resolve spontaneously and have a higher rate of progression to cancer. The greater the abnormality of the cells as determined by staging, the higher the risk for developing cervical cancer. Cervical cancer is the third most common gynecological malignancy in US women (see site). Cervical dysplasia is inversely related to the age of first intercourse; it is directly related to the number of sexual partners in the woman’s lifetime, and the risk increases for the sexual partners of men whose previous partners had cervical cancer. The development of cervical dysplasia and cervical cancer is strongly associated with infection by human papillomavirus (HPV). There are many different types of human papillomavirus that are classified as high risk, most notably types 16 and 18. Contributing factors in the transformation of cells from dysplasia to neoplasm are smoking, poor diet, oral contraceptive use, chronic cervicitis, herpes virus infection (herpes simplex virus), HIV, exposure to DES, immune suppression, and exposure to environmental carcinogens.
Eclectic Specific Condition Review: Endometriosis
Endometriosis, or adenomyosis externa, was not recognized as a disease by nineteenth-century physicians. It may have been much rarer than today or simply misdiagnosed as chronic menorrhagia with abdominal pain. Most Eclectic treatments would be to relieve pain and control bleeding, i.e., they are palliative rather than curative.
Blue Cohosh (Caulophyllum thalictroides)
Canada Fleabane (Erigeron canadense)
For heavy endometrial bleeding.
Chaste Tree (Vitex agnus-castus)
For general reproductive support, to lower estrogen load, and reduce growth of endometrial tissue (modern clinical use).
Cinnamon (Cassia cinnamomum)
To arrest uterine hemorrhage, whether postpartum, menorrhagia, or metrorrhagia.
The essential oil of cinnamon, combined with the essential oil of Canada fleabane (formerly known as Erigeron) in alcohol oil base, was known as Ellingwood’s Compound: 10 to 30 gtt of the mixture was put on a sugar cube and taken 1 to 2 per day to stop uterine bleeding.
Cotton Root (Gossypium spp.)
Endometriosis with excessive bleeding.
Gravel Root (Eupatorium purpureum)
Chronic uterine disease with painful dysmenorrhea.
Helonias Root (Chamaelirium luteum)
General reproductive support, and to normalize estrogen / progesterone balance and help eliminate feelings of pelvic engorgement and a bearing down sensation.
Jamaican Dogwood Bark (Piscidia erythrina)
Endometriosis of the fallopian tubes with nauseating pain, ashen skin color, and cold sweat.
Tiger Lily: entire fresh plant (Lilium lancifolium)
White Ash Bark (Fraxinus americana)
Decreases cell proliferation in uterine hypertrophy. Helps to restore uterus to normal position, size, and function. Dragging pains in the lower abdomen.
Wild Yam Rhizome (Dioscorea villosa)
Endometriosis of the fallopian tubes with painful cramping and ovarian colic.
Cervical Dysplasia: Diagnosis
Cervical dysplasia is usually asymptomatic and most commonly discovered upon routine Pap smear. In contrast, cervical cancer may be asymptomatic or present with abnormal vaginal bleeding. Pap testing has significantly reduced mortality from cervical cancer, a privilege of developed nations that if made available worldwide would nearly obliterate this disease. Current guidelines recommend that all women over aged 18 have a Pap test done every 1 to 3 years, depending on individual risk factors and medical history. With routine Pap smears, advanced morbidity and mortality from cervical cancer should be entirely preventable, particularly because it is a slowly progressing cancer allowing plenty of time for detection and treatment. Sadly, 50% of all women diagnosed with cervical cancer have not had a Pap smear in greater than 10 years. Any suspicious lesion should be biopsied directly. Colposcopy-directed biopsy usually provides enough clinical evidence for an accurate diagnosis. The diagnosis of cervical dysplasia is largely anxiety provoking for women because of the association between dysplasia and carcinoma. Therefore, it is important that practitioners take the time to thoroughly explain to each woman the level of concern that is warranted by her degree of dysplasia, and compassionately review options with her.
Cervical Dysplasia: Conventional Treatment Approaches
Medical treatment depends on the severity of the lesions. For women with preinvasive cervical disease, treatments options include laser therapy, cryotherapy, loop electrical excision procedure (LEEP), and conization biopsy. Most physicians have abandoned laser and cryosurgery because of the inaccuracy of treatment compared to loop electrical excision procedure. The depth of the treatment and amount of collateral tissue damage is easier to control with a loop electrical excision procedure. The loop electrical excision procedure removes tissue precisely and cauterizes simultaneously. Cone biopsy is the removal of a cone-shaped amount of cervix the depth of the entire cervix. In both, the loop electrical excision procedure and the cone biopsy the physician is trying to obtain clean borders, meaning that there is no evidence remaining of cervical dysplastic cells. If the woman has progressed to cervical cancer treatment, it usually consists of a total hysterectomy and / or radiation treatment. Conventional treatment is an efficient solution, usually covered by insurance. However, conventional treatments often cause permanent scarring and do not address potential underlying causes. Scarring can interfere with women’s ability to conceive by obstructing the endocer-vical canal with scar tissue, and damaging cervical crypts that are important in providing proper nutrition for advancing sperm and the proper formation of cervical mucus. The scarring also may interfere with cervical dilatation in labor. Further, conization can occasionally lead to “incompetent cervix” during pregnancy, necessitating cervical cerclage, in which a suture is inserted into the cervix to allow the woman to maintain pregnancy and prevent premature labor.
Staging of Cervical Dysplasia
The Bethesda System was developed by the CDC and NIH as a comprehensive, standardized scheme for classifying Pap smear results. It uses the term squamous intraepithelial lesion (SIL) to describe abnormal changes in the cells on the surface of the cervix. Changes are classified on a scale of low grade to high grade. It has largely replaced previous grading systems.
• ASCUS (atypical squamous cells of undetermined significance): borderline, some abnormal cells
• LGSIL (low-grade squamous intraepithelial lesions): mild dysplasia and cellular changes associated with human papillomavirus
• HGSIL (high-grade squamous intraepithelial lesions): moderate to severe dysplasia, precancerous lesions, and carcinoma in situ (preinvasive cancer that involves only the epithelium)
Because of the risks associated with sexually transmitted infections and subsequent cervical dysplasia, current sexual partners should be screened and treated for human papillomavirus as necessary. Adolescent girls should be educated about the risk factors for developing cervical dysplasia. The sociologic components of women’s health also cannot be ignored. A history of sexual abuse, for example, is not an uncommon clinical finding in women with a history of cervical dysplasia.