Intrinsic to both herbal and naturopathic treatment of cervical dysplasia is the belief that conventional therapy alone does not address a woman’s underlying propensity to dysplasia, nor does it address preventable causes. This is significant as the 5-year return rate, with conventional therapies is as high as 75%. In contrast to conventional approaches, botanical and naturopathic treatments attempt to addresses multifactorial causes, treating the woman, not just her cervix. A disadvantage is that natural medicine protocols are demanding, inconvenient, and potentially costly, requiring multiple office visits. Naturopathic and botanical medicine practitioners emphasize a number of therapies including the use of immune enhancing, anti-inflammatory, hormone-regulating, and antiviral botanicals both for internal and topical treatments. Adaptogens often feature prominently in a botanical program to address immune and endocrine function. Stress can depress immune response, which can increase viral activation. Recent lifestyle changes or stressors, even as seemingly benign as exposure to increased amounts of sunlight, may suppress the immune system sufficiently to cause viral activation. Environmental causes of gynecologic disease — ranging from exposure to excess exogenous estrogens to stress — must be addressed in the long-run for the benefit of all women. (See Endometriosis for a brief discussion of the role of exogenous estrogens on gynecologic health.)
Herbal and naturopathic treatment for the treatment of cervical dysplasia should occur in the context of a complementary relationship with a conventional care provider and in conjunction with appropriate medical care. The development of cervical cancer from dysplasia is highly preventable with proper integrated conventional and natural medical treatment.
An Herbalist’s Approach to Cervical Dysplasia
Because mild cervical dysplasia has a high rate of spontaneous regression one approach of botanical practitioners is to encourage watchful waiting while using antiviral and immune supportive herbs internally to boost immunity and topically to reduce viral proliferation and inflammation and promote tissue healing. For persistent or more than mild cervical dysplasia, experienced gynecologic botanical practitioners favor the use of the loop electrical excision procedure procedure in combination with the postprocedural use of herbal suppositories and internal therapies to enhance immunity, reduce inflammation, and promote healing. Because stress may play both a contributory role in immune and endocrine dysregulation, and is often a consequence of a diagnosis of cervical dysplasia, long-term use (3 to 6 months) of adaptogens is also commonly recommended. Topical herbal applications consist of insertion of a medicated suppository 5 nights per week for as many as 12 weeks, with a repeat PAP at the end of 12 weeks. Several companies sell preformulated suppositories (see Resources at the end of this chapter). Alternatively, practitioners can make suppositories for patients using a suppository mold, or make a mold available to patients who wish to prepare their own. General instructions for preparing suppositories can be found in site, with specific recipes for dysplasia treatment in the following pages. They can be prepared in large batches and kept refrigerated for the duration of treatment for use as needed. If after 3 months of botanical treatment the dysplasia has not improved or has progressed, further medical treatment should be pursued.
Although there are many similarities between botanical and naturopathic treatment of cervical dysplasia, the two approaches diverge over the use of escharotic treatments, a popular naturopathic approach. Escharotics can be caustic and irritating, and are much less controllable and reliable than the loop electrical excision procedure. The direct experience of herbalists with escharotic treatments does not endorse their use. There is no evidence for the efficacy of escharotic treatments for cervical dysplasia, and side effects seen with the loop electrical excision procedure, such as cramping and abdominal pain, may also be seen with escharotics. Additionally, escharotic treatment used topically on other tissue (e.g., for the treatment of breast tumors or skin cancers) has been associated with significant tissue damage in some cases. One observational study reports on dermato-logic cases in which four patients had used escharotics in the treatment of basal cell carcinomas (skin cancer) in lieu of the recommended conventional treatment. One patient had a complete clinical response but had a residual tumor on follow-up biopsy. A second patient successfully eradicated all tumors but experienced severe scarring. A third patient disagreed with the physicians regarding her care and was lost to follow-up. One patient presented with a basal cell carcinoma that “healed” for several years following treatment with an escharotic agent but recurred deeply and required extensive resection. The lesion eventually metastasized. The researchers concluded that physicians should advise their patients against the use of escharotics. Low Dog states that although at this time there is only anecdotal evidence of the efficacy of escharotic treatments for cervical dysplasia, and because several of the herbs typically used possess antiviral and anti-inflammatory effects, further research is warranted. Nonetheless, their use is popular among naturopathic physicians, and women may choose this option when looking for alternatives to conventional medical treatments. Thus, practitioners should be aware of their use.
Many licensed naturopaths specializing in the treatment of gynecologic complaints report excellent results and a high level of safety when using these preparations. No evidence for efficacy or safety for cervical dysplasia was identified in the literautre. Naturopathic protocols, including the use of escharotics are described in detail in Women’s Encyclopedia of Naturopathic Medicine by Tori Hudson. It remains a popular alternative that women may seek or be offered through their naturopathic care provider. It is strongly urged that only licensed NDs with adequate training and experience in the use of escharotic treatment for cervical dysplasia be consulted for this procedure.
Herbs commonly used internally and topically, both for herbal and naturopathic treatments are listed in Table Botanical Treatment Strategies for Cervical Dysplasia.
. Evidence and discussion of adaptogens is found elsewhere in this volume. Readers are also referred to the chapter on cervical cancer for relevant botanical information as well as to site.
Botanical Treatment Strategies for Cervical Dysplasia
|Therapeutic Goal||Therapeutic Activity||Botanical Options||Common Name|
|Reduce viral infection||Antiviral||Calendula officinalis||Calendula|
|Prevent neoplasia||Antimicrobial||Commiphora mol mol||Myrrh|
|Reduce cervical inflammation and heal tissue||Antitumorigenic||Echinacea spp.||Echinacea|
|Melaleuca alternifolia||Tea tree|
|Sanguinaria canadensis||Blood root|
|Reduce viral infection||Demulcent||Althea officinalis||Marshmallow|
|Prevent neoplasia||Vulnerary||Ananas comosus||Pineapple (bromelain)|
|Reduce cervical inflammation||Anti-inflammatory||Calendula officinalis||Calendula|
|and heal tissue||Proteolytic||Clycyrrhiza spp.||Licorice|
|Reduce viral infection||See site|
|Reduce cervical inflammation and heal tissue|
|Support immune response and||Adaptogens||See Stress, Adaptation, the Hypothalamic Pituitary|
|HPA regulation||Adrenal-Axis (HPA) and Women’s Health|
Botanical Treatment Program for Cervical Dysplasia
|Reishi mushroom||(Ganoderma lucidum)||30 mL|
|Echinacea||(Echinacea spp.)||25 mL|
|St. John’s wort||(Hypericum perforation)||15 mL|
|Ginseng||(Panax ginseng)||15 mL|
|Licorice||(Glycyrrhiza spp.)||15 mL|
Total: 100 mL
Dose: 4 mL twice daily for 12 weeks, or as needed for the duration of treatment.
Suppository For Cervical Dysplasia / Human Papillomavirus Infection
¼ cup cocoa butter
¼ cup coconut oil
1 tbl calendula oil or tincture
1 tbl each: dried goldenseal root powder and marsh-mallow root powder
Preparation instructions: See Special Preparations
Use: Insert one suppository on each of 5 consecutive nights per week for up to 12 weeks. It is advisable to wear a disposable cotton menstrual pad nightly during use, as the suppository will melt and leaking can cause staining of bedding or nightwear.
Combine the preceding protocol with the dietary and nutritional strategies described in the following as part of the naturopathic program. After 12 weeks, recheck the cervix with a Pap smear. If the degree of dysplasia has improved, repeat protocol for 8 to 12 additional weeks and recheck the cervix. If there has been no improvement, but also no worsening, make sure the patient has followed the protocol and repeat, modify the herbal protocol, or proceed with conventional medical care.
Alternatively, the naturopathic protocol can be followed as a botanical and nutritional protocol, omitting the escharotic treatment and using either the suppository described in the preceding or those described in the following.
Low Dog states that a multivitamin with folate and B vitamins may be especially indicated for women with cervical abnormalities, citing one study evaluating the relationship between individual nutrients and persistent human papillomavirus infection, which showed that circulating levels of vitamin B12 were inversely correlated with persistent human papillomavirus infection after adjusting for numerous factors, and another study demonstrating that low serum homocysteine levels were highly predictive of invasive cervical cancer risk, possibly suggesting folate, B12, or B6 insufficiency. Also see Cervical Cancer.