Natural Treatments for Endometriosis

Endometriosis is a chronic, often painful condition in which the tissue that normally lines the uterus (called the endometrium) starts growing outside the uterus. The overgrowth most commonly affects the fallopian tubes, ovaries, and pelvic lining but can also spread beyond the pelvic area.

Endometriosis is commonly treated with hormone therapy, surgery, pain medications, and lifestyle changes, but, because it can be so difficult to treat, many women will turn to natural therapies to support the medical treatments prescribed by their doctors.

Alternative therapies aim to alleviate the symptoms of endometriosis. They cannot "cure" the disease. As a general rule, there is little scientific evidence to support the use of any alternative therapy in treating endometriosis. With that said, the potential harms tend to be low, so they generally won't make things worse.

Symptoms of endometriosis include:

• Painful periods, including pelvic pain and cramping
• Lower abdominal or low back pain
• Sharp, deep pain during ovulation, sexual intercourse, bowel movements, or urination
• Shooting pains (sciatica) during menstruation
• Heavy menstrual periods
• Bleeding in between periods
• Indigestion, diarrhea, constipation, or nausea
• Infertility

Estrogen is a female hormone that regulates the normal growth of the endometrium. It is believed by some that the dysregulation of estrogen may contribute to the development of endometriosis.

To this end, alternative practitioners believe that a group of plant-based chemicals, called isoflavones, may help reduce the symptoms of endometriosis by inhibiting aromatase, an enzyme that converts male hormones (androgens) to estrogens. Good food sources of isoflavones include celery, parsley, soybeans, chickpeas, fava beans, pistachios, and peanuts.

Similarly, an organic compound called indoles found in broccoli, cauliflower, cabbage, kale, Brussels sprouts, and bok choy have mild anti-estrogen effects that may be beneficial to women with endometriosis.

Some studies suggest that long-term exposure to environmental chemicals called dioxins and polychlorinated biphenyls (PCBs) may increase the risk and severity of endometriosis. One way to reduce the intake of these toxins is to cut back on saturated fats, especially high-fat dairy and red meat. Dioxin and PCBs both accumulate in animal-based fats, which can readily be passed to humans in foods.

Alternative practitioners will often recommend progesterone cream to treat the symptoms of endometriosis. It is believed that progesterone cream inhibits the proliferation of endometrial cells and the development of blood vessels (angiogenesis) that feed the uterine growth. By inhibiting these processes, the endometrial overgrowth may be significantly reduced along with the accompanying pain.

Progesterone cream is derived from either soy or Mexican wild yam. A plant-based steroid called diosgenin is extracted in a lab and converted to a bioequivalent form of progesterone. Wild yam cream is often sold as "natural progesterone," a marketing ploy that is misleading since the diosgenin content cannot be converted in the body to progesterone.

Progesterone cream is available from compounding pharmacies or at some regular drugstores. It can be applied to the wrists, inner arms, inner thighs, or upper chest at a dose recommended by your doctor.

It is important that the treatment to be medically supervised because too much progesterone can cause mood changes, depression, water retention, weight gain, and abnormal menstrual bleeding.

Prostaglandins are a class of complex fatty acids that are largely responsible for menstrual cramps and pain caused by endometriosis. There are "good" prostaglandins that alleviate inflammation as well as "bad" prostaglandins that do promote inflammation. Too much of one or too little of the other can trigger pain.

Omega-3 fatty acids found in fatty fish such as salmon, mackerel, sardines, and anchovies are believed to be beneficial to women with endometriosis as they are converted in the body to anti-inflammatory prostaglandins. At the same time, they appear to suppress the production of inflammatory prostaglandins derived from saturated fats in dairy and red meat.

An increased intake of omega-3 fatty acids—most specifically a compound called eicosapentaenoic acid (EPA) found in fish oil—can alter the balance of prostaglandins and alleviate many of the inflammatory symptoms of endometriosis.

The jury remains split on how robust these dietary interventions are, although studies have shown that women with high concentrations of EPA are 82% less likely to have endometriosis compared to women with low EPA levels.

Chamomile, often embraced for its "calming" effects, has long been used as a home remedy for premenstrual syndrome (PMS). These same effects are assumed to be useful in providing the generalized relief of cramps and pain caused by endometriosis.

Research has suggested that the effects may be more direct than previously imagined. According to a 2018 study published in the Journal of Cellular Physiology, chamomile contains an isoflavone known as chrysin which appears to trigger apoptosis (cell death) in uterine tissues that have grown out of control.

The test tube study suggested that chrysin found in chamomile and other substances (such as honey) may one day lead to the development of drugs that can relieve endometriosis symptoms. Further research is needed to see if the same results can be replicated in humans.

Resveratrol is a plant-based nutrient mainly found in grapes, peanuts, and mulberries. Resveratrol is believed to treat endometriosis by inhibiting aromatase (associated with estrogen activity) and COX-2 enzymes (associated with pain).

Animal research has shown that resveratrol implants in rats reduced the number and size of endometrial lesions by 60%. Whether the same can be achieved by eating resveratrol-rich foods has yet to be proven.

A small 2016 study published in the Journal of Clinical Endocrinology and Metabolism reported that women provided 1,500 milligrams of resveratrol per day in tablet form had a 23% reduction in blood testosterone levels after three months. What the supplement did not reduce, however, was the inflammation that promotes endometriosis symptoms.

Turmeric is a mainstay of naturopathic medicine and a spice that may offer significant benefits to women with endometriosis.

Turmeric contains an anti-inflammatory and antioxidant compound known as curcumin that has been shown to slow endometrial cell proliferation in test tube studies. It appears to do by inhibiting the production of estradiol, the strongest of the three types of human estrogen.

Further research is needed to determine whether the oral use of turmeric can render a therapeutic effect in women with endometriosis. At present, the evidence is lacking.

Green tea has similar properties to progesterone in that it is a potent inhibitor of aromatase. Moreover, it an anti-angiogenic and suppresses the development of tiny blood vessels that feed endometrial overgrowth and promote inflammation.

Green tea appears to do so by blocking vascular endothelial growth factor C (VEGFC), a protein released by red blood cells. A 2018 study in the journal Human Reproduction reported that lab mice implanted with a green tea derivative achieved significant reductions in endometrial vascularization (blood vessel growth) compared to mice treated with a placebo.

It is unclear if drinking green tea offers any of the same benefits.

Acupuncture involves the insertion of tiny needles in the skin, mainly to treat pain. A 2017 review of studies published in the journal PLoS ONE found evidence, albeit slight, that acupuncture can reduce abdominal and pelvic pain and the size of the endometrial overgrowth in women with endometriosis.

Despite the positive findings, the quality of the studies was generally poor with largely arbitrary or subjective measures. Of the 10 studies included, only one was placebo-controlled.

Massage therapy is believed to relieve the symptoms of endometriosis in two ways: by gently releasing adhesions that stick uterine tissues together and by alleviating stress that can amplify pain sensations and trigger uterine spasms.

A small study conducted in 2010 reported that 23 women with endometriosis had a significant reduction in pelvic pain after six weeks of massage therapy. In total, the women were given 20 twenty-minute sessions focusing on the abdomen, sides, and base of the spine (sacrum). No other treatments were prescribed during the six-week study.

Practitioners of traditional Chinese medicine (TCM) typically used a combination of herbs to treat uterine conditions like endometriosis. Endometriosis is not categorized as a disease in TCM but is rather described as a "blood stasis syndrome" characterized by the formation of abdominal lumps.

A comprehensive review of studies published in the Cochrane Database of Systematic Reviews found that Chinese herbs used to treat blood stasis appeared comparable to the steroid gestrinone in relieving endometriosis pain after laparoscopic surgery. When used outside of surgery, the Chinese herbs (taken orally and in enema form) appeared to be just as effective as the synthetic androgen danazol in providing endometriosis pain relief.

Despite the positive findings, the researcher concluded that "more rigorous research is required to accurately assess the potential role of (Chinese herbs) in treating endometriosis."