Endometriosis is a chronic, painful inflammatory condition that affects around 190 million women of reproductive age¹ worldwide.
Why does endometriosis cause pain? The lining of the uterus (aka, endometrium) is present in other places such as the ovaries, lower abdomen, bowel, and fallopian tubes. Hormones cause this additional endometrial tissue to thicken and shed during a woman’s monthly menstrual cycle. However, when endometriotic tissue is around organs or nerve endings, the blood has nowhere to be expelled. As a result, endo can cause swelling and inflammation — which can cause heavy cramping and pain in the abdomen, lower back, or pelvis.
Although surgeries and conventional medical treatments can be effective and are the most common way to treat endometriosis, these interventions can be expensive, have undesirable side effects, and come with a high risk of recurrence². As a result, many women want to treat their endometriosis using natural remedies and lifestyle changes.
There is currently no prevention or cure for endometriosis. However, the natural treatments described in this article can help to relieve the pain by focusing on reducing inflammation and loosening pelvic muscles.
When trying natural remedies or seeking advice on lifestyle changes, it is essential to look for information backed up by scientific studies, preferably based on human data.
Even though more research needs to review these treatments, this article’s remedies and lifestyle advice are generally safe and beneficial for treating endometriosis-related symptoms. Note: Before stopping any conventional medication, making any significant dietary changes, or starting a new treatment, you should consult your doctor about their suitability for your overall health needs.
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Natural remedies and lifestyle changes go hand in hand. For simplicity, we will divide them into physical therapies and dietary changes. Both are worthy considerations for managing endometriosis without surgery.
Menstrual cycle regularity
Since endometriosis is an inflammatory condition, a diet rich in anti-inflammatory foods⁴ can help manage symptoms and pain. Anti-inflammatory foods or ingredients include primarily:
Omega-3 fatty acids
Omega-3s are a type of fatty acid that we eat and then store in our bodies. You may have heard these polyunsaturated fats referred to as “healthy fats.”
Omega-3s are in many foods, such as salmon, tuna, pumpkin seeds, dark-green leafy vegetables, walnuts, blueberries, vegetable oils, and flaxseeds.
You must obtain Omega-3s from food as the human body is incapable of manufacturing them on its own.
Your body also has chemicals called prostaglandins⁵ derived from fats. Some prostaglandins are anti-inflammatory, and some are inflammatory.
Prostaglandins typically cause the uterine muscles to spasm, helping to expel the womb lining during your period (or the placenta during childbirth).
Omega-3 fatty acids can convert into anti-inflammatory prostaglandins.
When studied, an increase in omega-3 fatty acid intake led to a reduction in pain during menstruation and endometriosis symptoms⁶.
Furthermore, the women with the highest omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis⁶ (compared to the women with the lowest intake).
Curcumin is a compound extracted from turmeric, which can help with swelling and inflammation associated with endometriosis⁷.
It has anti-inflammatory, anti-oxidant, anti-proliferative, and hormonal regulatory properties, which protect against endometriosis symptoms.
Curcumin does the following:
Slows growth and number of endometrial cells by reducing estrogen⁸
Suppresses inflammatory cytokines (small proteins that affect the immune system by allowing cells to communicate with each other)
Inhibits the invasion, attachment, and formation of new blood vessels that supply endometriotic lesions
Decreases oxidative stress in the peritoneal fluid with its anti-inflammatory properties
Turmeric is a spice that you can use when cooking curries or soups. Alternatively, you can buy curcumin as a supplement or a liquid form that you could add to smoothies.
If you want to take a curcumin supplement, seek advice from your doctor beforehand because it will likely be a high dose, and it may interact with other medications you take.
Reduce saturated and trans fats
Saturated and trans fats are pro-inflammatory and can cause estrogen imbalances⁹, partly because they stimulate the inflammatory prostaglandins (the opposite of what omega-3 fatty acids do).
Trans fats are in margarine and many fried or battered foods. Red meat and dairy are the primary sources of saturated fat. In addition, they’re associated with higher concentrations of estradiol¹⁰ which can maintain endometriosis and may worsen symptoms¹¹. Red meats also contain omega-6 fatty acids, which are inflammatory.
However, if you enjoy these foods, you don’t necessarily need to eliminate them from your diet — especially since they have other essential nutrients such as protein, iron, and calcium. Instead, you can focus on moderation or reducing your intake of inflammatory foods. It might require a bit of planning so you can find alternatives, such as choosing leaner meats.
Similarly, the relationship between dairy consumption and endometriosis is not straightforward. Dairy products contain essential nutrients like calcium, vitamin D, and magnesium.
Still, consumption of high-fat dairy can increase estrogen levels which can worsen endometriosis¹². The relationship between inflammation and dairy is a long-standing debate. However, a recent study confirms that dairy does not cause inflammation¹³.
However, if eating dairy products leads to digestive problems like diarrhea or bloating, eliminating dairy may significantly reduce abdominal discomfort, aka “endo-belly.” Women with endometriosis are frequently misdiagnosed with irritable bowel syndrome or have both conditions¹⁴.
Vitamin C and E are antioxidants — molecules that prevent or slow cell damage.
Recent studies in women with endometriosis have shown¹⁵ that taking vitamin C and E supplements for two months decreased inflammatory markers¹⁶ and experienced less chronic pelvic pain during menstruation, sex, and in their everyday lives.
Isoflavones act as phytoestrogens, aka estrogen mimickers. They are found in soybeans, chickpeas, peanuts, pistachios, and certain vegetables. Soy isoflavones may play a role in estrogen-related diseases¹⁷, and endometriosis is estrogen-dependent.
In addition to focusing on nutrition and making changes to your diet, physical therapies can also relieve your pain and significantly improve your quality of life.
Some of these therapies require you to see a specialist, while others are basic remedies that you can carry out by yourself at home. The main goal of physical therapy¹⁸ is to learn how to relax your pelvic muscles, which can tighten due to endometriosis.
This is probably the most simple remedy that can help to relieve your endometriosis symptoms. Heat relaxes the pelvic muscles¹⁹ and reduces cramping and pain.
You can use heat by
Applying a hot water bottle or heating pad to your pelvic region
Having a warm bath
Pelvic massage therapy
Pelvic massage therapy involves massaging the stomach, abdomen, and sacrum area. Generally, about 20 minutes at a time²⁰ is sufficient.
Recent studies have shown that pelvic massage therapy can help relieve endometriosis-related symptoms²⁰ by:
Decreasing the intensity of the menstrual pain caused by endometriosis
Reducing uterine spasms
Releasing adhesions (scar tissue that binds the affected organs together)
Increasing your pain threshold
Decreasing pain during sex²¹
These positive effects can be felt both immediately after massage therapy and after six weeks when the body begins to adjust to the treatment²⁰.
Pelvic floor muscle therapy
Endometriosis is associated with pelvic floor dysfunction (inability to control your pelvic floor muscles).
Five sessions of pelvic floor muscle therapy can greatly relax the pelvic floor muscles²², reduce pain during sex, and lessen chronic pelvic pain.
Studies suggest²³ that acupuncture is effective in managing the painful symptoms of endometriosis. Acupuncture involves inserting thin needles into specific places on your skin.
Acupuncture manages pain by mediating the central nervous system, activating the pain-killing mechanisms in your brain, and releasing neurotransmitters.
Some of the benefits of acupuncture as a natural remedy for endometriosis pain include:
Increasing your pain threshold
Preventing estrogen levels from rising too high
Reducing the concentration of CA-125, an antigen protein high in women with endometriosis²³
Providing anti-inflammatory effects
Natural progesterone cream
Progesterone is one of the female sex hormones usually balanced by estrogen. If you have endometriosis, your progesterone is affected as the growth of lesions causes estrogen dominance²⁴ and lowered progesterone levels.
Synthetic progesterone, known as progestin, is a hormone replacement therapy that can manage endometriosis symptoms. Synthetic progesterones are used in clinical studies and have FDA approval to treat endometriosis.
There is also a natural, “bio-identical” progesterone derived from soybeans or wild yam (an inedible variety). It is available over-the-counter at most pharmacies, either as a moisturizing cream or capsules that you place under your tongue. Bioidentical progesterone has not been given FDA approval (yet), so safety and dosing requirements are not fully established.
Studies show²⁴ that progesterone cream:
Has anti-inflammatory properties
Can suppress the extent of lesions
Reduces conversion of estrone to estradiol (the main type of estrogen responsible for the growth of endometriotic tissue)
Alters estrogen receptors
Reduces the expression of an enzyme needed for endometriotic tissue growth
As with any medication, there is still a risk that you may experience some side effects, such as a headache, drowsiness, or acne.
If you choose to try natural progesterone, speak to your doctor beforehand for advice on whether or not it would be a good fit for you.
Endometriosis is a debilitating inflammatory condition for many women. If untreated, it can significantly reduce your quality of life.
Thankfully, natural remedies and lifestyle changes can be excellent management tools with relatively low to no risk.
If your symptoms do not improve after trying natural remedies, you should see your doctor for advice on your next steps.
Curcumin and endometriosis (2020)
Assessment of levator hiatal area using 3D/4D transperineal ultrasound in women with deep infiltrating endometriosis and superficial dyspareunia treated with pelvic floor muscle physiotherapy: randomized controlled trial (2021)
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