Endometriosis affects roughly 10 percent of women ages 15 to 44 according to John Hopkins University. Women with endometriosis are more likely to have fertility issues, inflammation, scarring and cysts. There is no cure for endometriosis but there are ways to treat the symptoms and alleviate the pain associated with endometriosis. Unfortunately this is a common women’s health issue.
What is Endometriosis?
Endometriosis is often regarded as a gynecologic condition in which tissue normally found exclusively in the uterus (endometrial tissue) begins to grow in areas outside the uterus. Most commonly, these lesions are found in the pelvic region such as the ovaries, fallopian tubes, bladder, and rectum. It can be argued that this condition is not only a reproductive disease, but rather a systemic whole-body condition as this tissue can migrate to other areas of the body such as the abdominal wall, lungs, pancreas, and liver, among others.
Conventional Treatment Options
Conventionally endometriosis is treated with a combination of laparoscopy to remove the lesions in addition to pharmaceutical methods of managing symptoms. These include anti-inflammatory treatments (NSAIDs) and hormonal treatments (oral contraceptives, GnRH analogs, progestins). It should be noted that even with these therapies, endometriosis has a high recurrence rate (5-20%) unless there is surgical removal of the uterus and ovaries.
Natural Treatment Options
Natural treatments for endometriosis require addressing the disease from several angles. This can include hormone regulation, reducing inflammation, immune modulation, pain management, addressing gut health, and reducing environmental toxin exposures.
Hormone Regulation:
Endometriosis is an estrogen-mediated condition, meaning that the more estrogen activity that’s occurring in the body the more severe the disease can become. There are various tactics to address estrogen directly including nutritional changes, such as the cruciferous vegetables like broccoli, cauliflower, brussels sprouts, etc. When we need a little extra boost of support to help with estrogen balance, the following supplements may help:
- Diindolylmethane (DIM)
- N-acetyl cystine (NAC)
- Calcium D-glucarate
- Vitex agnus castus
Reducing inflammation:
Inflammation is a well-known component of endometriosis with increased inflammatory cytokines being found in patients with this condition. This inflammatory process being left unaddressed in endometriosis patients could be making symptoms and severity of the condition worse. Nutrition, exercise, and stress management are all important components of managing inflammation. In addition, we also have various supplementary and herbal options to help reduce inflammation such as:
- Ginger root (which additionally can help reduce pain),
- Green tea extracts
- Curcumin
- Omega-3 fatty acids
Pain management:
While working on a deeper level to improve symptoms, faster treatments are often necessary to address the chronic pain of endometriosis. This is why NSAID therapy can be beneficial for short-term use to improve pain, however, long-term use can lead to other concerns such as peptic ulcer disease, renal disease, and heart attack/stroke risk. Other therapies we often use to help improve pain include botanical formulations that help to relax the smooth muscle and alleviate pain. Some of these include:
- Magnesium glycinate
- Cramp Bark (viburnum opulus)
- Ginger
- Valerian Root
Environmental toxin exposure:
Environmental toxin exposure can worsen endometriosis due to xenoestrogens that strongly bind to estrogen receptors. In particular, dioxins and PCBs can directly impact symptoms due to having an effect on growth factors, cytokines, and hormone balance. It is often impossible to avoid any and all exposures, therefore, the ultimate goal is to reduce exposures to these types of chemicals so to prevent worsening of endometriosis symptoms. The Environmental Working Group (EWG) can be a great resource for assessing your at-home personal products.
Gut Health:
Natural treatments for endometriosis don’t always focus on the hormones or pain directly. Endometriosis and concerns of the gastrointestinal tract are highly linked with gastrointestinal symptoms affecting up to 90% of people with this condition. The gut microbiome and health of the GI tract plays a role in inflammation, immune function, and hormone balance. The gut microbiome directly affects estrogen levels through the activity of an enzyme called β-glucuronidase that can cause an increase of estrogen in the body when it becomes overproduced due to gut dysbiosis. Assessing for dysbiosis and making recommendations tailored to reestablishing a healthy microbiome, making nutritional changes, reducing inflammation, and promoting healing of the gut lining can all be helpful in treating endometriosis.
Getting Started:
Whether you’ve been formally diagnosed with endometriosis or have symptoms that make you suspect you might have the condition, the first step in treating endometriosis naturally is finding a professional to help you navigate these treatments safely. It’s always important to check in with your doctor before starting any supplement or botanical to ensure that it is safe for you.
References:
- Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am. 1997;24(2):235-258. doi:10.1016/s0889-8545(05)70302-8
- Wellbery C. Diagnosis and treatment of endometriosis [published correction appears in Am Fam Physician 2000 May 1;61(9):2614]. Am Fam Physician. 1999;60(6):1753-1768.
- Jiang L, Yan Y, Liu Z, Wang Y. Inflammation and endometriosis. Front Biosci (Landmark Ed). 2016;21(5):941-948. Published 2016 Jun 1. doi:10.2741/4431
- Vallée A, Lecarpentier Y. Curcumin and Endometriosis. Int J Mol Sci. 2020;21(7):2440. Published 2020 Mar 31. doi:10.3390/ijms21072440
- Marcum ZA, Hanlon JT. Recognizing the Risks of Chronic Nonsteroidal Anti-Inflammatory Drug Use in Older Adults. Ann Longterm Care. 2010;18(9):24-27.
- Birnbaum LS, Cummings AM. Dioxins and endometriosis: a plausible hypothesis. Environ Health Perspect. 2002;110(1):15-21. doi:10.1289/ehp.0211015
- Bruner-Tran KL, Osteen KG. Dioxin-like PCBs and endometriosis. Syst Biol Reprod Med. 2010;56(2):132-146. doi:10.3109/19396360903381023
- Jiang I, Yong PJ, Allaire C, Bedaiwy MA. Intricate Connections between the Microbiota and Endometriosis. Int J Mol Sci. 2021;22(11):5644. Published 2021 May 26. doi:10.3390/ijms22115644
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