Chronic pain and bloating in a woman’s abdomen may point to
an abnormality of the endometrial tissue. According to research or other evidence, the
following self-care steps may provide some relief:
- Ease the soreness with C and E
- Lessen the pain by taking a daily combination of 1,000 mg of
vitamin C and 1,200 IU of vitamin E
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full endometriosis article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About endometriosis
Endometriosis is a progressive and chronic condition in which endometrial tissue (the inner
lining of the uterus that is shed each month during menses) is found outside of the uterus and
implanted within the pelvic cavity.
Endometriosis is believed to affect as many as 10% of all women in the United States and is
the third leading cause of gynecologic hospitalization and a leading cause of
hysterectomy.1 Although many theories exist, the cause of endometriosis is unclear.
However, there does appear to be a genetic link—women who have a mother or sister with
endometriosis are more likely to develop this condition.
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endometriosis
What are the symptoms?
Women with endometriosis may have symptoms including pain before and during menstrual
periods, pain with sexual intercourse, abdominal bloating, pain during urination or bowel
movements, pelvic tenderness, premenstrual spotting, abnormally heavy or long menstrual
periods, rectal bleeding during menstrual periods, and an inability to become pregnant.
Medical options
Over the counter drugs for pain and inflamation, such as aspirin (Genuine Bayer, Ecotrin, Bufferin), ibuprofen (Motrin IB, Advil), and naproxen (Aleve), might be beneficial.
Prescription drug treatment focuses on controlling inflammation and reducing estrogen and
progesterone blood levels. Prescription-strength
nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin), naproxen
(Anaprox, Naprosyn), meloxicam (Mobic),
celecoxib (Celebrex), indomethacin
(Indocin), ketoprofen (Orudis), and diclofenac (Voltaren), help control pain and
inflamation. Oral birth control pills
(Ortho-Novum, Mircette, Loestrin, Triphasil), antiestrogens such as danocrine (Danazol), the
progestin norethindrone (Aygestin), and gonadotropin-releasing hormones, such as leuprolide (Lupron) and goserelin (Zoladex), are
prescribed to affect hormone levels.
Surgical treatments, such as removal of the endometrial areas, ovaries, or uterus may also
be recommended.
Dietary changes that may be helpful
There has been no research investigating the effect of any specific diet in women with
endometriosis. Preliminary research suggests that women who consume more than 5 grams of caffeine per month (about 1.5 cups of coffee a day) are more likely to have
endometriosis.2 No study has investigated whether avoiding caffeine improves the
symptoms of endometriosis.
Lifestyle changes that may be helpful
Preliminary studies suggest that women who exercise two to four hours per week have less
risk of developing endometriosis.3 4 However, the benefit seems to be
limited to those women who participate in vigorous exercise, such as jogging or other
activities that raise the heart rate. Whether exercise will reduce the symptoms of existing
endometriosis is unknown.
Vitamins that may be helpful
In a study of women with pelvic pain presumed to be due to endometriosis, supplementation
with vitamin E (1,200 IU per day) and vitamin C (1,000 mg per day) for two months resulted
in an improvement of pain in 43% of women, whereas none of the women receiving a placebo
reported pain relief.5
Animal research suggests that fish oils may
reduce the severity of endometriosis,6 7 and fish oils have been shown
to improve symptoms of dysmenorrhea (painful
menstruation),8 which may be caused by endometriosis. Therefore, while no specific
research has been done on the effects of fish oils in women with endometriosis, some health
practitioners recommend several grams of fish oil per day for this condition.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Vitex is recommended either alone or in
combination with other herbs, such as dandelion
root, prickly ash, and motherwort, by some doctors to treat the symptoms of
endometriosis.9 10 Although vitex affects hormones that in turn affect
the severity of endometriosis,11 and it may be effective for premenstrual syndrome,12 no research has
tested the effect of vitex supplementation on women with endometriosis. Similarly, no other
botanical medicines have been scientifically researched for treating this disease.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
According to preliminary reports, regular meetings with other endometriosis sufferers may
help women with endometriosis learn about the disease and cope better with the many
psychological and emotional issues that often accompany this condition.13 One
preliminary study found that women who had the opportunity to speak with other women with
endometriosis, as well as to meet with their physician, had a higher satisfaction with their
overall care.14
Acupuncture has been reported anecdotally
to help control the pain associated with some cases of endometriosis,15 but no
controlled studies have confirmed this claim. One small, preliminary study found that
auricular acupuncture (acupuncture of the ear) was as effective as hormone therapy in treating
infertility due to endometriosis.16
References:1. Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet
Gynecol Clin North Am 1997;24:235–58 [review].
2. Grodstein F, Goldman MB, Ryan L, Cramer DW. Relation of female
infertility to consumption of caffeinated beverages. Am J Epidemiol
1993;137:1353–60.
3. Cramer DW, Wilson E, Stillman RJ, et al. The relation of endometriosis
to menstrual characteristics, smoking, and exercise. JAMA 1986;255:1904–8.
4. Signorello LB, Harlow BL, Cramer DW, et al. Epidemiologic determinants
of endometriosis: a hospital-based case-control study. Ann Epidemiol
1997;7:267–74.
5. Johnson K. Antioxidant therapy quickly improves endometriosis pain.
Fam Pract News 2004(March 15):75 [News report].
6. Yano Y. Effect of dietary supplementation with eicosapentaenoic acid
on surgically induced endometriosis in the rabbit. Nippon Sanka Fujinka Gakkai Zasshi
1992 Mar;44(3):282–8 [in Japanese].
7. Covens AL, Christopher P, Casper RF. The effect of dietary
supplementation with fish oil fatty acids on surgically induced endometriosis in the rabbit.
Fertil Steril 1988;49:698–703.
8. Harel Z, Biro FM, Kottenhahn RK, Rosenthal SL. Supplementation with
omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents. Am J
Obstet Gynecol 1996;174:1335–8.
9. Batchelder HJ, Hudson T, Lewin A, et al. Therapeutic approaches to
endometriosis. The Protocol Journal of Botanical Medicine
1996;Spring:25–60.
10. Hudson T. Women’s Encyclopedia of Natural Medicine.
Los Angeles: Keats Publishing, 1999:79–88.
11. Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit
prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25:253–5.
12. Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual
tension syndrome with Vitex agnus-castus. Controlled, double-blind study versus pyridoxine.
Phytomedicine 1997;4:183–9.
13. Whitney ML. Importance of lay organizations for coping with
endometriosis. J Reprod Med 1998;43(3 Suppl):331–4.
14. Wingfield MB, Wood C, Henderson LS, Wood RM. Treatment of
endometriosis involving a self-help group positively affects patients’ perception of
care. J Psychosom Obstet Gynaecol 1997;18:255–8.
15. Maciocia, G. Obstetrics and Gynecology in Chinese Medicine.
New York: Churchill Livingstone, 1998:691–733.
16. Gerhard I, Postneek F. Auricular acupuncture in the treatment of
female infertility. Gynecol Endocrinol 1992;6:171–81.