26 Alternative Treatments for Endometriosis

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This article has been reviewed by a Leva pain specialist clinician May 2024. Please remember that all herbal remedies should be checked with your GP due to interactions with other medication.

How do I treat my endometriosis naturally?

Treating endometriosis naturally isn’t just about swapping pills for popping supplements.

It’s a holistic journey that might encompass dietary changes, practices to change the way you respond to pain and alternative therapies. It's about empowering yourself to take control of your health in a way that feels right for you.

In this article, we'll explore a range of clinically trustworthy non-pharmacological or surgical treatments for endometriosis. From dietary tweaks to mind-body practices and exercises, we'll delve into approaches that have shown promise in scientific research.

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26 alternative treatments for endometriosis - with evidence

Here's the list - a compilation of natural remedies and holistic practices aimed at easing the burden of endometriosis. We’ve cited specific studies and research in the scientific literature for you to learn more.

Remember: always consult with a healthcare provider to determine the most appropriate treatment plan for your individual needs - especially important if you’re prescribed medication as some of these may interact with your meds. All herbal remedies should be checked with your GP due to interactions with other medication.

Medication and clinician interventions

1. Pelvic floor physiotherapy

Can be beneficial for people with endometriosis, especially those experiencing pelvic pain or discomfort. A skilled physio can provide exercises and techniques to strengthen pelvic muscles, improve posture and reduce pain.

A 2017 study found that an eight-week physio programme is very effective for decreasing pain and abnormalities in posture related with endo [1].

2. Cannabis-based medication

Since 2018 it’s been legal for specialist doctors in the UK to prescribe medical-grade cannabis-based medication. Among other pain conditions, this includes for endometriosis where at least two first-line treatments have failed.

Much can be written on the topic of THC-CBD ratios, dose and how it’s delivered, but a 2021 review of 252 people living with endo over a three year period concluded that cannabis appeared to be effective across all reported symptoms - pain, gastrointestinal and mood [2].

Additionally, a study of 484 women with endometriosis in Australia found that cannabis was the most effective self-management strategy, showing a 7.6/10 score in effectiveness in pain reduction [3].

3. Cognitive-behavioural therapy (CBT)

CBT is a type of psychotherapy that helps you identify and change negative thought patterns and behaviours. It has been shown to be effective in managing chronic pain conditions, including endometriosis, by helping you develop coping strategies and reduce stress.

A review of the scientific literature in 2022 found that CBT provided an improvement in pain and depression scores, as well as reduced stress perception [4].

4. Pain Management Programme (PMP)

You may well have been recommended or joined a PMP if you’ve seen a pain specialist in the past few years. PMPs are designed to teach you self-coping skills to help you reduce the impact pain has on your life.

They’ve been proven effective in managing chronic pelvic pain, leading to improved quality of life (as this NICE article explains). More research is needed for endometriosis specifically.

As of 2024, an open question by NICE has laid down the gauntlet for providers to rise to the challenge and conduct studies specifically on endo. Watch this space!

👀 Try our own self-guided digital pain management programme free here.

Supplements and diet changes

5. Omega-3 (and omega-6) fatty acids

Include sources of omega-3 fatty acids in your diet, such as oily fish (salmon, mackerel, trout), flaxseeds, chia seeds and walnuts. Omega-3s have anti-inflammatory effects and may help reduce pain associated with endometriosis.

An intensive review of 64 people with endometriosis who underwent a laparoscopy (with blood tests before and after) found that compared with 74 women without endo, those with the condition found a relationship between two different types of omega-3 and omega-6 fatty acids could determine the severity of a patient’s endometriosis [5].

6. Curcumin (turmeric)

Curcumin, the active compound in turmeric, has potent anti-inflammatory and antioxidant properties. A 2020 review, found that curcumin has shown potential in reducing inflammation and oxidative stress* in endometriosis [6].

The same study posited that curcumin can directly affect processes like cell invasion, adhesion, cell death (apoptosis) and the formation of new blood vessels (angiogenesis) in endometrial lesions.

This suggests that incorporating curcumin into the diet could be beneficial for preventing and managing endometriosis. However, there haven't been enough studies focusing on how curcumin interacts with endometriosis to confidently recommend it as a treatment.

*oxidative stress is like a buildup of harmful molecules that can damage our body if not kept in check by antioxidants.

7. N-acetylcysteine (NAC)

N-acetylcysteine is a dietary supplement with antioxidant and anti-inflammatory properties. Some studies suggest that NAC supplementation may help reduce inflammation, the oxidative stress process detailed above and pain associated with endometriosis. It may also improve fertility outcomes in women with endometriosis-related infertility [7].

8. Mediterranean diet

The Mediterranean diet, characterised by high consumption of fruits, vegetables, whole grains, legumes, fish and olive oil, has been associated with reduced inflammation and improved health outcomes.

Some observational studies suggest that adherence to a Mediterranean diet may be associated with a lower risk of endometriosis and less severe symptoms [8].

9. Low-FODMAP diet

The low-FODMAP diet is an eating plan that restricts foods containing certain types of carbohydrates that are poorly absorbed in the small intestine.

While originally developed to manage symptoms of irritable bowel syndrome (IBS), some people with endometriosis have reported improvements in gastro symptoms, such as bloating and discomfort, when following the low-FODMAP diet.

But, scientific studies are limited. One encouraging experiment with 62 women with endo saw the participants split into three groups. One group followed a low-FODMAP diet, one group an “endometriosis diet” and one control group. Those in the diet groups reported lower pain scores and better quality of life after 6 months [9].

10. Magnesium supplement

Magnesium is an essential mineral that plays a role in muscle relaxation, nerve function and pain modulation. A 2022 review of the scientific evidence found that magnesium supplementation was found beneficial in animal studies due to its ability to prevent unwanted blood vessels (antiangiogenic effects) [10], though human studies are lacking.

11. Ginger

Ginger is a natural anti-inflammatory and analgesic agent that has been used traditionally to alleviate menstrual pain and discomfort.

Some research suggests that ginger supplementation or consumption may help reduce pelvic pain and inflammation in women with endometriosis [11], though more rigorous research is needed. Ginger can be consumed fresh, as a tea or in supplement form.

12. Vitamin C

Vitamin C's antioxidant properties may help reduce oxidative stress and inflammation associated with endometriosis, potentially offering relief from symptoms. Additionally it may be beneficial to prevent unwanted blood vessels from forming [12].

13. Milk thistle

Milk thistle is a flowering herb that has been traditionally used to support liver health and detoxification. Some research suggests that milk thistle supplementation may help improve liver function and reduce inflammation in women with endometriosis [13].

14. Quercetin

Quercetin is found in fruits, vegetables and herbs that has antioxidant and anti-inflammatory properties.

A 2023 study found that quercetin offers various health benefits, including affecting key factors related to endometriosis like cell growth, cell death, invasiveness, inflammation and oxidative stress [14]. Quercetin-rich foods include apples, onions, berries and green tea.

15. Pycnogenol (French maritime pine bark extract)

Pycnogenol is a natural plant extract derived from French maritime pine bark that has antioxidant and anti-inflammatory properties. A small 2007 study found that pycnogenol supplementation may help reduce symptoms of endometriosis [15]. It also found it to be more effective in women with smaller endometriomas (tumors containing endometrial tissue).

16. Vitex (chasteberry)

Vitex agnus-castus, also known as chasteberry, is a herbal supplement that has been traditionally used to regulate menstrual cycles and hormonal balance.

Some studies suggest that chasteberry may help alleviate symptoms of PMS, but more evidence is needed, especially as relating to endometriosis [16].

17. CBD

CBD is a non-intoxicating ‘cannabinoid’ derived from cannabis plants. It has gained traction in recent years for its potential therapeutic effects on pain, inflammation and anxiety, though the jury’s still out.

Some research suggests that CBD supplementation may help alleviate pelvic pain and improve quality of life in women with endometriosis [17]. However, more studies are needed to determine the safety and efficacy of CBD for managing endometriosis symptoms.

Habits and changes you can make

18. Regular physical exercise

Regular physical exercise has numerous health benefits, including reducing inflammation, improving circulation and feeling good.

A systematic review in 2014 looking at over 25 years of research reported an 11-90% reduction of risk of endometriosis among people in the studies who were active [18].

Ultimately it concluded that more rigorous research is needed, though that shouldn’t negate from the obvious benefits of regular physical activity.

19. Heat therapy

Applying heat to the abdomen or lower back can help relax muscles, increase blood flow and alleviate pain associated with endometriosis.

Heat therapy methods include using heating pads, hot water bottles or warm baths. While the scientific literature suggests that more research is needed to draw a conclusive recommendation [19], applying heat is non-invasive option for managing pelvic pain, tried-and-tested for generations.

A 2019 survey of 484 women with endo in Australia found heat was commonly used (70% of participants) and rated 6.52/10 on the self-evaluated pain reduction effectiveness scale [20].

20. Mindfulness-based stress reduction (MBSR)

Mindfulness-based stress reduction programmes, which combine mindfulness meditation, yoga, and body awareness practices, have been shown to reduce stress, improve coping skills and alleviate symptoms of chronic pain conditions - including endo.

A 2022 Brazilian study concluded that MBSR significantly improved pain unpleasantness, pelvic pain and constipation - as well as general psychological wellbeing [21].

Practices to do alone or in a group

21. TENS

Transcutaneous electrical nerve stimulation (TENS) has shown promise in providing relief from pain associated with endometriosis for some individuals.

TENS works by delivering mild electrical impulses through electrodes placed on the skin, which can help block pain signals from reaching the brain and stimulate the release of endorphins, the body's natural painkillers.

A 2007 study followed 21 women during four menstrual cycles and evaluated TENS for its pain relieving effects. It found that it significantly dropped the average pain score among participants and corresponded with a reduction in medication among them [22].

22. Mind-body practices such as Tai Chi, Qi Gong and yoga

Mind-body practices such as Tai Chi and Qi Gong combine slow, flowing movements with deep breathing and meditation to promote relaxation, balance and harmony in the body. Tai Chi and Qi Gong may help reduce pain, improve mobility and enhance overall quality of life for individuals with endometriosis.

Techniques such as yoga, meditation and mindfulness may help also reduce stress and improve feelings of wellbeing, which can in turn alleviate some symptoms of endometriosis.

In a 2019 review of multiple studies, researchers found that psychological and mind-body practices for endo showed promise in reducing pain, anxiety, depression, stress and fatigue in women with endometriosis [23].

23. Art therapy

Engaging in creative activities like painting, drawing or journaling can provide a creative outlet for expressing emotions and coping with the physical and emotional challenges of living with endometriosis.

Art therapy may help reduce stress, improve mood and promote self-awareness and acceptance - as described in a small 2023 study of the use of Mandala painting and the impact on pain score [24].

24. Hypnotherapy

Hypnotherapy involves guided relaxation and focused attention to help people achieve a state of heightened awareness and suggestibility.

It may be used to manage pain, reduce stress and improve coping strategies for endometriosis symptoms.

A 2023 small study of 22 women in Iran found that a greater reduction in pain was found when combining hypnotherapy with traditional medication vs medication alone [25]. A similar 2010 study looking at the role of both hypnotherapy (SART) and traditional Chinese medicine “may result in a substantial reduction of pain” [26].

Complementary therapies

25. Acupuncture

Acupuncture is a traditional Chinese medicine practice involving the insertion of thin needles into specific points on the body. It’s been studied as a potential treatment for endometriosis-related symptoms.

A 2023 study found it to be an effective method of relieving endo pain, reducing length of pain and improving overall sense of wellbeing and quality of life [27].

26. Hydrotherapy

Hydrotherapy involves the therapeutic use of water for pain relief and relaxation. Techniques such as contrast hydrotherapy (alternating hot and cold water applications), hydrotherapy baths, or at home with Epsom salts may provide temporary relief from pelvic pain and muscle tension associated with endometriosis.

Though current data is lacking, a team at the Royal Brisbane and Women’s Hospital in Australia are researching the use of hydrotherapy in chronic pelvic pain, with results to follow [28].

What is the most successful treatment for endometriosis?

Naming the single most successful treatment for endometriosis can be challenging because it varies greatly from person to person.

Conventional treatments such as hormonal medications, surgery and pain management programmes are often effective for managing symptoms and improving quality of life.

But, some people may find relief from alternative and complementary therapies- like the 26 examples listed above.

The most successful approach often involves a combination of treatments tailored to your specific symptoms, preferences and overall health goals - hence the importance of a specialist pain clinician helping you find pain-life balance out of the available options.

What vitamins help with endometriosis?

Vitamins such as vitamin D and omega-3 fatty acids (found in fish oil) may help reduce inflammation associated with endometriosis.

What shrinks endometriosis?

Hormonal treatments like birth control pills, GnRH agonists and progestins can help shrink endometriosis lesions and reduce symptoms. Additionally, surgical interventions like laparoscopy can remove endometrial tissue, providing relief for some people.

Will a hysterectomy cure endometriosis?

A hysterectomy can alleviate symptoms of endometriosis by removing the uterus, where endometrial tissue can grow. However, it does not guarantee a cure, as endometriosis lesions may persist elsewhere in the body. Discuss with a healthcare provider to determine the best treatment approach.

Period pain: mild or more than you bargained for? A webinar between Boots and Leva

Boots Online Doctor GP Dr Megha Pancholi and Leva’s Dr Charlotte Small discuss how to manage chronic period pain and pain from endometriosis. Additionally, they share the top three things that you can do right now to help yourself.