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.

Rating	Nutritional Supplements	Herbs
	Fish oil	Vitex
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms of endometriosis?

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.

Dietary changes that may be helpful for endometriosis

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 for endometriosis

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.

Nutritional supplements that may be helpful for endometriosis

There have been no human studies examining the effect of specific nutrients on endometriosis. Animal research suggests that fish oils may reduce the severity of endometriosis,^{5 6} and fish oils have been shown to improve symptoms of dysmenorrhea (painful menstruation),⁷

Are there any side effects or interactions with endometriosis?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful for endometriosis

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.^{8 9} Although vitex affects hormones that in turn affect the severity of endometriosis,¹⁰ and it may be effective for premenstrual syndrome,11 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 with endometriosis?

Refer to the individual herb for information about any side effects or interactions.

Holistic approaches that may be helpful for endometriosis

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.¹² 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.¹³

Acupuncture has been reported anecdotally to help control the pain associated with some cases of endometriosis,¹⁴ 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.¹⁵