A functional approach to treating endometriosis “supports an optimal immune response, reduces inflammation and pain, promotes natural detoxification of environmental toxins, and helps to balance hormones,” explains integrative-medicine physician and herbalist Aviva Romm, MD. These are the main pillars.
1) Use food as medicine.
An anti-inflammatory diet is the first critical step in healing from endometriosis. Eliminating inflammatory, ultraprocessed foods and emphasizing whole, fresh ones can help repair a leaky gut, balance the microbiome, and reduce inflammation — all of which can help reduce symptoms of endometriosis.
“Because so many people have a problem with dairy and gluten, I have people take those out immediately,” says integrative practitioner Marcelle Pick, OB-GYN, NP. Sugar, alcohol, refined carbohydrates, and excess saturated fats can also contribute to inflammation.
“Omega-3s from fish, nuts, and seeds have an anti-inflammatory effect and help provide our immune system with what it needs to resolve inflammation once it starts,” notes Cindy Geyer, MD, a functional-medicine physician at the UltraWellness Center in Lenox, Mass. Bone broth, collagen, and fermented foods can help create a healthy intestinal barrier.
And a diverse array of plant-based, fiber-dense foods supports a balanced immune system and healthy hormone regulation. “Getting enough dietary or supplemental fiber is essential for reducing inflammation and overall body-toxin load and eliminating excess estrogen from your system,” says Romm. She recommends taking one to two tablespoons of freshly ground flaxseed daily in a smoothie or mixed into food.
Cruciferous vegetables, such as cauliflower, Brussels sprouts, broccoli, and broccoli sprouts, are superstars for supporting estrogen metabolism. Herbs and spices, including ginger, rosemary, and turmeric, also contain anti-inflammatory compounds. (Explore this simple five-step diet plan to help you fight inflammation.)
Plastics are a major source of estrogen-mimicking compounds called xenoestrogens, which can worsen endometriosis, so Romm suggests avoiding foods packaged in soft plastic wrap, as well as those that are stored in plastic. Avoid microwaving food in plastic because this leaches more of these compounds into the food.
2) Reduce stress.
Because endometriosis can be an intensely painful condition, it is also a stressful one — and chronic stress suppresses the innate immune system, Geyer notes. This includes the natural killer cells that typically recognize and eliminate errant endometrial cells.
Research on animals shows that stress increases the size and severity of endometrial lesions. This means it’s important to prioritize stress management when attempting to control symptoms.
Our bodies synthesize a variety of hormones from cholesterol, including estrogen, progesterone, and the stress hormone cortisol. “We can’t live without cortisol, but we can live without our sex hormones. So, if we have too much need for cortisol due to chronic stress, the body will make cortisol at the expense of our other hormones, causing tremendous hormonal dysregulation,” Pick explains.
Breath-based practices, mindfulness meditation, and guided imagery can help the body shift out of fight-or-flight mode and support the parasympathetic, or rest-and-digest, response. This can help lower inflammation, reduce pain, and ease the burden of chronic stress. Massage, pelvic-floor physical therapy, acupuncture, and myofascial-release techniques are other modalities that can help alleviate chronic pain.
A systematic review in the Journal of Psychosomatic Research found that mind–body interventions are useful — think yoga, mindfulness, relaxation training, cognitive behavioral therapy combined with physical therapy, and biofeedback. The study determined that these all “show promise in alleviating pain, anxiety, depression, stress, and fatigue in women with endometriosis.”
3. Supplement wisely.
Herbs and supplements can help soothe the effects of endometriosis in various ways, including by calming inflammation and repairing tissue damage. It’s always a good idea to work with a certified practitioner when adding herbs or supplements to your routine. These are some of the supplements experts recommend.
⋅ Modified citrus pectin (MCP) is a dietary fiber made from the pulp of citrus fruits. “This nutraceutical has the ability to block the activity of galectin-3,” Geyer says. Research on its effectiveness for endometriosis is thin, but because of MCP’s potential benefits and low risk profile, Geyer still recommends it.
“Not only can it block the activity of that molecule that’s driving scarring and adhesion, but it’s also a gentle chelator, so it can bind to heavy metals and other toxins we might be exposed to. And it’s a prebiotic, so it can support the growth of beneficial gut microbes.”
⋅ Anti-inflammatories, such as mushroom extracts, fish oil, curcumin, resveratrol, and green-tea extract, may help, Geyer says.
Romm adds bromelain (from pineapple), quercetin (found in apples, onions, and capers), ginger, and the herbal extract boswellia to the list. “Not only will inflammation be reduced, but these herbs also relieve pain over time,” notes Romm.
⋅ Antioxidants help prevent and reverse local tissue damage from inflammation, Romm adds. Resveratrol, N-acetylcysteine (NAC), pine bark, green tea, and curcumin are all powerful antioxidants available in supplement form.
A study published in 2013 found that women with endometriosis who took 600 mg of NAC three times a day on three consecutive days each week for three months saw a greater reduction in cysts and pain than a control group did, with results “better than those reported after hormonal treatments.”
Explore how dietary and lifestyle adjustments can alleviate the discomfort of this painful condition by reading “A Functional-Medicine Approach to Endometriosis,” from which this article was excerpted.
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