Endometriosis? 4 Herbs & Supplements That Can Help

Endometriosis. If you've been suffering with it, as so many women are and all too often, silently, you know how much it can impact your life. And if you're miserable and in pain, I get that you'd try anything. Endometriosis can feel like it's taking over your life – so much so that young women, like Lena Dunham, have chosen to have a hysterectomy and go through surgical menopause rather than go through the pain of endometriosis for one more minute!

You also know that the only treatments doctors recommend include pain medications, hormonal therapies, and surgery. Unfortunately, as I reviewed in The Natural Approach to Endometriosis: Getting to Your Root Causes, a pharmaceutical and laparoscopic surgery approach to endometriosis isn't always effective, has risks, and leads to high rates of recurrence and the need for more meds and more surgeries.

While I support all of the choices a woman makes to live her life free from pain and suffering – I also know that there are risks and consequences to medical therapies, and a high rate of recurrence of endometriosis lesions and symptoms with many treatments. Also, endometriosis is not in the uterus – it's outside of the uterus – that's the problem. Uterine tissue grows in the abdomen, and with each change of your monthly hormonal cycle, proliferates and bleeds like the endometrial tissue – ultimately leading to pain, irritation, and adhesions. A hysterectomy doesn't reverse the damage that's been done, nor does it get to the root causes of the condition.

In this article and podcast I share:

  • The risks and shortcomings of conventional treatments
  • How to combine natural and conventional therapies
  • 4 evidence-based herbs & supplements
  • Why you can expect

In the podcast I also specifically talk about why and how to keep a symptom journal.

Try Natural Therapies, Too

While endometriosis is a tough condition to treat and natural therapy doesn't lead to overnight results, there are herbs and supplements that have been shown scientifically to help not only relieve the pain associated with endometriosis, but to reduce lesions and cysts. This can allow you to get off the treadmill of pain medications that you, like so many of the women who come to see me, have been on. My patient Liz, at  36, was in so much pain from a diagnosis of endometriosis that had been missed for years, that she had become dependent on the narcotics her gynecologist eventually prescribed.

Getting even some natural relief may also help you avoid more extreme measures – including hysterectomy, which, as a result of surgical menopause, not only leads to infertility, but can lead to loss of sex drive, changes in hair and skin, loss of fullness in your breasts, and to painful vaginal changes and annoying urinary symptoms. Then there are risks to your bones and heart due to the loss of estrogen, or the need for on-going hormone replacement therapy to offset these symptoms and risks. So not a great choice in my book until all other options are completely exhausted.

Including natural therapies in your endometriosis treatment plan doesn't preclude using conventional therapies. They can be used integratively – that is, combined with standard endometriosis treatments. And you can always escalate to more aggressive therapies if needed. But I do recommend a trial of these natural therapies for 6-12 months before taking more drastic measures, including even laparoscopic treatment which has a high recurrence rate and risks of its own.

I always recommend that any comprehensive approach to endometriosis addresses the root causes and incorporates an anti-inflammatory diet.

It can take even 6-12 months to see a reduction in the overall number of endometrial implants in your abdomen, though one study (discussed below) found improvements in just three months. While improvement can be tracked with laparoscopic evaluation, it is not necessary to follow up with laparoscopy; if your symptoms improve, that can be your guide that your endometriosis is also improving. Keeping a casual symptom journal, even if just keeping track of dates and a 1-10 pain scale (1 = no pain, 10 = horrible pain) weekly or a couple of times each week can be helpful.

4 Herbs & Supplements for Healing Endometriosis

The first 3 supplements below have been shown to directly improve both endometriosis and quality of life including reduction in pain, pain during sex, urinary and bowel pain, and have led to regression or resolution of endometrial lesions and related ovarian cysts. They have improved fertility, reduced need for surgery, and improved sleep. The fourth supplement, ginger, has been found to be an effective natural pain-reliever and anti-inflammatory, especially with menstrually related pain. I recommend a ‘protocol' combining all 4 products on a daily basis for 6-12 months for maximal effectiveness, and continuing if needed.

Melatonin: We usually think of melatonin as a sleep supplement, and indeed, it is the natural substance that increases at night in our brains to tell us to get some sleep! However, melatonin is also a powerful natural detoxifier, especially of excess or harmful forms of estrogen, and perhaps this explains its powerful role in endometriosis care.

In one study of 40 women with chronic pelvic pain, who were between 18 and 45 years old, 10 mg of melatonin per day was able to significantly:

  • Reduce chronic pelvic pain due to endometriosis
  • Reduce pelvic pain during menses and during sex
  • Reduce pain during urination and associated with bowel movements, and
  • Led to an overall 80% reduction in the need for pain medication in women taking the melatonin, including reduction in NSAIDS and narcotic use.
  • Women in the melatonin group also reported substantially improved sleep and a greater sense of wellness on morning waking. In animal studies, melatonin led to regression and shrinkage of endometriosis tissue.

How to use it: I recommend starting at 1-3 mg/day, preferably taken in the evening as it can make you feel sleepy (a plus if sleep doesn't come easily!). Over a month build up to the 10 mg which can be taken at bedtime, or if it doesn't make you too sleepy, you can divide it between an evening and bedtime dose. At this dose, melatonin supports the body’s natural detoxification processes.

NAC: Short for N-acetyl-cysteine, NAC is a powerful supplement that increases glutathione, one of the most important detoxifiers naturally produced in our bodies. However, many of us aren't producing quite enough to keep up with the demands put on our bodies by chronic exposure to environmental toxins and even overproduction of our own natural hormones – including estrogen. NAC has some impressive data behind it specifically for endometriosis. In a 2013 study of 92 women in Italy, 47 took NAC and 42 took a placebo. Of those who took 600 mg of NAC three times a day, three consecutive days each week for three months:

  • 24 patients cancelled their scheduled laparoscopy due to a decrease or disappearance of endometriosis, improved pain reduction or because they had gotten pregnant!
  • Fourteen of the women in the NAC group had decreased ovarian cysts
  • 8 had a complete disappearance of their symptoms – and lesions
  • 21 had pain reduction

In the other group, only 1 patient cancelled surgery. A total of 8 women got pregnant in the NAC group, while 6 did in the placebo-only group.

How to use it: I recommend taking 600 mg, three times daily (not just 3x/week as in the study). Continue for at least 3 months (the timeframe for seeing substantial reduction of cysts in the above study), and if you experience improvement, this very safe supplement can be taken on an ongoing basis if needed.

Pine Bark: In yet another study of natural substances for healing endometriosis, this time pycnogenol, an extract of pine bark (yes, as in the trees – this one being a specific species of Maritime Pine), women taking 30 mg twice daily for 48 weeks showed:

  • A 33% reduction in pain, including severe pain
  • While the pain reduction was not as strong as hormonal treatment, it actually persisted without relapse, unlike the medication group
  • Further, 5 women in the pycnogenol group became pregnant

How to use it: Pycnogenol, 30 mg, twice daily for 1 year, continue as needed.

Ginger: Ginger root powder (or the equivalent in extract form) at a dose of 500 mg 2-4 times/day has been shown to reduce pain equal to the effects of ibuprofen. I highly recommend taking it with the above supplements, daily, and in  the few days prior to and during your menses, at the higher dose, for best pain relief. 

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Porpora M, Brunelli R, Costa G, et al. A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Evidence-Based Complementary and Alternative Medicine. 2013; April. Article ID 240702,

Schwertner A, Conceicao dos Santos C, Costa G, et al. Efficacy of melatonin in the treatment of placebo endometriosis: A phase II, randomized, double-blind, placebo controlled trial. PAIN 2013;154(6):874-881.

Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetateJ Reprod Med 2007; 52(8):703-708.

Jenabi E. The effect of ginger for relieving of primary dysmenorrhoea. J Pak Med Assoc. 2013 Jan;63(1):8-10.

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Read or leave comments 7 Comment

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Thank you Dr. Aviva for taking the time to post this. I just added some of these to my grocery list. Hugs!

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Thank you for this. I frequently feel completely alone and overwhelmed in trying to navigate treatment and healing for my endometriosis, so I always appreciate and feel hopeful about alternative information from trustworthy and holistic sources.

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It's really hard when I ask my doctor, point blank, "are there any natural treatments for this?" And I'm told no, I just need to keep trying different birth controls until I can find one I'm not allergic to in order to have pain management. Thank you so much for this wonderful information, I am eager to try these supplements.

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Could anybody recommend a reputable brand for N-Acetylcysteine (NAC)

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Thank you for this article. I just ordered some new supplements as I want to rid myself of hormonal replacements (birth control) and try the natural route again. I can’t say I’m excited because the pain alone is crushing but I know this is the healthier alternative.

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I was in strong gradually increasing pain for the last six years. I couldn’t live the normal life. I couldn’t sleep because of pain. I had strong burning pain in my belly and daily bleedings in between the circles and many other unpleasant symptoms. Doctors smiled and told that there is no reason for such a big pain. They prescribed only pills for pain. It looks like there is no qualified gynecologist in my region, as even my family doctor couldn’t help. I was desperate. I suffered from endometriosis over ten years ago and was treated with care in another country. I knew what the symptoms are and knew that the endometriosis was back. Thank you very much for publishing this information! I do thank you every single day for this!! I followed your instructions and feel much better just in three months. The pain is almost gone! Is was about 7 and decreased to 1. I wish you all the best! Thank you again!!!