Integrative Therapies for Endometriosis & Adenomyosis

Although there is currently no cure for endometriosis, several mainstream treatment approaches can help manage symptoms and enhance quality of life, with surgery and hormonal therapy being the primary options. Research continues to advance toward additional multidisciplinary treatments involving immunomodulation, anti-inflammatory therapy, and the alteration of molecular signaling pathways. In the absence of a curative mainstream therapy, an approach that has gained traction in recent years for reducing symptoms and addressing certain underlying endometriosis mechanisms is integrative therapy, which incorporates a holistic, natural component.

What is Integrative Therapy?

Integrative therapy is a healthcare approach that considers the whole person—addressing physical, emotional, and spiritual well-being. It combines conventional medical treatments with complementary therapies such as nutrition, supplementation, botanicals, acupuncture, massage, yoga, and more. The goal of integrative therapy is to target the underlying causes of a person’s health issues rather than solely focusing on symptom relief. Although it often incorporates elements of Eastern medicine, it is not the same as “alternative therapy,” which can sometimes be ineffective, costly, or even unsafe. This overview only touches on the range of available options and is not intended to be comprehensive in depth or authority.

Some complementary therapies that may be included in integrative therapy for endometriosis are:

Acupuncture

Nearly everyone is familiar with acupuncture, but to summarize briefly: it is a form of Traditional Chinese Medicine in which extremely thin needles are inserted into specific points along body pathways known as meridians. These meridians and acupoints are situated near areas where peripheral nerves are known to run. Acupuncture has been practiced for centuries to address a wide range of conditions, including chronic pain, headaches, anxiety, and infertility.

Acupuncture is believed to support healing by stimulating the body’s natural repair mechanisms and promoting the flow of energy, or Qi, throughout the body. From a conventional medical perspective, it may also influence nerve function. In the setting of endometriosis, acupuncture is thought to help by reducing inflammation and relaxing pelvic muscles, which can ease pain and support fertility.

What is certain is that acupuncture is not merely a placebo. A 2018 systematic review in the Cochrane Library evaluated acupuncture for pelvic pain associated with endometriosis, reviewing seven randomized controlled trials with 527 total participants. The authors found that acupuncture produced a statistically significant reduction in pain intensity when compared to no treatment or sham acupuncture.

Another systematic review, published in the Journal of Obstetrics and Gynecology in 2021, examined acupuncture for endometriosis-related dysmenorrhea. This review analyzed 17 randomized controlled trials involving 1,232 participants. The authors reported that acupuncture significantly reduced both pain intensity and duration compared to no acupuncture or sham acupuncture. Their conclusion was that acupuncture may be a safe and effective option for managing endometriosis-related dysmenorrhea.

Although the growing evidence for acupuncture’s benefits in endometriosis is encouraging, it is important to recognize that acupuncture is not a cure. It may help manage pain and other symptoms, and it may reduce inflammation, but it does not correct the underlying disease process. For this reason, acupuncture is best used as one component of a comprehensive treatment plan that incorporates conventional medical care, lifestyle modifications, and other complementary therapies.

Acupressure

Acupressure is a related modality within Traditional Chinese Medicine that involves applying pressure to specific points on the body to support healing and reduce pain. Common acupressure points used for endometriosis include those located on the lower abdomen, lower back, and inner ankle. These points are believed to help regulate menstrual flow, decrease inflammation, and encourage relaxation.

A randomized controlled trial published in the Journal of Complementary and Alternative Medicine in 2013 examined the effects of acupressure on pain and quality of life in women with endometriosis. The study followed 60 participants who received either acupressure or a placebo. The authors reported that acupressure led to a statistically significant decrease in pain intensity along with an improvement in quality of life.

Another study, published in the Journal of Obstetrics and Gynaecology Research in 2018, evaluated the effects of acupressure on menstrual pain and quality of life in women with endometriosis. This study included 62 participants who underwent either acupressure or placebo treatment. The authors found that acupressure produced a statistically significant reduction in menstrual pain intensity and improved quality of life.

Massage Therapy

Massage therapy is a complementary treatment that involves manipulating the body’s soft tissues—such as muscles and tendons—to encourage relaxation and reduce pain. It has been used for centuries for a variety of conditions, including chronic pain, anxiety, and depression. The type of massage discussed here is intended as an adjunct to other care, not a replacement for appropriate medical treatment.

Endometriosis often leads to significant pain and discomfort, especially during menstruation. Massage therapy can help relieve tension in the pelvic muscles and lessen pain. A systematic review published in the Journal of Nursing Scholarship in 2019 assessed the effectiveness of massage therapy for reducing pain and improving quality of life in individuals with endometriosis. The review analyzed 13 studies with a combined total of 602 participants. The authors found that massage therapy resulted in a statistically significant decrease in pain intensity and duration, as well as improvements in quality of life and anxiety levels.

Massage therapy may also help reduce stress and anxiety—both of which are commonly experienced by those with endometriosis. Chronic pain can cause considerable emotional strain, and massage has been shown to effectively lower anxiety and support relaxation. A randomized controlled trial published in the Journal of Psychosomatic Obstetrics and Gynecology in 2018 involved 60 participants who received either massage therapy or no treatment. The findings showed a statistically significant reduction in anxiety levels among those who received massage therapy compared to those who did not.

Beyond reducing pain and anxiety, massage therapy may also enhance circulation and support lymphatic drainage, which can reduce inflammation and encourage healing. A review published in the Journal of Manual and Manipulative Therapy in 2016 evaluated massage therapy for chronic pelvic pain, including endometriosis. The authors concluded that massage therapy may be a safe and effective treatment for chronic pelvic pain, particularly when used alongside other therapies.

Mind-Body Techniques

Mind-body therapies such as meditation, yoga, Tai chi, and others can be used as complementary approaches in the treatment of endometriosis to support physical, emotional, and mental well-being. These techniques emphasize the connection between the mind and body and are designed to help individuals use thoughts and emotions in ways that promote healing and reduce pain.

Endometriosis frequently contributes to emotional and mental challenges, including anxiety, depression, and stress. Mind-body techniques can help manage these symptoms by encouraging relaxation and lowering stress levels. A systematic review published in Obstetrics and Gynecology Clinics of North America in 2020 examined mind-body therapies for chronic pain, including endometriosis. The review assessed 20 studies with a combined 1,126 participants. The authors found that mind-body therapies—such as meditation, yoga, and Tai chi—produced statistically significant reductions in pain intensity, pain duration, and stress levels.

Meditation is a mind-body practice that involves focusing the mind on a particular object or thought to foster relaxation and reduce stress. A randomized controlled trial published in Pain Medicine in 2018 studied the effects of mindfulness meditation on pain and quality of life in women with endometriosis. The study included 20 participants who received either mindfulness meditation or no treatment. The authors found that mindfulness meditation resulted in a statistically significant reduction in pain intensity and improvements in quality of life.

Yoga combines physical postures, breathing exercises, and meditation to promote relaxation and decrease stress. A randomized controlled trial published in Obstetrics and Gynecology in 2018 evaluated yoga’s effects on pain and quality of life among women with endometriosis. The study involved 90 participants who received either yoga or no treatment. The results showed that yoga was associated with a statistically significant decrease in pain intensity and improved quality of life.

Tai chi consists of slow, gentle movements combined with deep breathing to induce relaxation and reduce stress levels. A systematic review published in Pain Medicine in 2015 assessed Tai chi for chronic pain management, including endometriosis. The review included ten studies with 494 total participants. The authors found that Tai chi was associated with statistically significant reductions in pain intensity and duration, as well as stress levels.

Diet and Nutrition

Adjusting diet can directly influence inflammation, hormone balance, and immune system function. While no single diet has been proven to cure endometriosis, dietary changes and nutritional supplementation may help reduce inflammation and pain associated with the condition.

Inflammation plays a major role in the development and progression of endometriosis. Some foods and nutrients contribute to inflammation, while others have anti-inflammatory properties that can help reduce it. Omega-3 fatty acids—found in fatty fish such as salmon and mackerel, as well as in flaxseeds and chia seeds—have demonstrated strong anti-inflammatory benefits. Magnesium, present in leafy greens, nuts, and whole grains, can also help reduce inflammation and muscle tension. Vitamin D, found in fatty fish, eggs, and fortified dairy products, may support immune system regulation and reduce inflammation. Overall, the most anti-inflammatory, antioxidant-rich diet is whole-food plant-based.

Hormone balance is another key factor in managing endometriosis. Certain foods help balance hormones, while others can disrupt hormone balance and worsen symptoms. Phytoestrogens—found in soy products, flaxseeds, and lentils—can help regulate estrogen levels and ease endometriosis symptoms. In contrast, foods high in saturated and trans fats, such as red meat and processed foods, can increase inflammation and negatively affect hormone balance.

A systematic review published in the journal Nutrients in 2021 evaluated dietary interventions for managing endometriosis. The review included 17 studies with a total of 1,311 participants. The authors found that dietary approaches—such as increasing intake of fruits and vegetables, omega-3 fatty acids, and phytoestrogens, while reducing saturated and trans fats—were associated with improvements in pain, quality of life, and other endometriosis symptoms.

Supplements

As with diet, supplements may help manage endometriosis by reducing inflammation, promoting hormonal balance, and supporting immune system function. While prioritizing a transition to an anti-inflammatory, antioxidant diet is ideal, targeted supplementation may enhance results for some individuals.

A randomized controlled trial published in the Journal of Reproductive Medicine in 2013 assessed the effects of omega-3 fatty acids on pain and quality of life in women with endometriosis. The study followed 59 participants who received either omega-3 supplementation or a placebo. The authors reported that omega-3 fatty acids produced a statistically significant reduction in pain intensity and improved quality of life.

A systematic review published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology in 2017 examined magnesium for managing menstrual pain, including pain related to endometriosis. The review included 13 studies with a combined total of 1,870 participants. The authors found that magnesium led to a statistically significant reduction in menstrual pain intensity and duration.

The same review also evaluated vitamin D for managing menstrual pain, including endometriosis-related pain. It included five studies with 238 total participants. The findings showed that vitamin D was associated with a statistically significant reduction in menstrual pain intensity and duration. Vitamin D supplementation is often necessary, as even in sunny regions, an estimated 30% of the population is deficient.

It is important to remember that supplements can cause side effects and may interact with medications. For this reason, consultation with a healthcare provider is essential before using supplements for endometriosis.

Herbal Medicine

Herbal medicine, or herbalism, involves using plants or plant extracts to treat or prevent illness. Many herbs possess anti-inflammatory and pain-relieving properties, which makes them potentially useful for managing endometriosis. Although more research is needed to fully understand the effectiveness of herbal medicine for endometriosis, many individuals report positive results when using herbal remedies as a complementary approach.

Turmeric is frequently recommended for reducing inflammation and pain related to endometriosis. Its active compound, curcumin, has strong anti-inflammatory effects. A randomized controlled trial published in Complementary Therapies in Medicine in 2013 examined the effects of curcumin on pain and quality of life in women with endometriosis. The study included 67 participants who received either curcumin or a placebo. The authors found that curcumin led to a statistically significant reduction in pain intensity and improved quality of life.

Ginger is another herb that may help reduce inflammation and pain in endometriosis. Ginger contains gingerols and shogaols, compounds known for anti-inflammatory and analgesic effects. A randomized controlled trial published in Pain in 2014 evaluated ginger’s impact on pain and menstrual symptoms in women with endometriosis. The study followed 70 participants who received either ginger or a placebo. Results showed that ginger produced a statistically significant reduction in pain intensity and improved menstrual symptoms.

Chasteberry, also called vitex, is an herb believed to help regulate hormones and reduce endometriosis symptoms. Chasteberry contains compounds that may help balance estrogen and progesterone levels, which can decrease inflammation and pain. A systematic review published in Complementary Therapies in Medicine in 2018 assessed chasteberry for endometriosis-related pain. The review included six studies with a total of 596 participants and found that chasteberry was associated with a statistically significant reduction in pain intensity and duration compared to no treatment.

As with supplements, it is important to work with an expert to avoid potential interactions between herbal remedies and prescription medications.

Aromatherapy

Aromatherapy is a complementary therapy that uses essential oils to support health and well-being. Essential oils are concentrated plant extracts believed to offer therapeutic benefits. They may be used in various ways, including inhalation, topical application, or adding them to bathwater.

Although scientific research on aromatherapy for endometriosis is limited, some individuals with the condition report symptom relief through its use. Aromatherapy may be especially helpful for managing emotional symptoms—such as anxiety and depression—which are all too common among those with endometriosis.

A short list of essential oils that may be beneficial for individuals with endometriosis includes lavender, clary sage, rose, peppermint, and eucalyptus.

When using aromatherapy, it is important to dilute essential oils with a carrier oil such as coconut or almond oil, as undiluted oils may irritate the skin. Aromatherapy should also be used cautiously during pregnancy or while breastfeeding, since certain essential oils may not be safe in these circumstances.

Hyperbaric Oxygen Therapy (HBOT)

The concept behind using HBOT for endometriosis is that elevated oxygen levels in the body may help reduce inflammation and support the healing of damaged tissues. Early studies suggest that HBOT may lessen pain and improve quality of life in individuals with endometriosis, though larger, more comprehensive research is needed to verify these findings.

It is important to note that HBOT is not currently approved by the U.S. Food and Drug Administration (FDA) for treating endometriosis and should only be considered under the supervision of a qualified healthcare provider. HBOT also carries certain risks, including ear pain, sinus pressure, and, in rare instances, oxygen toxicity, which can be serious.

Summary

By addressing both the physical and emotional components of endometriosis, integrative therapy can help individuals achieve a better quality of life and target some of the suspected root causes of the condition. Benefits may include improved energy levels, better sleep, and an enhanced overall sense of well-being.

Integrative therapy is not a substitute for conventional medical treatment for endometriosis. Rather, it serves as a complementary approach that can be combined with standard treatments to support improved outcomes.

In conclusion, endometriosis is a complex condition that requires a multidisciplinary treatment strategy. Integrative therapy provides a promising addition to symptom management by blending conventional medical care with complementary therapies that support physical, emotional, and spiritual well-being.

Your endometriosis specialist can help connect you with practitioners best suited to provide integrative therapies for endometriosis. Ideally, you would work with a specialist who is also trained in some form of East–West integrative medicine. While such practitioners can be difficult to find, they do exist.