Resources

Complementary and Alternative Medicine: A Guide for People With Endometriosis

The purpose of this resource is to help you understand options for managing your endometriosis symptoms beyond surgery and medications. This resource covers acupuncture, cannabis, diet, exercise, heat, meditation, breathing, and relaxation practices.

Alternative medicine practitioner working with a patient.

If you have endometriosis, you may be wondering about whether there are any additional approaches to managing endometriosis symptoms beyond surgery and medications.

People with endometriosis often try complementary and alternative medicine (CAM) alongside traditional medical approaches. CAM refers to approaches people use to take care of their health that are different from the usual medicines and treatments. Considering these approaches may be especially helpful if you are waiting to see a specialist or waiting to have surgery.

In general, CAM for managing endometriosis hasn’t been extensively researched. Some CAM, like acupuncture, have been used within certain cultures for centuries. When deciding which, if any, CAM is right for you, you can consider what the research has shown (including what’s outlined in this resource), the experiences of people you know, the advice of your healthcare provider, and the potential benefits and costs.

For some of these approaches, you will need to see a specific type of CAM healthcare provider. Your provincial or territorial health card does not usually cover these healthcare providers. Private insurance plans might provide some coverage.

Complementary and alternative medicine options used by people with endometriosis include

Person receiving acupuncture treatment on their back.

Acupuncture

This traditional Chinese medicine technique involves putting thin needles into your skin to stimulate points in different areas of your body. Research supports the use of acupuncture to treat some chronic pain conditions like arthritis and lower back pain. More and more evidence is showing that acupuncture can also be helpful in people with endometriosis.

To get acupuncture, you will need to go to a healthcare professional with training in acupuncture or traditional Chinese medicine.

Cannabis

Cannabis comes in many forms. It can be smoked, vaped, ingested (as oils, pills, or edibles), or used topically as creams creams or vaginal suppositories. There are many different ingredients in cannabis that create different effects on your body. THC can make you feel high, and it also has some medical uses. CBD is another ingredient found in some types of cannabis. CBD doesn’t make you high and is used for pain relief and lowering anxiety.

There is some research showing that cannabis can help relieve pain in endometriosis. Research also suggests that for people with endometriosis, cannabis can improve sleep, nausea, anxiety, and depression. But more research is still needed to confirm this. It’s also important to keep in mind that the long-term effects of cannabis use are still not well understood.

Cannabis is legal in Canada, so you can buy cannabis without a prescription. But it’s a good idea to discuss using cannabis to help manage your endometriosis symptoms with a healthcare professional like a nurse practitioner, family doctor, or pain specialist. You can get a prescription for medical cannabis from a doctor or nurse practitioner. Qualified healthcare professionals will also be able to give you advice about how best to use cannabis to manage your pain. If you have a medical cannabis prescription, the cost of cannabis bought with that prescription is a tax-deductible medical expense.

Mother and daughter preparing a healthy meal, by cutting vegetables on the counter.

Diet/nutrition

Specific diets that have been studied include:

A gluten-free diet

Following a gluten-free diet means not eating foods that contain gluten. Gluten is found in grains like wheat, barley, and rye. Instead of eating wheat bread, pasta, and other foods containing gluten, people on a gluten-free diet can eat other alternatives like rice or gluten-free versions of bread and pasta.

The Mediterranean diet

This diet focuses on foods that are traditionally part of the diet of countries that are on the Mediterranean Sea, like Spain, France, Greece, Italy, Morocco, Egypt, and Lebanon. These foods include fruits, vegetables, whole grains, beans, nuts, seeds, low amounts of healthy fats like olive oil, and low to moderate amounts of fish, poultry and eggs.

A low FODMAP diet

(Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols). This diet reduces FODMAPs, which are types of carbohydrates that can cause digestive issues like bloating. FODMAPS are found in onions, garlic, wheat, some dairy products, beans, and some fruits and vegetables.

There is some research suggesting that specific diets might decrease pain in people with endometriosis. For example, if you have bladder pain or frequent urination, removing foods that trigger bladder pain from your diet can help. The Mediterranean diet may decrease endometriosis pain. The low FODMAP diet can be especially helpful for people who have bowel symptoms. People with celiac disease must eat a gluten-free diet, and it may also reduce pain in people with endometriosis.

It’s important to talk to a doctor or pharmacist if you are trying supplements to make sure your supplements don’t interfere with any medications you are taking. A naturopath can help guide you in using supplements as well. For Chinese herbal medicines, you will need to go to a healthcare provider with training in traditional Chinese medicine. A registered dietitian, registered nutritionist, or naturopath can assist you with changing your diet.

Young African person training with dumbbells at the gym

Exercise

It isn’t clear from the current research whether exercise reduces pain for people with endometriosis. In general, exercise has many health benefits. It lowers the risk of heart disease, dementia, and other health conditions. It can also reduce stress and make your mental health better. However, some research shows that for 1 in 3 people with endometriosis, exercise could cause an increase in pelvic pain or fatigue.

Some research suggests that Hatha yoga can reduce pelvic pain and improve the quality of life in people with endometriosis. Hatha yoga involves moving slowly through different physical poses along with controlled breathing. Researchers have yet to specifically study other types of yoga in people with endometriosis. Yoga can be practiced at home using online videos or in a yoga studio with an instructor. Community centres also often offer yoga classes. Whether you are practicing with an instructor or at home on your own, it’s important to listen to your body and modify your movements according to your needs.

If you want to try an exercise program, consider starting slowly. You can gradually increase the amount of exercise if your body responds well. You may have sore muscles at first if you aren’t used to exercising. You can try different things to see what works best for your body. Your local community centre is a good place to find fitness classes and swimming pools. Going outside for walks is good exercise and is gentle for people with chronic pain.

For guidance on exercise, consider seeking the help of a physiotherapist who has training in pelvic health and treating pelvic pain conditions like endometriosis. A pelvic health physiotherapist will work with you to determine which type of exercise would suit your needs, help you with pacing strategies, and modify your exercises when needed.

Heat

Research shows that people with endometriosis find heat to be one of the most effective CAM approaches for managing endometriosis pain. Heat can be applied to the abdomen and pelvis, as well as the lower back. You can safely use heat like a hot water bottle or a heating pad to help with your endometriosis pain at home if you follow these tips:

  • To protect your skin from burning while applying heat, you should put a towel between the source of heat and your skin.
  • If you apply heat to your skin for long periods of time over weeks or months, you can develop a reddish-brown rash on your skin called erythema ab igne or “toasted skin syndrome.” Try to limit the time you use heat and give your skin some breaks.
  • If you might fall asleep while using an electric heating pad, make sure your heating pad automatically turns off after a certain length of time. Most, but not all, heating pads have this feature.
  • Do not put water that is hot enough to cause burns (like boiling water straight from a kettle) into a hot water bottle in case the hot water bottle leaks.

Meditation/breathing/relaxation practices

Research shows that these practices can decrease pain in people with endometriosis. These techniques are typically part of the pain management program recommended by chronic pain clinics and pelvic health physiotherapists..

For a simple meditation, try closing your eyes and focusing on your breath or a peaceful image. You can set a timer for 2 minutes, 5 minutes, or 10 minutes — any length of time is helpful.

For a simple breathing exercise, place one hand on your stomach. Take a deep breath in through your nose, guiding your breath down to your hand on your stomach. Then breathe out through your mouth, letting your stomach fall. Take several breaths like this.

If you want to experiment with these practices more, many different apps and websites offer guided meditations, breathing exercises, and progressive muscle relaxation. You can also get help learning these practices from a trained therapist.

Complementary and alternative medicine: A guide for people with endometriosis

If you found this page helpful, feel free to download this resource as a PDF so you can reference it later. 

References

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The views expressed herein do not necessarily represent the views of Health Canada.

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