Alternative treatments and support for endometriosis
Endometriosis is a condition caused by endometrial (uterus lining) like tissue deposits in areas outside the uterus. It affects around 1 in 10 women with varying degrees of severity (1). The average wait from presenting symptoms to diagnosis is around 8 years in Northern Ireland but charity Endometriosis UK is campaigning for earlier recognition and better treatments(2).
Treatment options include pain killers to reduce symptoms, hormone therapy to slow growth of endometrial lesions and surgery to excise the lesions (3). This article will focus on lifestyle measures and pill free options that can be used alone or alongside any of these treatments. They may be especially helpful if you are planning pregnancy and are needing to avoid stronger pain killers and contraceptives. To be clear endometriosis is not a lifestyle disease but the below advice is to broaden your options for managing such a challenging condition.
Nutrition
Nutrition plays a role in all of our health and wellbeing but there is increasing evidence of its influence in inflammatory conditions. There is a large amount of research on the influence of different foods in improving and exacerbating the symptoms of endometriosis. A quick Google search on the subject brings up such a vast array of advice that it can be overwhelming and difficult to know the right advice to follow. A safe and reliable resource is the book Endometriosis: a key to healing and fertility through nutrition by Dian Shepperson Mills and Michael Vernon and can be bought relatively cheaply on the likes of Amazon (4). It was originally published in 2002 but has been recently updated in 2023 and is a good basis for understanding the relationship between food and disease.
Physiotherapy
A second and in my opinion an under utilised option is pelvic physiotherapy. This can be especially helpful for women experiencing deep dypareunia (pain during sexual intercourse) which is often something women hesitate to bring up with their doctor and something healthcare professionals should be more direct in asking about. An excellent resource for further information on the role of physiotherapy in sex and endometriosis can be found on Endometriosis UK website; link in the references below (5).
TENS and acupuncture
As previously mentioned a lot of treatment options for endometriosis are not available to you when you’re planning pregnancy but that shouldn’t mean that you’re left in pain and discomfort. Alternative safe options include the use of TENS machines and acupuncture. TENS machines have good evidence for reducing pain and improving quality of life in women with endometriosis (6). There are now a good range of discreet TENS devices designed specifically for endometriosis pain; these include brands such as Myoovi and Beurer and Boots own brand TENS for period relief. Acupuncture is also a good evidence based option for pain relief as shown in a recent meta-analysis in 2023 with very few studies reporting any adverse effects (7).
Expert Patient Programmes
Expert patient programmes have been shown effective for many chronic and painful conditions. These are available in certain areas in the UK but there isn’t equal access across all areas. In my own area of Northern Ireland we have what’s called condition management programmes which have a similar principle to Expert Patient Programmes. These are programmes ran by phyiotherapists, occupational therapists and mental health workers and aim to provide a more holistic approach to disease management (8). What I love about these programmes is they reduce the sense of isolation often experienced with chronic and painful conditions.
I hope you have found this blog helpful. I would highly recommend checking out the Endometriosis UK website for a comprehensive overview of treatment options and local support groups.
References:
https://cks.nice.org.uk/topics/endometriosis/background-information/
https://www.endometriosis-uk.org/campaigning-northern-ireland
https://cks.nice.org.uk/topics/endometriosis/management/management-of-endometriosis/
Vernon, M. and Dian Shepperson Mills (2002). A key to healing through nutrition. London: Thorsons.
https://www.endometriosis-uk.org/webinar/endometriosis-and-sex
https://www.sciencedirect.com/science/article/abs/pii/S0301211515002468
Giese N, Kwon KK, Armour M. Acupuncture for endometriosis: A systematic review and meta-analysis. Integr Med Res. 2023 Dec;12(4):101003. doi: 10.1016/j.imr.2023.101003. Epub 2023 Oct 28. PMID: 38033648; PMCID: PMC10682677.
https://www.nidirect.gov.uk/articles/condition-management-programme
