What Supplements Should I Take For Endometriosis?
Dr. Natalie Bozinovski ND., MSc.
Natural health products aka nutraceuticals aka supplements can be hugely beneficial for women with endometriosis. Which ones you take definitely depend on what symptoms you’re experiencing and what else is going on with your body.
I NEVER recommend self-prescription. The decision of what supplements to take and for how long should be made with a naturopathic physician who can ensure that you are taking them safely and effectively. Furthermore, brands are not synonymous, meaning they cannot be used interchangeably due to differences in quality, dose and even active ingredient. So having someone to guide you regarding which brand to use can make all the difference in treatment outcomes.
The great news is that the medical and research communities are taking more of an interest in both endometriosis and natural medicine. We are learning more and more about the HUGE capacity for herbs and nutraceuticals to impact endometriosis. How exciting is this?! Natural supplements are effective therapeutics with minimal side effect profiles (bonus!).
Here are a few of my favourites:
Melatonin
Melatonin, typically recommended as a sleep-aid has been shown to significantly reduce endometriosis-associated chronic pelvic pain. When prescribed 10 mg of melatonin each night for 8 weeks, females aged 18-45 experienced reduced pain by about 35%, improved sleep quality, and reduced the risk of using an analgesic pain medication by 80%. In addition to chronic pelvic pain, melatonin also produced statistically significant reductions in pain during vaginal penetration, pain during urination, and pain during defecation.
Melatonin also reduced levels of BDNF. Melatonin has antioxidant, anti-inflammatory and analgesic properties.
N-acetyl cysteine
There is evidence that natural supplementation can reduce the size of endometrioma lesions. N-acetyl cysteine (NAC) is one of those supplements! Italian women treated with N-acetyl cysteine had their cysts significantly reduced in size, by an average of −1.5 mm versus a significant increase +6.6 mm in untreated patients. Additionally, 24 NAC-treated patients, versus 1 in the control group cancelled scheduled laparoscopy due to cysts decrease/disappearance and/or relevant pain reduction (21 cases) or pregnancy (1 case). Authors conclude that NAC represents a simple effective treatment for endometriosis, without side effects, and a suitable approach for women desiring a pregnancy. NAC supports the body’s production of glutathione, our most potent antioxidant.
Pycnogenol (pine bark extract)
Pycnogenol has been shown to steadily reduce endometriosis pain when prescribed at 60 mg per day for 48 weeks. This study compared pycnogenol with Gn-RHa, a hormone-suppressing medication called leuprorelin acetate depot. The leuprorelin reduced pain scores more quickly, but 24 weeks after the end of treatment, symptoms had returned and menstruation was affected.
CA-125 decreased in both groups and those with smaller endometriomas responded better than those with larger endometriomas.
The pycnogenol group experienced a reduction of pain from “severe” to “moderate” (33% improvement) and maintained normal menstruation.
Magnesium
Magnesium acts as a muscle relaxant with calming properties (also great for those of us who have trouble falling asleep or have anxious thoughts). Women who are deficient in magnesium may experience cramps. So if a woman is experiencing cramps, she could start taking Magnesium daily and then increase the dose approximately 1 week before her period. Typically women could start at 300-450 mg of magnesium at bedtime and increase to 600 mg beginning 1 week before her period is due. In my practice, I recommend magnesium glycinate because it is super absorbable and is unlikely to cause loose stool.
If you want to learn more on how to manage endometriosis naturally, check out my free masterclass.
Yours in health,
Dr. Natalie Bozinovski ND., MSc.
References
Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007 Aug;52(8):703-8.
Porpora MG, Brunelli R, Costa G, Imperiale L, Krasnowski EK, Lundeberg T, Nofroni I, Piccioni MG, PIttaluga E, Ticino A, Parasassi T. A Promise in the Treatment of Endometriosis: An Observational Cohort Study on Ovarian Endometrioma Reduction by N-Acetylcysteine. Evid Based Complement Alternat Med. 2013; Published online 2013 May 7. doi: 10.1155/2013/240702
Schwertner A, Conceição Dos Santos CC, Costa GD, Deitos A, de Souza A, de Souza IC, Torres IL, da Cunha Filho JS, Caumo W. Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial. Pain. 2013 Jun;154(6):874-81. doi: 10.1016/j.pain.2013.02.025. Epub 2013 Mar 5.