Desmayo

Alpha-lipoic acid is a universal antioxidant cofactor evaluated for endometriosis-associated pain. Human studies have demonstrated that alpha-lipoic acid improved endometriosis-associated pain, and a combination preparation with NAC and bromelain (LEAP study) significantly reduced pelvic pain. A clinical study using alpha-lipoic acid plus PEA and myrrh showed significant reduction in dysmenorrhea, dyspareunia, and chronic pelvic pain.

In a rat model of endometriosis, BCP (10 mg/kg and 30 mg/kg) suppressed endometrial implant growth by over 50% and induced apoptosis in luminal epithelium and blood vessel endothelial cells, without affecting fertility.

Curcumin, the principal polyphenol of turmeric, has demonstrated anti-inflammatory, anti-angiogenic, and estradiol-suppressing effects on endometrial cells in vitro and in animal models. A 2025 randomized double-blind controlled trial showed 80 mg nanomicellar curcuminoids added to dienogest significantly improved pain, quality of life, and sexual function over 8 weeks. An earlier triple-blind RCT (68 women, 2022) found no significant effect on pain, indicating mixed clinical results.

Diindolylmethane (DIM), formed from indole-3-carbinol during digestion of cruciferous vegetables, promotes favorable estrogen metabolism by shifting 16α-hydroxyestrone toward 2-hydroxyestrone, potentially reducing the hyperestrogenic drive of endometriosis. No clinical RCTs specifically for endometriosis have been published; evidence is preclinical and mechanistic.

EGCG, the primary catechin in green tea, exerts potent anti-angiogenic effects by inhibiting VEGF expression and signaling in endometriotic lesions, demonstrated in multiple in vitro and animal studies. It also decreased endometriotic lesion size in animal models. No published RCTs in humans exist yet; one large registered RCT (185 women) completed enrollment but has not published results as of 2025.

In a rat endometriosis model, oral fisetin reduced endometrial implant size, mast cell infiltration, NLRP3 inflammasome activation, and oxidative stress markers. A 2026 Johns Hopkins review also identified fisetin's preclinical relevance to endometriosis.

Indole-3-carbinol (I3C) is the direct dietary precursor to DIM, found in cruciferous vegetables. It promotes favorable estrogen metabolism, inhibits estrogen receptor signaling, and exhibits anti-proliferative effects on endometrial cells. Its relevance to endometriosis derives from anti-estrogenic and anti-proliferative mechanisms; clinical RCT data specific to endometriosis are not yet published.

L. gasseri OLL2809 has been assessed in a randomized, double-blind, placebo-controlled trial in endometriosis patients and was shown to effectively reduce menstrual pain and dysmenorrhea. Animal studies show it suppresses growth of ectopic endometrial tissue via NK cell activation stimulated by IL-12 induction.

Magnesium is a widely studied muscle relaxant and anti-inflammatory mineral evaluated in endometriosis for relieving dysmenorrhea and pelvic pain. It is recommended in traditional integrative approaches for uterine muscle spasm. One single RCT on magnesium for endometriosis pain did not confirm effectiveness by itself, but animal studies support its antiangiogenic properties.

Melatonin is a neuroendocrine hormone with antioxidant, analgesic, and anti-inflammatory properties that has been evaluated in endometriosis RCTs. A landmark phase II RCT (2013) found 10 mg/night significantly reduced endometriosis-associated chronic pelvic pain by approximately 40% and reduced analgesic use by approximately 80% over two months. A subsequent RCT yielded mixed results.

N-acetylcysteine has demonstrated significant antiproliferative and antioxidant effects on endometriotic tissue. A prospective study found 600 mg three times daily for three consecutive days per week over three months reduced ovarian endometrioma cyst size. A combination RCT (LEAP study) with NAC, alpha-lipoic acid, and bromelain showed reduced endometriosis-related pelvic pain.

Omega-3 polyunsaturated fatty acids exhibit anti-inflammatory, antiproliferative, and anti-angiogenic effects relevant to endometriosis. Animal studies consistently show reduction of lesion size and inflammatory cytokines. Human RCT evidence is mixed: one RCT found improvement in endometriosis-associated pain, while two others showed limited or no significant benefit over placebo.

Palmitoylethanolamide (PEA) is an endogenous lipid mediator with anti-inflammatory and analgesic properties. Clinical trials show that ultramicronized PEA, alone or co-micronized with the polyphenol polydatin, significantly reduces endometriosis-associated chronic pelvic pain, dysmenorrhea, and dyspareunia. A 2026 critical review confirmed one RCT showing effectiveness.

Clinical data shows Pycnogenol (60 mg/day) reduces symptoms of endometriosis, including pain and menstrual complaints. MSKCC reports preliminary clinical data supporting symptom improvement. The American Botanical Council monograph includes endometriosis as a clinical indication with supportive trial data.

A clinical study published in the Journal of Reproductive Medicine showed Pycnogenol reduced endometriosis symptoms by 33%. A subsequent study found 90% of patients became pain-free. Pycnogenol does not exert estrogen-like activity, which is important for safety in this estrogen-sensitive condition.

Progestins and progesterone are established medical treatments for endometriosis, reducing lesion growth by suppressing estrogen production and endometrial proliferation. Endometriosis is characterized by progesterone resistance in ectopic lesions, and overcoming this resistance is a major therapeutic target. Clinical guidelines include progestogens as first- or second-line hormonal therapy.

Bee propolis has demonstrated anti-inflammatory, antioxidant, and immunomodulatory properties evaluated in endometriosis. A single RCT confirmed propolis supplementation was effective in reducing endometriosis-related pain. Propolis contains bioactive compounds including flavonoids, phenolic acids, and Artepillin C with direct anti-inflammatory activity.

Pycnogenol, a standardized extract from French maritime pine bark (Pinus pinaster), was tested in a controlled study of 58 surgically confirmed endometriosis patients. Oral administration of 60 mg/day for 48 weeks progressively reduced pain scores and CA-125 levels; unlike GnRH-agonist comparator, no hormonal suppression occurred and five patients became pregnant.

Quercetin is a polyphenol flavonoid with anti-inflammatory, antioxidant, and anti-estrogenic properties studied in endometriosis. A single RCT found that 200 mg quercetin daily significantly reduced dysmenorrhea, chronic pelvic pain, and dyspareunia compared to placebo. It also inhibits aromatase, potentially reducing local estrogen production in ectopic endometrial tissue.

Resveratrol is a polyphenol phytoalexin studied for antiangiogenic, anti-inflammatory, and pro-apoptotic effects in endometriosis models. A small randomized clinical trial found resveratrol (40 mg/day) combined with oral contraceptives reduced dysmenorrhea pain scores more than contraceptives alone. Animal studies consistently show reduced lesion vascularization and size.

Selenium is an essential trace mineral that serves as a cofactor for antioxidant selenoproteins (glutathione peroxidases). One single RCT confirmed selenium supplementation was effective in reducing endometriosis-associated pain. Lower selenium levels have been observed in women with endometriosis compared to controls.

Reduced SPM levels and impaired resolution mechanisms have been documented in peritoneal fluid and endometriotic tissue of human patients. SPMs reduce endometriotic lesion size and inflammation in preclinical models. Endometriosis is listed among conditions for which SPM evidence has been documented in validated scientific sources.

Curcumin has demonstrated beneficial effects on pathways involved in endometriosis in preclinical (animal and in vitro) studies, including reduction of inflammation, hormone balance modulation, and anti-proliferative effects on endometrial lesions. Human clinical evidence is currently limited; the relationship is primarily mechanistic and preclinical at this stage.

Vitamin C is a potent antioxidant studied in endometriosis for its ability to reduce oxidative stress and inflammatory lesion growth. Combined vitamins C and E (1000 mg C + 1200 IU E) demonstrated consistent pain reduction across four RCTs, representing the most robustly supported antioxidant combination in human endometriosis trials as of 2026.

Lower circulating vitamin D levels are consistently associated with higher endometriosis risk and severity. Multiple RCTs have assessed vitamin D supplementation for endometriosis-associated pain, yielding mixed results—significant pain changes were observed but often comparable to placebo. Vitamin D has immunomodulatory and anti-inflammatory properties directly relevant to endometriosis pathophysiology.

Vitamin E, as a lipid-soluble antioxidant, is consistently studied together with vitamin C in endometriosis trials. Four RCTs assessing the combination of vitamins C and E uniformly found reductions in endometriosis-associated pain. Lower vitamin E levels are associated with increased risk of endometriosis. Vitamin E alone has not shown anti-angiogenic effects in endometriosis animal models.

Dong quai (Angelica sinensis) is a core traditional Chinese medicine herb for female reproductive disorders, used for centuries to treat 'blood stasis' and associated conditions including endometriosis-like presentations. It acts as an anti-inflammatory, emmenagogue, and female hormone normalizer, and is traditionally combined with Vitex for endometriosis pain. Clinical evidence for endometriosis specifically is limited to traditional use and combination formula studies.

EPO is traditionally used as a supportive remedy for endometriosis-related pelvic pain due to its proposed prostaglandin-modulating and anti-inflammatory properties via GLA. Clinical trial evidence specifically in endometriosis populations is absent from the published literature.

White peony has been used in TCM for endometriosis-related gynecological pain and blood stagnation for centuries. Experimental animal data show P. lactiflora extract can reduce endometriotic lesion size and improve embryo implantation, but human clinical trials are lacking.

Endometriosis is listed as a traditional herbalist indication for prickly ash in contemporary professional herbal sources, based on the herb's action as a circulatory stimulant, emmenagogue, and antispasmodic that improves pelvic circulation and reduces cramping. No clinical trial evidence supports this use.

R. cordifolia is indicated in Ayurvedic practice for endometriosis, classified under conditions of 'congested uterus' with fixed pain, clots, and amenorrhea. Herbal Reality (a practitioner evidence resource) specifically lists endometriosis among its indications, grounded in its blood-moving and anti-inflammatory Ayurvedic properties. No clinical or preclinical studies on endometriosis specifically have been conducted.

Vitex agnus-castus (chasteberry) has been traditionally used in herbal medicine as a female reproductive tonic and hormonal modulator for endometriosis. It acts on the pituitary gland to modulate prolactin and the hypothalamic-pituitary-gonadal axis, supporting progesterone relative to estrogen. Direct clinical RCT evidence specific to endometriosis is very limited; use is largely extrapolated from its established role in menstrual regulation and PMS.

Wild yam (Dioscorea villosa) has been used in traditional Western herbal medicine as an antispasmodic, anti-inflammatory, and hormone-balancing herb for endometriosis and dysmenorrhea. Herbalists use it to ease ovarian pain, relieve uterine cramping, and complement hormonal herbs like Vitex and dong quai. Its constituent diosgenin is a steroidal precursor, though human conversion to progesterone in vivo is unproven.