Research on Self-Management in Endometriosis

In a comprehensive review, Italian researchers explored a range of complementary treatment modalities for endometriosis (Buggio et al., 2017). Their findings suggest potential benefits through these complementary approaches. Nonetheless, it is crucial to note that many studies in this area have limitations, including small sample sizes and methodological issues. Therefore, further research is essential to establish the effectiveness of these treatment methods conclusively.

Diet

  • Numerous studies have indicated the potential benefits of fish oil and unsaturated fatty acids, which possess anti-inflammatory properties.
  • While one study suggested a connection between elevated red meat consumption and increased endometriosis risk, other studies have not consistently supported this finding.
  • One study proposed that a higher intake of fruits and vegetables could lower the risk of endometriosis.
  • Preliminary results from two studies indicated that a gluten-free diet might benefit women with endometriosis.
  • There is currently no substantial evidence to support the idea that coffee consumption increases the risk of endometriosis.

Learn more about nutrition in endometriosis.

Nutritional Supplements

  • Studies on vitamin D as a dietary supplement have yielded mixed results, with some indicating a positive effect and others not.
  • N-acetylcysteine (NAC), naturally found in foods like broccoli, red peppers, garlic, onions, and poultry, showed a reduction in pain after three months as a dietary supplement in an Italian study.
  • Resveratrol, found in grapes, berries, and nuts, has demonstrated positive effects on endometriosis tissues in mouse studies. However, human studies on this compound have not been conducted yet.
  • Endocrine disruptors, like bisphenol A in some plastic products, may have a negative impact on endometriosis. These substances are unintentionally ingested through food and the environment and can affect the hormone system.

Learn more about food supplements.

Osteopathy and Massage

  • Two small studies have shown a positive impact of osteopathy on the quality of life of individuals with endometriosis.
  • A small Iranian study demonstrated that massage can have a positive effect on relieving endometriosis-related pain.

Acupuncture and TENS

  • Three small studies have indicated that acupuncture can effectively reduce endometriosis-related pain and improve the overall quality of life.
  • A study involving 22 individuals with endometriosis demonstrated that TENS therapy significantly improved pain levels, quality of life, emotional well-being, social support, and self-image after an 8-week treatment period.

TCM/Traditional Chinese medicine

  • Chinese herbal medicine is a Traditional Chinese Medicine (TCM) component. However, no evidence has been found to support its effectiveness in improving endometriosis symptoms.

Learn more ore about osteopathy and TENS.

Sports and Exercise:

  • Exercise has shown overall positive effects on managing endometriosis.
  • For instance, a study by Gonçalves et al. involved 15 women with endometriosis who participated in 8 weeks of yoga training. These women reported that yoga helped them effectively manage their pain, enhance their sense of control and self-confidence, and improve self-care and self-esteem.

Psychological Support

  • Individuals with endometriosis often experience a high psychological burden.
  • A study of 67 patients by Meissner in 2016 explored the benefits of psychotherapy. This psychotherapy approach combined elements of mindfulness-based psychotherapy, hypnotherapy, problem-solving training, and cognitive-behavioral therapy alongside Traditional Chinese Medicine (TCM) techniques like acupuncture, moxibustion, and cupping. Patients were also encouraged to continue the therapies at home, incorporating practices such as qigong exercises, herbal teas, or heat applications. The study revealed that this comprehensive treatment improved pain and enhanced physical and psychological quality of life. Importantly, these positive effects persisted not only 3 months after treatment but also after 6 and 24 months.
  • Another study by Hansen et al. in 2016 investigated the effects of a 10-hour mindfulness-based psychological intervention in individual and group settings. The participants included ten women with chronic lower abdominal pain. The intervention encompassed mindfulness exercises, imagination exercises, counseling, group support, and psychoeducation on chronic fatigue, sleep quality, work, relationships, and family. These participants experienced lasting improvements in health-related quality of life, which remained even after six years.

Learn more about the benefits of sports and psychotherapy.

Good to Know!

  • Fish oil and unsaturated fatty acids may exhibit anti-inflammatory properties.
  • In an Italian study, N-acetylcysteine (NAC) demonstrated pain reduction after three months.
  • Two small-scale studies have indicated that osteopathy can positively impact the quality of life for individuals with endometriosis.
  • The authors conclude that compelling evidence supports the benefits of psychological support, particularly in improving both short-term and long-term pain. However, they emphasize that psychological support should encompass more than symptom improvement. It should also encompass broader aspects, including enhancing overall disease management and helping individuals integrate the disease into their life history and female identity.
  • The researchers also advocate for psychological-sexual therapy counseling to address pain during sexual intercourse, especially when sexual problems are causing significant distress. Specialized professionals can provide valuable support in addressing personal issues within a safe and supportive environment.
  • Useful tips may involve using lubrication, engaging in extended foreplay, practicing delayed penetration, and experimenting with different sexual positions that involve slow and gentle penetration. Additionally, considering the timing of sexual intercourse concerning the menstrual cycle, as discomfort may vary during this period, can be beneficial. Relaxation techniques and strategies to enhance relationships and foster open and honest communication are also recommended.

Conclusion

The scientists underscore the importance of a multidisciplinary approach in endometriosis treatment. The goal is to tailor therapy to each patient’s unique symptoms, challenges, needs, and preferences.

References

  • Buggio, L., Barbara, G., Facchin, F., Frattaruolo, M. P., Aimi, G., & Berlanda, N. (2017). Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. International journal of women’s health, 9, 281–293. https://doi.org/10.2147/IJWH.S119724
  • Gonçalves AV, Makuch MY, Setubal MS, Barros NF, Bahamondes L. A Qualitative Study on the Practice of Yoga for Women with Pain-Associated Endometriosis. J Altern Complement Med. 2016 Dec;22(12):977-982. doi: 10.1089/acm.2016.0021. Epub 2016 Aug 23. PMID: 27552065.
  • Hansen KE, Kesmodel US, Kold M, Forman A. Long-term effects of mindfulness-based psychological intervention for coping with pain in endometriosis: a six-year follow-up on a pilot study. Nord Psychol. 2017;69(2):100–109.
  • Meissner, K., Schweizer-Arau, A., Limmer, A., Preibisch, C., Popovici, R. M., Lange, I., de Oriol, B., & Beissner, F. (2016). Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: A Randomized Controlled Trial. Obstetrics and gynecology, 128(5), 1134–1142. https://doi.org/10.1097/AOG.0000000000001691

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Teresa Götz
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