11 Supplements for Endometriosis
These dietary supplements may be added to treatment plans to help ease endometriosis symptoms
Medically reviewed by Suzanne Fisher, RD
Endometriosis is a chronic, incurable disease in which tissue that typically only grows inside the uterus also grows outside of the uterus and in surrounding areas.
The disease is marked by heavy menstrual bleeding, pain, inflammation, and in some cases, infertility.
There are three main types of endometriosis:
Superficial endometriosis (on the pelvic peritoneum)
Cystic ovarian endometriosis (on the ovaries)
Deep infiltrating endometriosis (on the recto-vaginal septum, bladder, and bowel)
Rarely, endometrial tissue may be found outside the pelvic region and in other parts of the body.
There is no known cause of endometriosis. High levels of estrogen may cause the disease to develop, but the relationship between estrogen and endometriosis is not fully understood.
Some dietary supplements may be used alongside standard care to treat endometriosis. Common supplements for treating endometriosis include vitamin D, zinc, omega-3 fatty acids, N-acetylcysteine, diindolylmethane, and various herbs.
This article will discuss important information you should know about 11 supplements taken for endometriosis.
Explainer
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what their labels say. When choosing a supplement, look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
What Supplements Are Taken for Endometriosis?
Explainer
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
Although endometriosis isn't curable, it is treatable. Pain medications, hormone therapy, and surgery are common treatments for symptoms of endometriosis.
Some people choose to add dietary supplements to their endometriosis treatment plans. Supplements may help reduce estrogen levels, pain, and inflammation, easing endometriosis symptoms.
Remember that supplements should be used as a complementary treatment only and should never replace standard endometriosis treatments.
For the most part, research on supplements for endometriosis is in the early stages. However, there is some evidence that certain nutrients and herbs may be beneficial.
Vitamin D
Vitamin D is a fat-soluble vitamin needed by your body for several important functions. You can get vitamin D through the sun, certain foods, and dietary supplements.
Some research shows that vitamin D may be useful for endometriosis.
Benefits
According to one systematic review, vitamin D has shown positive results in lab and animal studies but not in human studies of endometriosis. Instead, vitamin D was found to have little to no effect on pain or other symptoms of endometriosis.
Other studies have found a potential link between vitamin D deficiency and the development of endometriosis. However, more research is necessary.
Dosage or RDA
In endometriosis research, vitamin D dosage has varied anywhere from 2,000 international units (IU) per day to 600,000 IU in a single dose.
Like many other nutrients, there is a Recommended Dietary Allowance (RDA) for vitamin D, which provides a recommended intake for health. Anyone between the ages of 1 and 70 years old should aim for 600 IU of vitamin D per day. Vitamin D needs are lower for infants and higher after the age of 70 and for people with certain health conditions.
A tolerable upper intake limit (UL) is the maximum amount of a nutrient you can safely consume in a day.
The UL for vitamin D for people over the age of 9 years old is 4,000 IU per day. The UL for babies and young children varies between 1,000 IU and 3,000 IU per day.
Special Considerations
Certain medications may interact with vitamin D supplements, including:
Orlistat
Thiazide diuretics
Although rare, vitamin D supplements may cause side effects including but not limited to the following:
Nausea
Muscle weakness
Loss of appetite
Dehydration
Excessive urination
Side effects may be more likely if you exceed the UL for vitamin D.
People who are pregnant or breastfeeding may need to take extra precautions when taking vitamin D supplements.
Zinc
Zinc is a trace mineral that you need in small amounts every day for your health.
Zinc is present in several foods as well as supplements and may provide benefits for people with endometriosis.
Benefits
In some clinical trials, zinc has shown promise as a complementary treatment for endometriosis due to its antioxidant properties.
Additionally, researchers have found that a zinc deficiency may play a role in the development of endometriosis. Studies have shown that people with endometriosis are more likely to have low zinc levels.
A zinc deficiency alone is not thought to cause endometriosis, however.
Dosage or RDA
Due to a lack of research, there currently isn't a recommended dose for zinc when taken for endometriosis.
In general, zinc supplement dosage ranges from about 15 milligrams (mg) to 50 mg per day.
Regarding RDAs, adult males over the age of 19 need 11 mg of zinc per day, while females need 8 mg per day. Babies and young children require between 2 mg and 8 mg of daily zinc. Zinc needs are higher during pregnancy and lactation.
The UL for zinc is 40 mg per day for adults. This means that adults should avoid consuming more than 40 mg of zinc daily through supplements and foods.
Special Considerations
Taking too much zinc may cause side effects in some people. Possible side effects include the following:
Dizziness
Headaches
Upset stomach
Excessive zinc intake may also cause levels of copper, another essential mineral, to decrease.
Zinc may also interact with certain medications, including antibiotics, penicillamine, and diuretics.
People who are pregnant or breastfeeding should especially take caution when using zinc and avoid taking large doses.
MementoJpeg / Getty Images
Female holding supplement bottle while sitting in armchairOmega-3s
Omega-3 fatty acids (omega-3s) are a type of essential fat that you must get through your diet or supplements. Omega-3s play many roles in the body, and there is some evidence that they may help with endometriosis symptoms.
Benefits
Omega-3s have been found to help regulate both pain and inflammation, two common symptoms of endometriosis. Additionally, omega-3 supplementation has been associated with reduced endometriosis lesion sizes in rats and less pain in females with the disease.
However, other studies have found omega-3s to have little to no effect on endometriosis-related pain.
Dosage or RDA
In scientific research, the typical omega-3 dosage ranges from 1,000–4,000 mg per day. However, whether these dosages are effective in treating endometriosis is not yet known.
Although there aren't RDAs for omega-3s, adequate intakes (AIs) are recommended for optimal intake. The AIs for omega-3s (and other nutrients) are thought to provide adequate amounts of the nutrient.
After the age of 14, males should aim for 1.6 grams (g), or 1,600 mg, of omega-3s per day. Females need 1.1 g (1,100 mg) of daily omega-3s. Needs are lower for infants and children and higher for people who are pregnant or breastfeeding.
There is no UL for omega-3s, but you should avoid taking more than 5 g of a combined dose of the omega-3s EPA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) over time.
Special Considerations
Omega-3 supplements are mostly thought to be safe. However, side effects like bad breath, heartburn, nausea, headache, and an upset stomach are possible. Chronically high doses of omega-3s may cause a weakened immune system or increased bleeding.
Omega-3s can act as blood thinners and may increase the effects of blood thinners and anticoagulants, such as warfarin.
Curcumin
Curcumin is a bioactive substance found in the spice turmeric. Curcumin has anti-inflammatory and antioxidant properties that may help with endometriosis.
Benefits
In lab and animal studies, curcumin has shown an ability to regulate certain steps of the inflammatory process, leading to inflammation reduction. Curcumin has also been found to reduce oxidative stress, which may be useful in endometriosis management.
To date, there isn't enough human research to back these claims up. More research is necessary.
Dosage
There isn't a consensus on how much curcumin you should take for endometriosis.
In general, little is known about curcumin dosages.
Some research has shown that a dose of 2 g of curcumin per day may reduce acute pain. Though other studies have used as much as 8 g of curcumin per day safely, researchers believe that benefits may occur with much lower doses.
Special Considerations
Curcumin has been deemed GRAS ("Generally Recognized as Safe") by the FDA.
However, there are reports of side effects like diarrhea, headache, nausea, rash, and yellow stool. These side effects may be more likely with high doses of curcumin.
People who are pregnant or breastfeeding should talk with a healthcare provider to learn if curcumin is safe for them.
Like other supplements, curcumin may interact with certain medications. There is some evidence that curcumin may negatively interact with:
N-acetylcysteine (NAC)
N-acetylcysteine (NAC) is a synthetic form of cysteine, an amino acid, commonly used in dietary supplements.
NAC may reduce endometriosis pain and other symptoms.
Benefits
In one study, NAC was found to significantly reduce menstrual pain, pain during sex, and chronic pelvic pain in patients with endometriosis. NAC supplementation was also associated with decreased size of endometriosis lesions and increased rate of fertility in the study.
Few other studies have been performed on NAC for endometriosis. Larger and better-designed studies are necessary.
Dosage
There isn't reliable information regarding the dosage of NAC. This is due to an overall lack of scientific evidence.
In the available research, safe NAC dosage ranges from about 600 mg per day to about 3,000 mg per day. Single doses of up to 8,000 mg have been given intravenously.
Special Considerations
Using oral NAC supplements may lead to side effects like upset stomach, nausea, diarrhea, and heartburn.
NAC may interact with certain medications. Possible interactions exist between NAC and the following medications:
Statins
Antibiotics
Diuretics
Cardiovascular medications
Other drug and supplement interactions may exist, so talk with a healthcare provider about any medications you take before starting NAC.
Epigallocatechin-3-gallate (EGCG)
Epigallocatechin-3-gallate (EGCG) is a type of natural plant compound found in green tea that is thought to provide health benefits.
In alternative medicine, EGCG has been used for endometriosis and other diseases.
Benefits
EGCG acts as an antioxidant and may help fight inflammation and pain related to endometriosis.
According to one scientific review, EGCG may shrink endometriosis lesions. However, these results have only been confirmed in lab and animal studies so far.
Dosage
EGCG dosage information is mainly based on animal studies. This means there is not enough data to provide safe EGCG dosage recommendations for humans.
EGCG supplements typically provide between 25 mg and 750 mg of EGCG. One cup of green tea provides between 100 mg and 300 mg of EGCG, depending on the product.
Special Considerations
EGCG is generally considered safe, but there are some factors to consider before using it.
A dose of 338 mg per day of EGCG is considered safe. Side effects may occur in some people and may include:
Headache
Fatigue
Dizziness
Upset stomach
Bowel changes
There is some concern that EGCG may be harmful to the liver, mainly if it's taken in high doses. However, liver damage cases are rare.
You may need to avoid using EGCG if you take the drugs irinotecan, atorvastatin, or nadolol because of possible interactions.
Milk Thistle
Milk thistle (Silybum marianum) is an herb and medicinal plant that people have used for centuries.
Small studies have shown that milk thistle can potentially benefit those who have endometriosis.
Benefits
The main active component of milk thistle, silymarin, has known antioxidant and anti-inflammatory properties.
In a small clinical trial, patients with endometriosis took 280 mg of silymarin or a placebo for 12 weeks. Compared to those who took the placebo, those who took silymarin had significant improvements in endometriosis pain and the size of their endometriosis lesions.
Additional long-term and well-designed studies are needed to confirm the effects of milk thistle and silymarin on endometriosis.
Dosage
There isn't much information regarding safe milk thistle dosage for endometriosis.
One small trial found positive results for those who took silymarin at a dose of 140 mg twice a day for 12 weeks.
Silymarin is considered safe in doses of up to 2,100 mg daily for 24 weeks. However, much smaller doses may be effective.
Special Considerations
Milk thistle may cause gastrointestinal side effects. Allergic reactions have also been reported in people who are allergic to ragweed, chrysanthemum, marigold, daisy, and other similar plants.
Because milk thistle may cause lower blood sugar, you should limit or avoid using it if you have diabetes.
If you are pregnant or breastfeeding, you should talk with a healthcare provider about using milk thistle. Though some research has studied milk thistle's safety during breastfeeding, more is necessary. Caution is advisable during pregnancy and breastfeeding.
Interactions between milk thistle and medications or supplements have not been proved. However, interactions are still possible, so take precautions.
Diindolylmethane (DIM)
Diindolylmethane (DIM) is a product of digesting cruciferous vegetables like broccoli and cauliflower. It acts as a phytochemical (a special plant chemical) and is said to have several potential health benefits.
Benefits
Research shows that estrogen receptors (which are important in endometriosis) are impacted by DIM.
In a very small study, DIM was randomly given in combination with dienogest (DNG), a common treatment for endometriosis, to people with endometriosis. Compared to participants who took only DNG, those who took both DIM and DNG had significant improvements in bleeding and pelvic pain.
Dosage
There isn't much reliable information regarding proper DIM dosage.
Some studies have found doses of 200 mg of DIM to be safe and effective, although there are reports of higher effective doses. It's worth noting, though, that these studies looked at DIM for cancer.
More research is necessary to determine safe and effective dosage for DIM, especially for endometriosis.
Special Considerations
DIM may cause side effects. Commonly reported side effects of DIM include nausea, headache, and vomiting.
Avoid using DIM if you are pregnant or breastfeeding because little is known about its safety for these populations.
Researchers worry that DIM may interact with some medications. However, there is no documentation of proven interactions at this time. Play it safe and talk with a healthcare provider before using DIM if you take any medications.
Vitex
Also known as chaste tree and chasteberry, vitex (Vitex agnus-castus) has been popularized in herbal medicine. It is most often used in women's health and reproduction.
Benefits
Clinical research supports the use of vitex for infertility. There is also some evidence that it may reduce estrogen levels, but research results have been mixed.
The role of vitex in endometriosis has mostly been studied in animals, so more human research is necessary.
Dosage
More data is necessary before vitex dosage recommendations are possible.
Vitex is commonly dosed at 20–40 mg per day, but higher doses of 1,800 mg may also be used.
In general, though, vitex dosing varies and may depend on the condition treated. A healthcare provider can help you determine the proper dosage.
Special Considerations
Side effects are possible but rare when taking vitex. Nausea, headache, upset stomach, acne, rash, and menstrual disorders have been reported as side effects of using vitex.
There is some concern that vitex may interact with medications used to treat Parkinson's disease, including dopamine agonists. Vitex may also interact with metoclopramide.
Avoid using vitex during pregnancy or lactation. This is because there isn't enough evidence that vitex is safe during these life stages.
Ashwagandha
Ashwagandha (Withania somnifera) is a medicinal plant used in Ayurveda and other forms of alternative medicine.
Although it is most commonly used for stress and anxiety, ashwagandha may also help with endometriosis.
Benefits
Various studies have found ashwagandha to have an estrogen-balancing effect. This may be due to polyphenols in ashwagandha that are thought to act similarly to estrogen.
As research on ashwagandha continues, more studies are necessary to prove its role in endometriosis.
Dosage
Ashwagandha dosage varies, yet there isn't much information on safe and effective dosing for it.
For some conditions, like stress and anxiety, ashwagandha appears to be most effective at doses of at least 500–600 mg per day.
More human research is necessary to determine the proper ashwagandha dosage for endometriosis.
Special Considerations
Ashwagandha is considered safe for most people, with few reported side effects.
In very rare cases, ashwagandha use has led to liver damage in some people, possibly due to contamination.
Due to safety concerns, people who are pregnant or breastfeeding should avoid using ashwagandha for any reason.
Ashwagandha may interact with supplements and medications that have similar effects. Avoid using ashwagandha at the same time as other drugs with anti-anxiety, sleep, muscle relaxing, or sedative properties.
Resveratrol
Resveratrol is a phytochemical and antioxidant found in various plants. It has long been studied for its potential benefits for certain health conditions, including endometriosis.
Benefits
According to one review, resveratrol has been shown to reduce inflammation and the formation of new endometriosis cells in small studies. The antioxidant may also reduce menstrual pain associated with endometriosis.
However, it's worth noting that other studies have found resveratrol to have little to no effect on endometriosis. More research is necessary.
Dosage
Resveratrol is water-soluble (meaning it dissolves in water) and typically requires a larger dose to be effective.
A dose of up to 5,000 mg per day of resveratrol is believed to be safe, but its effectiveness is not confirmed.
Additional studies are necessary to determine adequate resveratrol dosage for endometriosis. Until then, talk with a healthcare provider about the correct dose for you.
Special Considerations
Though small doses of resveratrol are not thought to cause side effects, larger doses may lead to nausea, vomiting, or diarrhea. Liver dysfunction has also been reported as a side effect of taking resveratrol.
Resveratrol may interact with anticoagulants (blood thinners), antiplatelets, and tamoxifen. There is also some evidence that resveratrol may interact with non-steroidal anti-inflammatory drugs (NSAIDs).
Talk with a healthcare provider about the safety of resveratrol if you are pregnant or breastfeeding or if you take any medications.
Summary
Endometriosis is a chronic condition in which abnormal tissue grows outside the uterus and in other parts of the pelvic cavity. In rare cases, endometrial tissue may grow in other parts of the body.
Though prescription medications and surgery are first-line treatments for endometriosis, supplements may also help.
Specific supplements for endometriosis have been studied and found to provide potential benefits. However, more research on how these supplements may be beneficial for people with endometriosis is necessary overall.
Read the original article on Verywell Health.
