What Is Endometriosis Supportive Therapy?

Brandi Jones, MSN-ED RN-BC
·5 min read

A Guide to Living With Cyclical or Chronic Endometriosis Symptoms

Medically reviewed by Cordelia Nwankwo, MD

Endometriosis supportive therapy is a comprehensive approach to treating endometriosis (endo). It involves nonsurgical treatments you can try to help manage your symptoms before seeking surgery or integrate into a postoperative plan.

This article reviews treatments like pelvic floor physical therapy, massage, nonhormonal and hormonal medications, herbs, devices, self-care, mental health therapy, and support groups. It also discusses the role of surgery in endometriosis treatment.

<p>stevelenzphoto / Getty Images</p>

stevelenzphoto / Getty Images

Supportive Therapies to Manage Endometriosis

Endometriosis—a disorder in which tissue similar to that of the uterine lining grows outside the uterus in areas it does not belong—does not have a cure. However, a treatment plan that combines the following strategies can help reduce symptoms.

Pelvic Floor Physical Therapy (PFPT)

When endometriosis contributes to pelvic floor dysfunction, it can cause pain, urinary disorders, bowel problems, and painful sex. Pelvic floor physical therapy improves the strength and function of the pelvic floor muscles. Example interventions include kegel exercises and biofeedback.



Vaginal Dilator Therapy

Vaginal dilator therapy utilizes soft medical-grade plastic or silicone cylindrical devices of increasing sizes that expand the vaginal canal gradually. Gently stretching and desensitizing the vaginal muscles and tissues helps reduce pain and enhance sexual comfort.



Massage

When done as part of PFPT, massage involves a physical therapist using gentle pressure, stretching, or trigger point release to:

  • Improve circulation

  • Lower cortisol (stress hormone)

  • Reduce muscle tension

  • Release endorphins (natural painkillers)

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives (birth control) are the first line of treatment for endo. Advil and Motrin (ibuprofen) or Aleve (naproxen) are over-the-counter NSAIDs. If those options don't manage your pain effectively, talk to a healthcare provider about prescription NSAIDs such as Celebrex (celecoxib) or Ponstel (mefenamic acid).



Endometriosis and Birth Control

Hormonal contraceptives suppress or regulate periods. While they are typically effective for endo, not everyone can take them because of medical history, side effects, or fertility concerns. In this case, talk with a healthcare provider about alternative supportive therapies.



Hormonal suppression agents or estrogen modulators are a second line of treatment for endometriosis and include:

  • Gonadotropin-releasing hormone agonists (GnRH) like Lupron (leuprolide)

  • Antigonadotropic drugs like Danocrine (danazol)

  • Aromatase inhibitors like Femara (letrozole)

  • Selective estrogen receptor modulators (SERMs) like Evista (raloxifene)

Other medications include:

  • Valium (diazepam) suppositories: Muscle-relaxing medications you insert into the rectum or vagina.

  • Gabapentinoids: Medications like Neurontin (gabapentin) or Lyrica (pregabalin) that treat nerve pain.

  • Antidepressants: Antidepressants like Cymbalta (duloxetine) or Elavil (amitriptyline) can increase the pain-reducing effect of other medications.



Self-Advocacy

If you see a healthcare provider who dismisses your symptoms, consider getting a second or third opinion, preferably from an endometriosis specialist. You can also consider a pain management specialist who may suggest nerve blocks or Botox (onabotulinumtoxinA) injections.



Herbs

Consult a healthcare provider before taking herbs or supplements to ensure safety.

Herbal pain relief options include:

  • Cannabis (strains high in cannabidiol,or CBD, and low in tetrahydrocannabinol, or THC)

  • Chamomile

  • Corydalis

  • European cranberrybush

  • Ginger

  • Jamaican dogwood

  • Pasqueflower

  • Wild yam (cream you spread on the inner arms, thighs, chest, or wrists)

The following may help balance hormone levels:

Transcutaneous Electrical Nerve Stimulation (TENS) Unit

A TENS unit is a small, battery-operated device that delivers low-voltage electrical stimulation to nerve fibers through electrodes (stickers) you place on the skin. These sessions are typically 15 to 30 minutes and work by disrupting pain signals in the brain.

Acupuncture

Acupuncture is an ancient Chinese therapy wherein a practitioner inserts thin needles into specific points on the body to promote the flow of energy and alleviate pain.

Chiropractics

Chiropractic care focuses on spinal adjustments and alignment to enhance nervous system function, potentially alleviating pelvic discomfort and nerve pain (like sciatica) and improving overall well-being.

Related: 13 Natural Endometriosis Treatments

Role of Surgery in Endometriosis Treatment

Surgical excision or ablation of endometrial implants and scar tissue may be necessary for those who do not respond to other treatments. Laparoscopic surgery is the most common type. However, it is not a cure, and symptom recurrence is possible.



Can You Prevent Endo From Spreading?

While there is no guarantee, one goal of hormone therapy is to prevent endometriosis from spreading.



Endometriosis Self-Care and Pain Relief

Self-care involves the following:

  • Resting

  • Drinking plenty of water

  • Avoiding stress

  • Getting regular physical activity

  • Eating a healthy diet

  • Treating pain at home

For immediate pain relief, you can try:

  • Hot packs

  • Self-massage

  • Topical medications (e.g., massage Aspercreme with lidocaine cream on trigger points)

  • Warm bath or shower

Which Foods Improve and Which Worsen Endo?

There is not one specific diet for those with endo. However, some find an anti-inflammatory diet beneficial. It helps to eat food (or take supplements) rich in antioxidants (vitamins A, C, D, E, selenium, and zinc), probiotics, omega-3 fatty acids, and magnesium.

Examples include:

  • Berries, cherries, oranges

  • Beans, lentils, chickpeas

  • Dark, leafy greens

  • Kefir, kimchi, miso, sauerkraut, yogurt

  • Pumpkin, flax, chia, or hemp seeds, walnuts

  • Salmon, mackerel, sardines

You can also try avoiding the following foods and beverages as they may worsen endo symptoms:

  • Caffeine and alcohol

  • Gluten

  • High-fat dairy

  • Processed foods and sugar

  • Red meat (mainly processed and fatty cuts)

Related: Endometriosis Self-Care to Manage Symptoms

Mental Health, Therapy, and Endometriosis

Endometriosis can take an emotional toll due to chronic pain, infertility, frustration, sadness, depression, or anxiety. It can also impact your partner or spouse. They may struggle with feelings of helplessness or guilt. Therapy provides a supportive space to process emotions and develop coping strategies, independently or as a couple.

Support Groups for Endometriosis

Support groups, online forums, and social media platforms can provide advocacy, resources, and a safe space for sharing stories or seeking advice from peers.

On Instagram, you can find advocates or organizations such as.

Facebook examples include:

Online organization examples include:

YouTube videos can also be a valuable resource to learn about:

  • Aromatherapy

  • Castor oil packs

  • Coping strategies

  • Pelvic floor physical therapy

  • Personal testimonies

  • Self-massage

  • Vaginal dilators

Summary

Endometriosis supportive therapy involves a comprehensive approach to treatment. It includes pelvic floor physical therapy, massage, medications, herbs, TENS units, self-care, and support groups. For some, especially those who do not respond to other treatments, laparoscopic surgical removal of endometriosis lesions may be part of their plan of care. 

Read the original article on Verywell Health.