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Endometriosis

Endometriosis as an inflammatory whole-body condition, from named specialists: the work that runs alongside medical and surgical care, graded honestly, and the questions worth taking to a consultation.

Every claim below carries an evidence grade. What do these grades mean?

EVIDENCE ENDOMETRIOSIS

Diet and movement coaching eased endometriosis pain

Limited

A randomized controlled trial in the European Journal of Obstetrics, Gynecology and Reproductive Biology tested structured Mediterranean style diet and aerobic activity coaching in women with symptomatic endometriosis, and found less pain and better well being than usual care. This is one trial, the effect is real but modest, and it is a lifestyle add on rather than a treatment for the disease. It belongs alongside your gynaecologist's plan or your surgery decision, never instead of it. Nothing here is a reason to delay a referral to an endometriosis clinic.

SOURCE →
Iris Kerin OrbuchEndometriosis Excision SurgeonFounder and Director, Iris Wings, Sanctuary for… Iris Kerin Orbuch
IRIS KERIN ORBUCH ENDOMETRIOSIS
Endometriosis, nothing has worked? Start here
  1. 1See a pelvic floor trained physical therapist weekly, with home exercises 2 to 3 times a weekModerate
  2. 2If gut symptoms are part of your picture, trial low FODMAP for 28 days with a dietitian, then reintroduceModerate
  3. 3Log pain by cycle day along with bowel, bladder and pain with sex, and bring the pattern to every appointmentLimited
  4. 4Protect your sleep window and add daily paced breathing to help a sensitized nervous systemLimited
  5. 5At a surgical consult ask about excision versus ablation, and know the pooled trial data shows no clear winner in mild diseaseLimited
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EVIDENCE ENDOMETRIOSIS

Pelvic floor therapy eases endometriosis pain

Moderate

A 2026 systematic review pooling seven small trials found pelvic floor physiotherapy eased endometriosis associated pelvic pain by roughly 2 points on a 10 point scale versus no physiotherapy. The pooled trials are small and mixed, so treat this as a promising adjunct, not a settled result. Physiotherapy does not treat the disease itself; it runs alongside your medical care, never instead of it.

SOURCE →
Iris Kerin OrbuchEndometriosis Excision SurgeonFounder and Director, Iris Wings, Sanctuary for… Iris Kerin Orbuch
ENDOMETRIOSIS
Endometriosis: The Whole-Body Work That Runs Alongside Your Medical Care
  1. 1Get a clinician-confirmed picture before you self-manage anything (Endometriosis cannot be diagnosed from symptoms or from a page like this one. Imaging can miss superficial disease, and definitive diagnosis is surgical. What you can do before an appointment is bring a written symptom history: pain by day of cycle, bowel and bladder symptoms, pain with sex, and what you have already tried.)
  2. 2Work with a pelvic-floor-trained physical therapist, not a general one (Trial protocols in this literature ran roughly weekly supervised sessions over about four months, with home work two to three times a week in between. Ask specifically for a physical therapist trained in pelvic floor work; this is a distinct specialty and a general musculoskeletal PT is not a substitute.)
  3. 3If gut symptoms are part of your picture, trial a low FODMAP diet with a dietitian, then reintroduce (In a 28-day randomized controlled crossover feeding trial in 35 people, 60 percent responded on the low FODMAP arm against 26 percent on the control arm (p = 0.008), with overall symptom scores of 35 mm against 58 mm. Run it as a structured short trial with reintroduction, ideally with a dietitian. It is not a permanent diet and it is not meant to be one.)
What to buy
Thorne Magnesium Bisglycinate ~$32
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