Endometriosis: 5 Natural Treatments That Really Work

Natural endometriosis treatmentEndometriosis is not like other period problems. It’s not a hormonal condition like PMS and PCOS. It’s affected by hormones, yes, but fundamentally endometriosis is a disease of immune dysfunction.

The medical consensus has not yet caught up with the new research into endometriosis and immune dysfunction so hormonal suppression remains the primary treatment.

There is a better way.

What is endometriosis?

Endometriosis is best defined as an inflammatory disease in which bits of tissue that are similar to uterine lining grows throughout the pelvis on structures such as ovaries. It causes pain (sometimes severe), scarring, and infertility.

Risk factors include genetics and exposure to toxins such as pesticides and dioxins. The microbiome (good bacteria) also plays a role. For example, women with endometriosis have a high level of gram-negative bacteria and the bacterial toxin LPS (lipopolysaccharide) in their pelvis, which can actively promote endometriosis and may be an initiating cause of endometriosis. See Endometriosis is a disease of immune dysfunction.

Endometriosis is common and often starts young (although it can take ten years to diagnose). One study found that two-thirds of teens reporting chronic pelvic pain will eventually go on to be diagnosed with endometriosis. Read Is it normal period pain or endometriosis?

Conventional treatment

Surgical excision of the lesions is effective for both pain and fertility and is the gold standard of treatment. Unfortunately, the lesions grow back within five years about 50 percent of the time. That’s why surgery is usually followed by hormonal suppression.

Hormonal suppression with birth control (or stronger drugs such as Lupron) works by shutting down ovulation and inducing estrogen deficiency. Estrogen deficiency slows the growth of the lesions, but it does not cure the disease. It has many side effects including depression and bone loss.

Mirena intrauterine device (IUD) works locally to suppress the uterine lining and endometriosis lesions. It is preferable to other methods of hormonal birth control because it does not shut down ovulation or cause estrogen deficiency.

Natural treatment of endometriosis

The following natural treatments work because they improve immune function and reduce inflammation. They can be tried on their own but sometimes they are not enough on their own. Natural treatments can work best when they are used as an adjunctive treatment after surgery.

Avoid dairy (and possibly gluten and eggs). Both A1 casein (dairy protein) and gluten disrupt immune function and stimulate the release of inflammatory cytokines. That’s why avoidance of those foods is an effective treatment for inflammatory diseases in general, and for endometriosis in particular. In one study, 75 percent of endometriosis sufferers improved after twelve months on a gluten-free diet. In my own work with patients, I have found women to do even better on a dairy-free diet, and I am convinced that the avoidance of A1 casein (normal dairy) is the single most effective treatment for endometriosis we currently have. Many endo-sufferers also tell me that they feel better off eggs because of a possible immune reaction to egg proteins.

Berberine is anti-inflammatory and repairs intestinal permeability (thereby improving immune function). It’s also anti-microbial and potentially addresses the bacterial aspect of endometriosis by neutralizing the bacterial toxin LPS. Caution: Do not take berberine if you are pregnant or breastfeeding, and do not take it for more than three months continuously except under supervision. Be cautious when combining with other medications.

N-acetyl cysteine (NAC) is a natural anti-inflammatory that did well in a recent clinical trial for endometriosis. Of the 47 women in the NAC treatment group, 24 cancelled their laparoscopy due to a disappearance of endometriomas, reduction of pain, or pregnancy. The researchers concluded that NAC offers better results than hormonal treatments–without the side effects!

Turmeric reduces the size and activity of endometriosis lesions. It works by reducing the inflammatory protein NF-kappa B, and by blocking estrogen’s stimulating effect. Turmeric works best as a concentrated capsule or tablet. It’s safe for long-term use.

Zinc is a key anti-inflammatory nutrient that is commonly deficient in women with endometriosis. Zinc repairs intestinal permeability (thereby improving autoimmunity) and reduces prostaglandins and pain.

Other helpful treatments include selenium, rosemary, resveratrol, castor oil packs, and body-identical progesterone (see Period Repair Manual). 

297 thoughts on “Endometriosis: 5 Natural Treatments That Really Work”

  1. Endo with visible ovarian cyst and Hashimoto’s/hypothyroidism. I’ve had an IUD for 2 years. Significantly reduced the pain and have the added bonus of no period and birth control. Been working for 7 months with nutritionist/func med as I have really high levels of inflammation and leaky gut. My gut is much better now after following paleo and supplement protocols. (Was vit D and zinc deficient. Took a bunch of cleanse and repair supplements. Tumero. Reverso. etc.) Next step is to work on hormones. They want me to use ashwaghandha. I tried one month and my period came back with bad cramps. Your post gives me hope that I don’t need to go that route. Would love your opinion. Thanks!

  2. Hello Lara,

    Great article that made me wonder. You are presenting eggs as something to avoid because of A1 casein if I understand well. This is something I have also read in articles from USA perspective. At least one expert in nutrition for endometriosis here in France is advising us to eat eggs as source of protein but ones that are from chickens raised eating omega 3 linseed, grass…, no OGM, no antibiotics…

    So my questions are:
    Is your affirmation only for Australia?
    According to you and your previous research is that ok for endogirls to eat those omega 3 eggs or the issue with A1 casein still remain?

    • hi Corinne, thanks for your comment. I didn’t mean to imply that eggs contain A1 casein; they do not. But rather that some women have a negative immune reaction to at least one of the proteins in chicken eggs. I’ve amended the text of the article to try to be more clear on that point.

  3. Hello Lara,
    Great article that made me wonder. You are presenting eggs as something to avoid because of A1 casein if I understand well. At least one expert in nutrition for endometriosis here in France is advising us to eat eggs as source of protein but ones that are from chickens raised eating omega 3 linseed, grass…, no OGM, no antibiotics…
    According to you and your research is that ok for endogirls to eat those kind of eggs or still not?

  4. Hi Lara, first of all thank you so much for your work, its so enlightening and I love the way you can write in simple terms the findings of scientific research! I am Naturopathy student and currently doing an assessment where I appraise research in regards to diet and endometriosis. I personally agree with your statements that dairy increases inflammation and hence would likely make endometriosis worse, however on my literature search of peer reviewed articles on the subject all the studies (includint RCT and meta-analyses) shows the opposite, that dairy actually improves endometriosis! I suspect the components of a high-fat dairy diet such as vitamin D and calcium would be causing the improvements but havent found any research to back me up on that, would you please be able to share any research with me with these results of higher endometriosis risk with dairy consumption?? thank you so much!

  5. Thank you for this article. This is the first thing I’ve read in my decades of living with endometriosis that offers support in a more natural way. With that, I’m curious if I can take all of those supplements at the same time? I just ordered the NAC, berberine and natural progesterone. I am getting my Kyleena IUD removed Tuesday due to side effects and really just want my life back. My energy. My sex drive and my happiness. I am not trying to get pregnant, I’m 40yo.

  6. I live in the U.S. The FDA recently made an announcement that NAC could not lawfully be used in dietary supplements because it was first approved as a drug in 1963. It is now nearly impossible to find. Is there another supplement that you recommend as a substitute for NAC? It appears that NAC is a precursor for glutathione. Is that maybe an alternative? Thanks so much.

  7. For the first time ever I hear about NAC as a treatment for Endometriosis. I just know it as cough medicine, I have never heard about its immune modulating effects. I suspect that I have endometriosis but I don’t know because you can only find out with surgery and I am scared of it. I wonder if it might be worth it trying with NAC. But I have also histamine intolerance and have heard that NAC is not a good idea for people with histamine intolerance? (that’s what my histamine app says, but I don’t know why?)

  8. Hi Lara!
    I was wondering I have painful periods prior to taking medicine. After taking medicine, I still have some pain though manageable. But I want to get to the root cause.
    I did an internal ultrasound which didn’t show anything however I’m not willing to have surgery to find out for sure.
    Apart from diet adjustments, are there tests I can do to further investigate the cause of my period pain?
    Thank you

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  10. If Endo is an inflammatory condition should soy products tofu etc still be avoided due to their phytoestrogenic effect or better to follow general anti-inflammatory guidelines?

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  12. I’m 7 days post op where I had 15 bits of endo removed from my bladder, ovaries and all over my pelvic cavity. I have asked my doctor and he has agreed to prescribe micronised progesterone – I am wondering, going forward is the cream or this oral form recommended? I am against hormonal treatment but have decided maybe this is the way forward.

  13. Hello.
    I have battled severe pelvic pain for over 4 yrs now. Had a laparoscopyy in late 9/2018. The OB expressed a very very very bad case of endometriosis. Compromising my bowel, colon, and ureters.
    Would the NAC help regress/vanish any of the current spread of adhesions?
    If not, does it help stop the spread?
    Or only with the inflamation?

    • Hi Nikki- so sorry to hear that. could you elaborate? what birth control and what other hormones? and how old how long? I feel for you and do know that birth control pills carry that risk over 40 but they always helped me. Would love to hear more if you could share about your stroke. Are you doing better? big hugs.

  14. Lara, thank you very much for your informative posts. I am 46. I`ve just read in your other blog that Vitex can make endo worse. I was diagnosed with endo by special ultrasound and symptoms (period pain for the first pne-two days of the cycle). I haven`t done laparoscopy, as with the recommendations from your book (in addition, I eliminated gluten and red meat) I completely eliminated all symptoms, except for feeling very weak and exhausted on the day 1 of my cycle despite not having heavy bleeding. I decided to take Vitex for several reasons: my functional medicine practitioner didn`t object it (but she does not specialize in women`s health), the ob-gyn from the endometriosis center recommended it for PMS (now I am thinking: why would I trust an advice from someone who was not trained in nutrition?), it helped me with PMS, it helped me to better tolerate stress. But I started getting ovulation pain, and for the past 6 months I am having almost daily pain sensations in my lower abdomen. Sometimes it`s more like stubbing pain for a moment. I addition, every time after a very mild cold exposure I have episode of low abdominal pain combined with lower back pain Both ob-gyn and orthopedic surgeon gave me no explanation of this pain following cold exposure.

    Do you think Vitex had “deleted” the positive effects of the treatment outlined in your book? Or may this symptoms stem from something else?
    Can this be reversed by stopping Vitex or do I need to do something in addition? I would like very much to avoid surgery.
    What herb would you recommend to help me tolerate stress instead of Vitex? Is it ok to take Ashwagandha?

    Thank you very much!
    Kind regards,

  15. Here’s what worked for me… I knew nothing about endo, it happened very suddenly for me, after having kids (which I conceived in the first cycle of trying). Period pain was not really a symptom so diagnosis took ages. I also had Ovarian Vein Prolapse and IC. Darkest 3.5 years of my life. I absolutely believe these are all auto immune conditions. After my first endo removal I embarked on gut health, quit sugar and dairy and that took care of the pain. Collagen/gelatine powder and Diotemaceous earth are my favourite supplements that I can FEEL work. I do consider myself to have these diseases any more. Any symptoms I treat calmly and naturally and I don’t freak out andcrun to a surgeon like I used to when I was afraid. Thank you for your book Lara.

    • Tara,

      Can you share more about how you use collagen, gelatin and diotemaceous earth? I have all of them and would love to see if they help my Endo! Have you found anything that helps ease cramps?


  16. Did you ever find that eating sauerkraut/fermented foods leads to an endo flare? My last cycle has been unexpectedtly rough (pain with ovulation, inflammed endo lesion, heavy cramping while period, digestive issues with diarrhea, still mild cramping although menstrual flow stopped). I have eaten lots of fermented sauerkraut throughout the month as part of a gut healing regime. Maybe the sauerkraut provoked the endo flare via the histamine-estrogen connection?

  17. Hello! I appreciate the time that you take to share your research! I have found this to be very helpful! I was wondering if you have any brands of supplements you would suggest to take the Tumeric or the Zinc? Also if I start avoiding Holstein dairy does that also include dairy that is in baked goods?

  18. Thank you very much for your wonderful blog and books.
    I completely avoid diary for more than 2 years. Is it ok to have organic ghee from grass fed cows/sheep/goat?
    Is it ok to use all the natural treatment`s listed above at the same time?
    In one of your blogs you`ve mentioned DotLab`s spit test for endometriosis. I`ve immediately written to them in order to get their kit, but they replied “our test can currently be ordered by physicians participating in our early access program”. Then I`ve asked my doctor to apply for their program, but she got the same answer. Do you know when this test will become available? Or do you know a name of any physician who is participating in this “early access program”. Knowing if I really have endo would make my priorities of treatment more clear. Thank you very much!

  19. Endometriosis is not autoimmune, or even secondary autoimmune. The immune system with endometriosis reacts exactly as it should to try to remove the irregular, hybridized endometriosis cells that should not be there. Endometriosis cells are not regular, expected tissue. In contrast, by definition, autoimmune disorders ONLY attack regular, expected tissue. The massive amounts of inflammation caused by endometriosis is the body trying to do its job to remove the endo lesions, which causes all the scarring and adhesions as a byproduct of that attack process.

    This full-fledged immune response is also why many people get sister illnesses like IC, IBS, arthritis, fibromyalgia, Crohn’s, etc., that are sensitive to inflammation *while* they have endo. It’s because the immune system is so inflamed that other body systems get hit with that inflammation, too.

    Excise the endo with excision surgery, and the other inflammatory diseases and freak allergies settle down, too.

    • thanks for your comment. I take your point of a reactive normal immune response, but there’s growing evidence that *immune dysregulation* lies at the heart of endometriosis (possibly triggered by an underlying microbial issue).

      For example, this 2015 paper concludes that “Endometriosis is now considered to be a disease of both endocrine and immune dysregulation.” Immunological aspects of endometriosis: a review

    • Is there evidence that with excision surgery as the only treatment all other “comorbids” resolve? If without addressing the root cause of endo it returns, so do all the other “sister illnesses”?

    • Wow I know your comment is a few years old now, but you hit the nail on the head. I have Graves disease and it was out of control for a year with an undetectable TSH despite many meds. I had my excision surgery and one month later I have a normal TSH for the first time ever since diagnosis (<0.01 to 0.77!). It looks as if I am in remission. Nothing has changed except the excision. You are exactly right.. Endo creates an extremely toxic environment which is the. catalyst for AI illnesses.

  20. Your comment is awaiting moderation.
    October 12, 2018 at 2:34 pm
    I have suffered with endometriosis and PCOS since I was a teen. I am now in my late 40s. I have gone through decades of surgeries and fertility treatments and have suffered painful menstruation for as long as I can remember. I also suffer from arthritis and in my early 40s managed my arthritis pain with the Dr. McDougal diet. The diet also alleviated much, but not all of my menstrual pain. I went off the diet when I was pregnant with my daughter who is now one and a half years old.
    I didn’t get back on the diet until recently. We recently had a cold front come into the state and my arthritis pain went off the scales. I realized it was time to get back on my diet which starts with a 7-10 day fast. Coincidentally this coincided with my menstrual cycle and, for the first time EVER, I have NO cramps, bloating or pain.
    I wish I had known this from the beginning. For however many months-years longer that I menstruate, I will be FASTING when it happens.

  21. Endometriosis is a condition in which tissue similar to the lining of the inside of the uterus — called the endometrium — grows outside the uterus. The most common places for endometriosis to occur are the ovaries, fallopian tubes, bowel, and outside walls of the uterus. Rarely, it can end up as far afield as the kidney, bladder, or lungs. Some women with endometriosis experience no symptoms, while others experience pelvic pain or pressure. The first sign or symptom for others is having difficulty getting pregnant. You can also refer to this article which states all the necessary details about endometriosis everydayhealth.com/endometriosis/guide/

  22. I saw a Gyn today to talk about Endometriosis options. He said the current thinking is that repeat laparoscopy surgeries make Endometriosis worse. He is recommending that I take a year of Lupron injections and then birth control until I reach menopause. I am 43 and was diagnosed with Stage 4 Endo in 2011. After reading your book, I am not comfortable with the idea of Lupron or birth control. What are your thoughts?

  23. Hi Lara!

    I have read your book and have been told by doctors and am pretty sure myself that I have endometriosis. I quit taking the pill about 2 months ago. I have noticed that I am still experiencing the same endometriosis pain off the pill as I did while on the pill, (Both before and after starting the pill) Any ideas why? I’m really curious as to what mechanisms in the body would result in the pill not even causing a reduction in pain symptoms. (I was on the pill for roughly 9 years and changed pills 4+ times. Even though it didn’t help the pain I stayed on it because I experienced that pain less often) I would just love your insight on how the human body would still react that way while on hormonal birth control. Thank you!!

  24. Hi Lara,

    Can you please tell me if I can take NAC with Visanne, how much and for how long? I am taking Visanne for almost an year and I feel good since I am on it, my endometrioma has reduced 2 cm. My doctor told me to continue with it until I will decide to have a baby, but I want to help my body healing while on this hormonal treatment.

    Thank you in advanced,

    • I am not aware of any interactions between Visanne and NAC. Some of my patients have used that combination.

  25. Dear Lara Briden,

    First of all, thank you very much for your amazing book, it helps me a lot to reconnect gratitude with my cycle with gratitude and to learn its wonderful language. I’m telling all my friends its a must read!

    I just wanted to share an observation concerning endometriosis et Saw Palmetto:

    I began to suffer peritoneal endometriosis, after quitting the pill with a very difficult transition (lots of unpleased symptoms), and was quite desperate when the doctors told me I had to take it back.

    The first two days of my period is a nightmare ( sudden diarrea, vagal syncope, and horrible pain) and only injections of anti inflammatory calm the pain.

    But one month, as I tried saw palmetto to help my acne, I noticed that I experienced zero pain when my period came! The flow was easy, lighter, and the blood was a bright red ! When I don’t take Saw Palmetto the pain comes back, so now it’s been three months that I use it few days before period and the first day, and I enjoy getting my periods!

    Do you have any explanation of how the Saw Palmetto works for endometriosis ? I would love to understands it better.

    Thank you very much for your response,

    With kindest regards from Paris,


    • Dear Anna, thank you so much for your comment. Could you please specify which brand are you taking and what dosage? Does saw palmetto also eliminate vagal syncope? I have it with almost every bowel movement.

      Thank you very much,

      Kind regards,


      • Dear Rosa,

        Yes, definitely, since I take the SP I have zero discomfort or feeling of faintless with my periods.

        I am taking the Saw Palmetto from Solgar : https://www.amazon.fr/Solgar-Baies-Palmetto-G%C3%A9lules-V%C3%A9g%C3%A9tales/dp/B00020IEWE

        I started with a high dosage : three capsules a day 5 days before my periods and until the 2nd day of my periods. Now, I can reduce it to two caspules three days before, and one day after the periods start.

        I would advise you to start with high doses and then reduces and refine it as you feel the best for you.

        I really hope it can help you, let me know!

        Kinds regards,


    • Dear Anna,
      thanks for sharing your experience and very interesting about saw palmetto. I am not familiar with its pain-reducing properties, but I’m always open to something new! I’ll have a think about it.

  26. Hi Lara,

    How do you gain access to micronized progesterone. I was talking to my endometriosis specialist/gynaecologist and he seems to know nothing about it or be willing to even discuss it. All he could offer me was removing my ovaries….bit drastic! He says upper abdominal endo can’t be cut out.

    How do you find someone who can prescribe bioidentical hormones…im in UK.
    Thank you thank you! Keep up the amazing work for women

    • Hi Rachel

      There’s a huge lack of knowledge about it in the UK. I brought mine after reading about it on Dr John Lee’s website (the American Doctor who wrote a number of bestsellers about it – his books are highly worth a read by the way) but you can also buy it off Amazon and a number of American health websites. The cream Dr Lee sells is ProgesterAll and it’s sold here: https://www.progesterall.com/more_progesterall.html The shipping cost is more expensive than the cream so it might be more cost effective to buy a few tubes.

      I chose to buy off Dr John Lee’s website because I was worried about the risk of not getting the correct product (buying things like this off the internet does involve an element of trust after all) and also his books very clearly explain dosage which I was worried about getting wrong.

      In some countries you can get people to prescribe it for you but I haven’t heard about anyone over here sadly.

  27. Hi Lara, thanks for your informative article. I have suspected endometriosis and unfortunately after trying all the natural methods for many years have had no relief and so am now having to go in for excision surgery as a last(and very desperate) option. My surgeon has recommended the insertion of a Mirena during surgery to help prevent future re-growth of the endometriosis but I am uncertain about the Mirena. I have had previous trouble with hormonal treatments (pills, and even bioidential progesterone) with aggravating my migraines and causing depression. Additionally, I have moved away from the more conventional approach over the last few years and focused on a more integrative health approach. So, I feel uncertain about putting artificial hormones into my body, even though my surgeon informs me that it is mostly local to the uterus and minimal to the rest of the body, for this reason as well as a general health approach. What are your thoughts on the Mirena? Do you think that it is a wise decision for a woman with Endo to prevent regrowth or do you think that the hormonal interference that it could create is not worthwhile in a larger sense? I also have been unwell over the last few years with Hashimoto’s disease (also trying to manage this with integrative medicine), so hormone balance for me is particularly challenging.

  28. Hello Lara, I’ve been following the Endo protocol. A question, what are the possible side effects of taking NAC? I’ve experienced a longer period of 6 days than usually (between 3-4) and a lot of blood clots. Does that mean that the body could be purging the Endo? P.S. no dairy for many years

  29. Hi Lara, thanks for the posts they’ve been really helpful in navigating my endo journey. I’m having trouble understanding whether a laporoscopy will assist with fertility if that is my primary concern, most articles seem to refer to pain only (including the one hyperlinked In your article). Is this because it’s hard to measure fertility? What do we know about laporoscopy and fertility? I’m following your dietary and supplement guidelines which have helped symptoms but want to be sure I am also managing potential impacts on fertility. Can you point me towards research or articles which might help me understand?

    • Endometriosis surgery can definitely help to improve fertility. Mainly because by “debulking” or removing the inflamed tissue, it reduces inflammation in the pelvis generally. Less inflammation is better for the ovaries and better for implantation.

  30. Hi My 23yr old daughter was diagnosed with pcos and was put on the patch but she has been struggling with irregular period and severe pain?

  31. Turmeric supplements have really worked for me in managing endo. They provide more relief for me than prescription pain killers. I’ve also found acupuncture extremely helpful in reducing pain, migraines, and bloating.

      • I just bought Gaia brand as I live in the states and the market is saturated so I had no idea what was a good brand or not. Gaia is a reputable brand and I found some good deals on it. Take one a day with that brand.

  32. Dear dr. Briden, I have been on Visanne for a year now and I am 36. The endo has recognized one year ago. Before that, I did not have any troubles with pain or my cycles. I have 2 kids. After starting with Visanne, the pain has reduced at first but before one month the pain has been suddenly sharp. I have the 4 cm cyst in my abdominal wall (cesarian birth before 7 years) and my gyno says it is in progression and this shouldnt happened on Visanne therapy. I have never had laparoscopy, only ultrasound and MR. I am taking a lot of supplements for about 3 months, serrapeptase, nattokinase, nac, msm, multivitamin and mineral, egcg, pycnogenol, resveratrol, astaxanthin, magnesium, vitamin E and C, q10, fish oil etc. I have been a vegetarian almost all my life. I dont use diary. MR shows that my liver is fat (Visanne?). The surgeon advice me to do a surgery. What can you advice me? Is laparoscopy essential or can I fix my cys on any natural way?

    • I cannot say what to do in your case exactly, but I can say that sometimes surgery is necessary.
      In the long-term, you might want to look at taking zinc and turmeric as I describe in the post.

  33. I have been taking Berberine, Alpha Lipoic Acid and Quercetin and have experienced terrible cramps and an early (and long) period. I have ceased taking them however given the positive reports about these supplements, I want to explore options. Have you witnessed this before? Any suggestions much appreciated.

  34. Do you have recommendations for adenomyosis I have heavy period that becoming unbearable and do not what a hysterectomy I’m 49 and hope menopause will come soon so no more period

    • I do discuss adenomyosis in my new book. Basic strategy: dairy-free, high-dose turmeric, natural progesterone capsules, and zinc. Mirena IUD as a fall-back plan.

    • I was diagnosed with adenomyosis in my 40’s (now 60) & after trying different contraceptive pills (Gynae prescribed) & a suggested uterine ablation which I didn’t like the sound of I did some research & found The Natural Progesterone Advisory Network. I found a GP (Australia) to prescribe Bioidentical Progesterone cream 16mgs/day in split doses for 25 days each month & found it controlled my heavy periods & erratic moods plus helped me avoid a hysterectomy which was recommended. I kept a diary of symptoms each month & went through menopause 4 years later at 51. I also saw a naturopath for dietary advice & supplements such as fish oil, magnesium, zinc & multivitamins. Bron

  35. I’m 37 and I started having endo pain throughout my cycle for the first time ever after reintroducing dairy 3 months ago. I’ve always had very painful periods but not pain throughout my cycle. Now that I’m almost positive I have endo (my gynecologist also believes this), is it best to go ahead and do excision surgery or should I wait to see if anti-inflammatory methods are enough for the pain? Second question: For two years I’ve had dysautonomia with fatigue and major anxiety, so I’m concerned about having the laparascopy and potentially having difficulty recovering. Would you recommend doing what I can do avoid surgery right now? I’m still working on finding the root cause of my illness.

  36. Hi, thank you so much for all this information! I was diagnosed today and started a treatment with dienogeste that will last 4 months. I would like to know if I can do any of these natural treatments and the medical treatment together. Thanks again =D

  37. Hi! Just come across your article and really enjoyed reading it! I’m going 21 and was diagnosed with endometriosis when I was 18 (after over 2 years of visits to the doctors!). I had a laproscopy and then got advised nothing more afterwards, the pain came back and I was then put on the depo injection. I hate being on it, i have mood swings, irritable and short tempered, increased appetite, get anxious! I’ve read on your article about what to avoid (dairy and gluten), but if I was to come off the depo what do you suggest to stop the endometriosis growing back when my periods become normal?

    Thank you

    • All the natural treatments discussed here could potentially help to prevent the endometriosis from growing back. Another good treatment is N-acetyl cysteine which I mention in this post and also discuss in the new edition of my book.

  38. Is there a max amount of curcimin/turmeric that one should take? I started taking a supplement called Curamed and it almost seems like my Endo is worse this month. I read later it’s possible for this to have an estrogenic effect so I started to wonder if that’s what happened.

    • I don’t think that would be what’s flared your endo. Has anything else changed? (coming off the pill, diet, antibiotics etc)

      • Thank you for your reply. My diet has been the same. The only other change I made is adding a fish oil/Vitamin d supplement which seems like would benefit vs the alternative. The curcumin supplement i took is called Curamed by Terry Naturals and has 750 mg per serving. Some days I took 2 thinking it should help more bc I was having bad inflammation only to wonder later if it was actually causing it. Is it possible that’s too high? It just seems so strange to have such a noticeable affect being sore breasts, cramps, horrible bloating almost the entire month vs just the week before my cycle starts.

        • Hi J Johanns! Thought I’d post my own experience here in hopes that it would help you 🙂 I started taking supplements from one brand and my endo symptoms got worse so I switched to another and now my symptoms have greatly decreased. Unfortunately, the supplement industry is not well regulated in America. Dosage can vary from pill to pill, what’s on the label isn’t what’s necessarily in the product, etc. *insert eye roll here* I’ve read about quite a few recalls on fish oil supplements so maybe switching supplement brands for the fish oil and turmeric might help??

  39. I am 26 with severe endo, done 2 surgeries to remove chocolate cyst and after that 2 failed IVF. Fast recurring of endo cysts. TTC for 4 years. I can only afford another ivf may be after 1 year. Before that i really want to heal my endo and body through natural way without Lupron. My periods are regular and have severe pain on first day of period,normal 3 day flow, have fatigue through out month.I have done lot of research and found a combination of natural medicines for getting a little relief from endo. So please tell me your suggestions regarding it.
    1. Neprinol
    2. DIM
    3. Phyto Multi (Multi Vitamin)
    4. Pycnogenol
    5. Bee Propolis
    6. Maca Femmenessencee Pro
    7. Omega 3 wild salmon fish oil
    8. Probiotic
    9. L-Glutamine

  40. Hi Lara, thank you for the post. Could you please specify the dosage and brands of at least some of the supplements mentioned above?
    Thank you very much!

    • Hi Lara, thank you so much for the information you share on an ongoing basis.

      Could you specify the dose for turmeric? I’d like to try it. In my experience, dairy and gluten free has worked.

  41. Hi, Please talk about Biopsy during surgery for Endometriosis, this is the only true diagnoses. Specifically excision surgery. I am the patient of several world known Endometriosis Specialists. Most of the people who promote Excision also understand that there must be biopsy during surgery. You can join our group on facebook to learn more: https://www.facebook.com/groups/endometropolis

  42. I think I’ve had this for years, unfortunely just had lap/ as well as dnc. I wish I would have done the research yrs ago, I’m 39. My doc finally took me seriously when I came into his office walking with a cane lol! I’m never having surgery again I’m still in so much pain it’s been 5 weeks now. Any suggestions?

  43. Hello Lara, I just found your site after looking for lots of answers online. My ob-gyn thinks I most likely have adenomyosis, based on my history, symptoms, and an ultrsound. She recommends a progesterone-only bcp or a hysterectomy. I am not a candidate for endometrial ablation because my uterus measures 12 cm. I just turned 40, I have terrible cramps and extremely heavy periods (filling up a menstrual cup many times a day on days 2-3 of a 6 day period), and I have anemia because of it. This has been going on for years. I also have hypothyroidism and take Armour thyroid 90mcg a day, and have for years. I am also now somewhat overweight, which has happened gradually over the past 10 years despite my attempts at a healthy diet. I used to manage things a little better through nutrition, but I have had a hard time with self-care the past few years, my daughter has cerebral palsy and it has drained so much of my time and energy and bank account! I do follow a 100% gluten-free diet. I am really not wanting to use either protocol my doc recommends but I am getting desperate. After reading a lot on your site and clicking around, I am considering this: magnesium, zinc, selenium, iodine, and a progesterone cream. Do you think it is possible to heal myself this way? Is there anything you think I’m missing that you’d recommend trying? Thank you for your help – I can’t find much about adenomyosis out there.

    • I’m just about to release a new edition of my book which has a greatly expanded adenomyosis section. Should be out by mid-August.

    • I was diagnosed with adenomyosis in my 40’s (now 60) & after trying different contraceptive pills (Gynae prescribed) & a suggested uterine ablation which I didn’t like the sound of so I did some research & found
      The Natural Progesterone Advisory Network. I found a GP (Australia) to prescribe Bioidentical Progesterone cream 16mgs/day in split doses for 25 days each month & found it controlled my heavy periods & erratic moods plus helped me avoid a hysterectomy which was recommended. I kept a diary of symptoms each month & went through menopause 4 years later at 51. I also saw a naturopath for dietary advice & supplements such as fish oil (Bioceuticals), magnesium (ultra muscleze – Bioceuticals brand), zinc(sustain-Bioceuticals ) & multivitamins (Bioceuticals). The dietary advice helped me lose weight. Bron

  44. When having endometriosis, IBS, leaky gut, SIBO, candida, parasites, multiple food sensitivities, what is the order, in which these problems shall be addressed/solved? What is the first priority? I remember getting PMS and period pain at least 3 years before I developed GI symptoms. I`ve read that endometriosis may lead to SIBO. Does it mean that I have to deal with the endo first or shall I heal the gut first?
    Thank you very much!

    • heal your gut, particularly the inflammation—imho. i have found in my own experience that when my digestion is regular and i feel no gut pain whatsoever, my endo symptoms can almost go away. i am working on trying to maintain that for longer than shorter periods. i also have recently been finding removing the fodmap foods – for me – is beneficial. cooked vegis help me a lot with achieving good digestion.

      • I completely agree with this!!! I only discovered I had endometriosis when I suffered a burst appendix and then fell sick with peritonitis when the wound from removing my appendix wasn’t cleaned properly by the surgeon. I told him I thought there was something else wrong with me and he told me I had endometriosis all over my appendix and the surrounding area. Long after the surgery had healed I still had pain where my appendix had been and I could only conclude that it was the endo.

        Since then I worked hard to change / improve my diet to be gluten and diary free, lots of vegetables, organic meat, probiotic supplements, etc…and all the endo pain had disappeared within 4 to 6 months.

        Sometimes when I am stressed i forget to eat properly / comfort eat and I notice inflammation comes back in my gut. When the inflammation comes back, the endo pain comes back.

  45. Hi there, I was diagnosed with endometriosis when I was 26 I took about 3 years to diagnose I when through alsorts p T first they thought it was my appendix then kidneys and eventually I had a laparoscopic op and they found it. This was back in 1996 I had never heard of it it was awful as the doctor said if I don’t have kids by the time I am 30 I never will and I didn’t. The attacks as I called them were horrific I would be doubled up in pain and I was sent home from work. I am now going through the primenapause and that’s a killer too I had a smear about a year ago and it was so painful I had to tell the nurse I really hurt and that when I found out about the next stage in life. I never really talk about what I go through and I accept it but it can be so hard especially when working full time I have sleep problems also but I’ve taken to Angus cactus as that helps me sleep and I was just surfing the net and I came across you it’s been nice reading your blogs I also put weight on it’s a constant up hill struggle I’ve cut out alcohol and caffeine just recently and I hoping to drop a few pounds. For any other women out there you are not alone

  46. Hi, my pain got worse after taking DIM so I stopped after 4 days. This was a couple of months ago and since then I have a constant pulling pain, like an ovulation pain. Might the DIM have caused an issue? Before then my pain wasn’t too bad – as far as the lap showed it’s grade 4 RVE and likely adeno. Otherwise I take zinc, C, d3, selenium, turmeric, sublingual b12, folate, fish oil and a probiotic, as we as occasionally magnesium and b6. Thanks for the info.

  47. Hi Lara,
    I have just read your book and would like to ask what you would recommend for a 14yr old with suspected endo. She is currently on the pill and surgery is not an option as she is too young. We are following a gluten free diet, reduced dairy and refined sugar, along with turmeric supplements. Would like to do magnesium, zinc and berberine but I am unsure of the doses to give, given her age and some supplements state ‘over 18yrs’.

    Many thanks for advice in advance!


    • Hi Jane,
      magnesium and zinc are safe for a teenager just make sure she takes them directly after food. And zinc could actually be very helpful.
      Also, “reduced dairy” may not be enough. I find that most endo-sufferers do better when they strictly avoid all cow dairy including yoghurt (but okay to have butter and goat cheese)

  48. Hi Dr Lara, whilst I don’t have endometriosis (or PCOS), I have battled with hormonal acne and dermatitis since 13 yrs old, I am now 36.

    I recently started taking Berberine but have been sick with cold / flu symptoms ever since, and it’s affecting my sleep too.

    My question is: Is this a start up reaction or could I be allergic?

    I have a very healthy diet.

    • If you think you’re having side effects, you should stop it. When it’s the right medicine, berberine doesn’t cause any reaction or side effects.

      • I’m about to start with the berberine, as well, but I have to wonder if no reaction is true. One of the things I have read is it is a potent CYP3A4 inhibitor. If you tend to feel hormonal shifts from milk thistle, grapefruit, or quercetin, for instance (other CYP3A4 inhibitors), this might be the case. It’s somewhat rare (less than 2% of the white Euro population), but can be significant. I after about a week of taking quercetin for allergies, I started having weird symptoms, which is why I will be starting very slowly with berberine.

        On the endo front, I’m doing well. Eliminating gluten and taking turmeric, zinc, and magnesium have significantly improved my life (I am extremely gluten sensitive and noted that eliminating it entirely, more than a decade ago, was enough to eliminate my terrible cramps). Adding zinc and magnesium have really made things significantly better. Just hoping to help my gut with the berberine more than anything (family history of Crohn’s and other autoimmunity). Helping my lady parts with the berberine is just icing on the cake, if it works!

        • I started with 500 mg a day. Only lasted 4 days because of intestinal symptoms and headache. I’ve since read that berberine can actually cause gut inflammation by reducing some good bacteria. What are your thoughts?

      • Update: So I battled on with the Berberine (on and off for a couple weeks) and finally made it past all the allergy symptoms. The dosage that now works for me is just 200mg a day, taking weekends off here and there. My acne is completely under control. I can’t believe how powerful this stuff is. Ive had the most persistent acne for decades and always had to resort to prescription medicine.
        Strangely it has also had a positive affect on my chronic fatigue as i rarely need to take my fatigue supplements anymore (which were ribose, coq10, carnitine). Better still, it has also improved my anxiety and panic attacks. This was a total surprise considering Berberine is a MAO inhibitor and I am already MAO++, so I would have thought I’d feel worse.
        I still get allergy flare ups from time to time, and the taste is revolting (even though I take capsules) but it’s worth it for all the other benefits. For anyone wanting to try it I would say proceed with caution, as you can see from my experience this is powerful stuff, even at my tiny dose.

  49. When a woman had already had radical treatment against endometriosis (Histerectomy), will she continue to have autoimmune problems with dairy/gluten that could cause other symptoms (digestive, mood, energy, etc.)?

      • Thank you! I also thought surgery was NOT a cure, but women are told that. Then, if they do mot make changes to their diet, things will remain pretty much the same due to inflammation/ autoimmunity.

  50. Dear Lara

    First, I would like to tell you how wonderful I have found your book. I wish it had been around when I was growing up! It makes me quite emotional because I finally feel like someone understands….

    Second, I can not prove a connection between my recent health issues and my endometriosis but to me, the autoimmune issue rings very true. I have had superb health the vast majority of my life…almost never needed antibiotics as a child, almost never getting colds. I have had the flu only once in my life. No problems with my periods etc…And then due to a chromosome issue in my DNA, I suffered 7 pregnancy losses within 5 years, sometimes requiring brief surgical intervention to help with the miscarriages. I am convinced that at some point during this time some cells were accidentally transferred outside of the womb.

    Since then I have had horrendous periods…gushing so hard I fill maternity pads the moment i stand up from the toilet etc..Thats on the months i had periods…there were other times when I had no period at all.
    Then i developed a serious kidney infection (i tested negative for a UTI repeatedly…it just went straight to the kidney), then i got a serious skin melanoma (that appeared out of the blue and grew rapidly), then i suffered a ruptured Appendix which then developed into Peritonitis….all of this happened within THREE years.

    So you can see why I started to suspect an immune issue!

    It was during the Appendix operation that the Surgeon found the Endometriosis. I contacted the Endometriosis Clinic in the U.K. around the same time I read your wonderful book.

    im currently taking a magnesium supplement, a multivitamin, a zinc supplement, a good probiotic and a digestive enzyme capsule every day. I add a B complex supplement on days im extremely stressed. I have been successful in eliminating diary from my diet but struggle with no gluten…I was tested for my estrogen and progesterone levels and they all seem normal. I’m think I may have trouble holding onto my Progesterone though because I get pre menstrual spotting. So this month I started supplementing with Vitex as well. For reference I am 40 years old.

    So far, my periods have become perfectly regular (28 days). Before, on average they were around 35 days but often longer. I have no pain either mid cycle or at period time. The blood flow has reduced to where I can wear a regular size tampon! And the period only lasts 3 days. I SLEEP so well these days. I can not tell you how much better I feel for the improved sleep! And I have so much more energy…300% more energy than I had before I started this. I’m still anxious that some other serious illness is going to suddenly hit me out of the blue….Because everything I’ve had in the last three years has involved hospitalization. I actually feel envious of people who get colds all the time …Would much rather that LOL. (I still haven’t started to get catch any colds). But I feel more and more confident that I’m regaining control over my body. I can see and feel it with my own eyes.

    I was advised by my Gynecologist to take a Progesterone only hormone pill but I have declined. She was concerned about the location of my endo and thought it was probable it had contributed to my appendicitis. So I feel quite scared about “defying” her medical judgment but without any pain or any obvious symptom at all at the moment the motivation to pump myself with artificial hormones isn’t there anymore.

    If anything stands out to you that I need to be aware of please can you say? Otherwise thank you again for a superb and inspirational book.

    Its one every woman should pass down to the daughters.
    Best wishes

    • Hi Nicola,

      thanks so much for sharing your story. Endometriosis is a serious disease, and I understand your gynecologist’s concern. At the present time, a progestin-drug is one of only a few medications that conventional medicine has to offer. I hope that will change sometime soon as other treatments become available. But in the meantime, you and many other endo sufferers have the difficult decision to take it or not.

      I’ll say this: After surgery, some of my patients take a progestin in addition to the natural anti-inflammatory treatments, and I support them in that. Some take natural micronized progesterone (Prometrium) in addition to the natural anti-inflammatory treatments. And some just use the natural anti-inflammatory treatments. There’s no one-size-fits-all treatment. I would encourage you to monitor your symptoms. The endometriosis might stay quiet, but if it seems to be ramping up again, then seek additional care.


    Hi Dr Briden,

    In your experience have any of your endo patients ever had elevated liver enzymes?
    I’m taking no meds and my doctor and I are baffled. I take a lot of ibuprofen for the pain but he didn’t think that was it.


  52. THANK YOU Dr. Briden!

    I got your book and devoured it – as well as ALL the replies you wrote to all the questions a/b endo on your blog. I was recently diagnosed with endo after surgery 3 weeks ago to remove a 4cm endometrioma (and a 10cm fluid filled cyst). Surgeon removed the cysts and took samples of the endo he found on my uterus but did not excise the endo. I have been 100% dairy/gluten free for 7 years and have Hashimoto’s. I also highly suspect PCOS. (I did try to make an appointment with you but Lisa V. said you can’t work with patients in the US. So I’m writing here to see if you would please be able to answer some general questions).

    I have read everything I could find online but haven’t been able to find answers. Would love any insight you could provide:

    1. I have low ferritin (~23, with total iron 77) and have been advised by my doctor to take iron. BUT that was before the endo was diagnosed. I’ve since read some things about iron overload promoting endometriosis and wonder what you think about this theory and if you would suggest iron supplements for low ferritin (~20). Here are links a/b iron overload and endo: https://molehr.oxfordjournals.org/content/14/7/377.full, https://www.ncbi.nlm.nih.gov/pubmed/12372445, https://endometriosis.org/news/research/overload-of-iron-in-the-pelvic-cavity-may-promote-proliferation-of-endometriosis-lesions-epithelial-cells/, https://bloominuterus.com/2016/03/30/endometriosis-iron-levels/ and some even recommend iron chelator: https://www.medicalnewstoday.com/opinions/109729

    2. I read this: https://www.medscape.com/viewarticle/712830 and wonder what you thought about using pills to reduce recurrence of endometriomas? I’d rather not take them if possible. I am dairy/gluten free (have been for 7 years) and newly sugar free. I plan to try all the supplements you suggest in your book to see what works for me. I don’t want to take birth control pills, but I also don’t want to harm my body by having endo progress. I see you wrote above “my clinical experience immune-modulating treatment is far more effective than hormonal suppression.” so I’m guessing you will say supplements/diet will work just as well if not better than birth control pills but I wanted to check to see what you thought (I’m 47 but still ovulating regularly and have family history of heart disease, osteoporosis and dementia so I want to delay menopause for those reasons)

    3. I’m trying to find ways to measure how my endo is progressing or regressing. Do you think pain is a good way to do that? I have very high ANA and high CA125. Would you say those would also be good markers to see how my diet/supplement changes are impacting my endo? (could high ANA be caused by endo?)

    4. I read that using a heating pad for cramps can cause adhesions – that somehow it can cause the fascia to ‘melt’ and cause adhesions. (https://peacewithendo.com/2017/01/stopped-using-heating-pad-endometriosis-pain.html) Would love your thoughts on this. I love my heating pad and would not want to give it up but would of course if it was causing damage.

    5. I read that you said we don’t need to restrict meat as long as it’s grass fed and raised without antibiotics. Does this include bison and beef? I ask because I’ve read elsewhere that it’s not good to eat red meat if you have endo so I wanted to double check. And what if it’s grass fed but grain finished? (it’s hard to find grass fed AND grass finished)

    6. I also saw that you recommend dairy free diet which I’ve been on for years. But you said goat and sheep cheese is okay. What about buffalo cheese? Is that okay too? I will only try these after being pain free for a couple months.

    7. I know you said “There would be greater benefit from a product with only one or two [probiotic] strains. I’m on the look-out for a new “endometriosis” probiotic.” Can you please explain why getting a single strain probiotic is better than a combo? Meaning if I could get the recommended amount of specific strains in a multi probiotic, why would it matter? Would it dilute it or possibly compete?


    • Yes, I’ve seen the research that iron may be part of the pathogenesis of endometriosis, and I had one patient whose endometriosis flared very badly after an iron infusion. So I’m cautious with iron. But if iron is very low, then yes I give a supplement.

      I think immune-modulation is the starting place for every endometriosis. But then Yes, some women also need post-surgery hormonal suppression with the Pill or preferably Mirena.

      I primarily use symptoms to monitor, but yes, sometimes uses CA-125 as a gauge.

      I have not been aware that heating pads are a problem.

      Beef is more immune-reactive than lamb or venison. With my own patients, I prefer lamb, venison, duck, chicken, fish, turkey.

      Yes, with my own patients, I find it’s ok to have goat, sheep or buffalo. (Milks that do not contain A1 casein)

      • OMG THANK YOU!!! You are such a godsend! I am so grateful I found your book/blog and for your reply!!!

        I do have two more questions about supplements:

        1. Do you think it’s a big deal if supplements have manitol, sorbitol, soy lecithin, magnesium stearate, steric acid (vegitable source) or the like? I try to get high quality supplements, and most of the time I do a pretty good job, but I spend a small fortune on supplements and sometimes it’s hard to avoid. Obviously I try to find those that don’t have these things but I wonder what you think about this? Are they okay in small doses or should we definitely not be taking supplements with these things in them? (I did find this https://chriskresser.com/harmful-or-harmless-soy-lecithin/ and https://chriskresser.com/harmful-or-harmless-magnesium-stearate/ where Chris Kessler thinks Soy Lecithin and magnesium stearate are probably ok in small doses)

        2. I want to take magnesium glycinate for period pain/detox/suspected borderline insulin resistance/stress (my magnesium is borderline low) but when I take it, it gives me diarrhea. What would you suggest? I do take it with food. I wonder if I should skip it altogether, scale back the dose, or just not worry about the since I do think I am better off with more magnesium in me.

        Thank you again!!!

  53. Hello Dr. Briden,
    I want to know what do you think about proteolytic enzymes as a treatment for endometriosis? I’m diagnosed with endometriosis and I had a laparoscopy last spring. Since that time I had a little pain at the region of the ovaries periodically. Short but very sharp pain, like from a knife. I read a lot about proteolytic enzymes ( serrapeptase, nattokinase and bromelain). I began to use them a month ago and I notice a big difference at my ovaries. This sharp pain is missing right now.
    I also take omega 3, zinc, magnesium, NAC, vit E, ubiqinol, inositol, L-arginine, folate and D3 more than a year (before and after my surgery) and I could say that my ovaries works perfect every month, I have regularly ovulation even at the “ill” ovary.

    • Proteolytic enzymes reduce inflammation, so I can understand why they would improve endo. I would recommend using them as part of a broader anti-inflammatory protocol, including diet changes.

  54. Hello and thank you for your blog. I am considering trying Mirena for managing endometriosis pain. I`ve read that it may aggravate yeast overgrowth. What do you recommend to take at the same time to prevent this from happening? I am on candida diet, but it is not enough to solve the problem, I also have leaky gut. I was also offered to try dienogest 2 mg. What do you think?
    Thank you so much!

  55. Hello and thank you for your post.

    What brands of Turmeric, Berberine and probiotics do you usually prescribe for endometriosis?
    Also, of the treatments (selenium, rosemary, NAC (N-acetyl cysteine), DIM (diindoylymethane), fish oil, castor oil packs, and natural progesterone) can be combined with Vitex, Turmeric, Zink and Magnesium?

    Thank you very much,

    • I usually use Thorne brand.
      In general, yes those treatments can be combined, but please consider speak to a clinician about your individual case.

  56. Hi Lara,

    I am very thankful that I found your website – thanks for all of the information!

    I am 24 years old and have just been diagnosed with endometriosis. I had a laparoscopy 6 weeks ago and they removed as much of it as they could. There was a lot that they were unable to remove due to its closeness to vital organs/arteries. The idea of any form of hormonal therapy really doesn’t do it for me and I was hoping to avoid it at all costs. But I had a review with the gynecologist two days ago and she told me that I have an extremely severe case of endometriosis and that suppression of periods is the only option if I want to maintain my fertility. She said that she is afraid that if I don’t have intervention now, I probably won’t be able to have children in the future.

    I am scared because I really don’t want to take the pill or have a mirena put in, but I also don’t want to risk my future fertility, given how severe the endometriosis is already and I don’t intend to be having children any time in the near future. I have decided to go ahead with a mirena because I see this as a better option than the pill.

    My question is, given that a mirena is a progesterone-only option, dietarily, what should I be eating to try and balance my hormones? I have read a bit about how phytoestrogens can worsen endo but I don’t want to avoid estrogen in foods if I am having a dose of progesterone everyday. What are your thoughts on this?

    Thank you! 🙂

    • To be honest, I think Mirena is an acceptable option for endometriosis treatment. I agree with your GYN that sometimes a form of hormonal suppression is required. But keep in mind that Mirena is not progesterone. No types of hormonal birth control contain progesterone. For more information, read The Crucial Difference Between Progesterone and Progestins.

      The good thing about Mirena compared to other birth control is that it permits some normal hormonal cycling, and permits your body to make some real progesterone. (Read The 7 Superpowers of Progesterone)

      But from a natural treatment perspective, the main focus for endometriosis is not hormones, but is immune function, and to reduce inflammation. I discuss that here and in my previous post: Endometriosis Is an Autoimmune Disease. That means strictly avoiding inflammatory foods such as gluten and dairy, and also using supplements such as zinc, selenium, turmeric and maybe berberine (preferably under the supervision of a herbalist).

      Phytoestrogens don’t worsen endometriosis. If anything, they help it because they block estrogen.

      • I react strongly to phytoestrogens. If i have anything with soy ( i.e. soy milk (organic) ) i get endo flare up. Every single time! I suspect the same with flax seeds/oil as well but have not tested it enough to draw a conclusion yet. But am extremely sensitive towards soy. I have endo stage 4.

  57. Hi Lara – are there any essential oils you would recommend for pain? I am willing to try anything and everything.

    I’ve been struggling with severe pain for over10 years and it always forces me back to the pill. the pain started out of the blue right when I started college. I had had some pain in my teen years but it was bearable and “normal.” when I got to college it was the kind up pain that woke me up at night…looking back it was nothing compared to what I go through now. I would use Arbonne’s progesterone cream on my stomach when the pain hit me and it seemed to help the immediate symptoms but they never stopped coming back month after month. by my 4th year of college they were much worse. I would get up in the middle of the night and have to walk around for the pain to go away so I could go back to sleep. again, looking back, that pain was nothing compared to now. I had always been a little overweight but when all the pain started it seemed like I just started packing on the pounds as well. I have ALWAYS been active. I played college sports so I was always working out as part of it. I eventually quit softball my senior year of college because my pain was so bad.

    it was also in college I started getting UTI’s on a regular basis (usually during final exams) so I had my first trip to the gyno and was put on the pill. All of my pain on the week leading up to my period was gone! I was so happy. after college I moved to Tauranga, New Zealand to work for a church through a program ran by my home church in Oklahoma. while I was there I ran out of my stash of birth control pills and thought I might as well just quit. my mother has always believed in homeopathic/natural medicine so I always had some guilt being on the pill, knowing that it was not good for me but I truly felt like I had no quality of life when I was off of it. it didn’t take long for the pain to come back. after my year in NZ I came back to Oklahoma and started a new job and the pain progressively got worse. it went from being a couple days before my period to an entire week and then to the point that the only time I was not in pain was when I was on my period. I started going to a nurse practitioner that allegedly specialized in hormones and found was told I had a thyroid problem, was insulin resistant, and had PCOS. so she put me on synthroid, spirinalactone, metformin and progesterone cream. I had been suffering with fatigue, to the point I was dozing off on the way to work and the synthroid seemed to help for about a week and then I would go back to be pretty tired. I had major stomach issues with the metformin…I won’t get into the graphic details of that! and the progesterone cream seemed to intensify my pain to the point I started passing out in the middle of the night it got so bad. I never felt like I knew what was going on with my heath. when I went back for her to check up on everything she changed dosages of the synthroid. not sure if this is normal but it was like we could never get it right. I was still working out 5 days a week and unable to lose weight, i was stressed out from the pain, work, not losing weight, being tired all the time. the pain was so bad i would have anxiety about being invited to walk to lunch because i know it would result in pain and that was embarrassing to me. i felt like i couldn’t live a normal life and went back to the pill.

    fast forward 5 years and i am now married and we are ready for a baby. I have been off the pill for 7 months and trying. my pain immediately came back when i got off the pill. it started off a week before my period and now it starts already a little over two weeks before i start my period. my periods are very regular, as they have been my whole life. when i came off the pill i immediately gained 20 lbs in the first 3 months all while hitting the gym 4 days a week during my lunch break. i thought most people lost weight when they got off the pill!? I’m not sure if i have gained more than that at this point. I am too scared to get on the scale. I am not 5’2″ – 270lbs. I have yo-yo’d with my weight since the whole journey through this pain started but this is heaviest i have ever been and i am terrified. two whole weeks out of the month i now don’t feel well enough to exercise. I started seeing an herbalist back in July and after reading your book and the labels of my herbs, i am on most of the things you suggest. i also started progessence plus young living oil about two weeks ago. I know any day the pain is going to arrive. The stress the pain causes in my life is destroying me. I feel so mentally weak and trapped. I have had vaginal ultrasounds in the past and there had never been signs of cysts. after much personal research and reading your book it is clear my symptoms line up exactly with endometriosis. I am so concerned about infertility. My mother had 8 children, never any issues, and the 4 of my sisters with kids have all conceived the first 3 months of trying. i have one sister who has been told she has thyroid problems and PCOS and she conceived 1 month after coming off the pill. I don’t even know where to start. sorry for the long post…i obviously don’t know where to stop either!

    • Sorry to hear about your troubles. Does sound like you’ve been through a lot.
      The most effective natural treatment for endometriosis (if you do have endometriosis) is to remove the inflammatory food cow’s dairy from your diet for a few months. Have you tried that?

  58. Please write more on endometriosis. Of all the information I find online, your knowledge makes the most sense and I am eager to follow your protocol. Thank you.

  59. Hi Lara,

    I’m so happy that I found your blog and your book. Since reading both I’ve finally gotten the courage to stop taking my BCP, lo loestrin. I was told that the only cure for endo was BCP, and I’m so happy that is false!

    Besides the endo, my biggest struggle right now is chronic telogen effluvium which has being going on for 17 months. Under the advise of my dermatologist, I’ve stopped the lo loestrin in hopes that I’ll ovulate again and perhaps regrow some of the hair loss. As far as the endo goes, my plan is to cut out dairy like you advised (I’ve been gluten free already for 3 years) and follow the other steps you’ve suggested in this post.

    I did want your opinion on my hormones if you’d be so kind—-I’ve never gotten a straight answer from my endocrinologist in regards to my levels. I was wondering what you thought? These results were taken last year when I was still on the lo estrin. I’m aware my levels will change now that I’m off:

    Free Testosterone: 0.9 ng/dL
    Testosterone, Bioavailable: 1.8 ng/dL)
    Sex Horm. Binding Glob. SHBG: 85 nmol/L
    Albumin: 4.3 g/dL
    Insulin Like Growth Factor: 203 NG/ML
    DHEA-Sulfate: 105 mcg/dL
    Prolactin: 18
    17 Hydroxy Progesterone: 14
    TSH W/FREE T4 RFX: 2.08 (Range: mIU/L 0.4/4.5)
    ferritin level was 68.

    Thanks so much in advance.

  60. not only is your description of endometriosis erroneous, you imply dietary changes “treat” endometriosis, which is misleading and unkind. Diet changes can ease some symptoms, they DO NOT treat endometriosis, that is only done thru skilled removal of the lesions. It is very distressing to see such misleading information put out to women who are already suffering greatly

    • thanks for your comment Nancy. Yes, I agree that surgery is an important part of treatment of endometriosis. If you had read the entire post, you’d see that I list surgery as the first treatment option.

      • Nothing was misleading. Food and herbs are medicine and in most cases you can heal your body without invasive procedures. Do your research, stay open minded, consistent and keep trying different approaches till you find what your body is looking for. Most Drs in all reality have not even taken a course on nutrition and they are called “practices” for a reason. Dictated information only takes doctors/people so far.
        I’m healing from conditions I was told would nEVER get better from. I was told that I would more than likely be bed ridden for the rest of my life at 22!!! After two years of changing my diet and taking herbs I’m walking again, cooking my own meals, can mentally function and am able to drive short distances. Believe in the power they never told you that you have. Remember this is your body and you live in it, own it and care for it. ??❤️?

  61. I am 46 and hypothyroid- took me more than 12 years to be diagnosed. Had surgery 6/20/2016. One month later I have so much pain and cramping I can’t sleep think or function. I was told mine was on left pelvic wall and behind uterus – my doctor has never seen me since surgery- I told him explicitly no steroids in surgery as I have VERY bad reactions to them. Found out later he never write in my chart – blamed others for the issue- two weeks of no sleep- headaches- high heart rate and crippling depression- he offer zero help. Now my overies are screaming and no period. Nothing stops the pain but in nyc they will never give u a pain killer. Also my b12 is 167 and I have Hashimotos – I take t3/4 combo. Steroids made me lose my hair instantly. We r also looking for a reproductive endo because although no hot flashes night sweats- my FSH is literally jumping from10 to 120 in 2-3 weeks. Then my body is trying desperately to have a period it can’t have. Imagine PMS 90% of the time. Every doc I’ve been to says these numbers are like anything they’ve ever seen. 10 point jumps yes but 120 in 3 weeks? No RE will see me if I can’t do IVF. Meanwhile I’m suffering so bad – surgery I did to help myself made everything worse. I’m in my final year of school and if it’s not better I lose school- any chance for a decent job. Pluse the pain now is unendurable- I’m lost. What can I do???

  62. Lara ! You are seriously the smartest ND all of us nutritionist have ever met! Can you kindly tell us again what brand supplements in Australia do you recommend—” probiotic strain Lactobacillus gasseri OLL2809 stimulated natural killer cells and significantly reduced endometriosis pain after just 12 weeks. I often prescribe a two month course of berberine followed by a two month course of a probiotic.” THank you

    • Thanks Michele. You’re sweet. Othoplex MultiFlora contains gasseri, but it’s a different strain, unfortunately. I’m speaking to the reps.

      • HI Lara, thanks for the probiotic info. Please keep me and my other nutritionist informed when you here back from the reps. x

  63. My friend directed me to your website. I’m 35 and was diagnosed with endo 5 years ago although I’ve suffered with awful pain since my teens. Everyone put it down to “period pain” so I accepted it and just believed I had a low pain threshold so just gritted my teeth and got through it.

    It all came to a head when running my own business is had the pain so much for a long period of time (2 -3 weeks at a time) even though my period had finished. I couldn’t sleep was taking paracetamol (max daily dose) but it was doing nothing. I was self diagnosing on Internet and thinking I had appendicitis called the non emergency doctor (3am) the only thing which helped was to sit in a hot bath but doing 15 hour shifts every day meant this wasn’t an option!!
    I drove to the hospital as I didn’t want to make a fuss and that kept me in.

    Over a period of time and endoscopy they diagnosed me with extensive endo and cysts on my ovary. So large it had pulled the ovary round, twisted my Fallopian tube and stuck to my bowls.

    For 6 months it seemed to be better but now I’m getting the pain again, sometimes for up to three weeks at a time. I regularly take co codamol 30/500 mainly on an evening before bed as its too strong while I’m working so have to make do with normal pain relief which takes a very slight edge off but the side affects of it (constipation) can actually make the endo more painful as it applies pressure, It’s a vicious circle.

    Reading your article is interesting that there are other ways to hopefully treat it/ease the pain so going to give them a go. It’s interesting to read other people’s accounts and makes me feel better about myself, that I’m not just making it up, or have a lower threshold of pain or that I’m just being a hypochondriac (I thought this for so many years)


  64. I’m so pleased to have found your blog. This is all so interesting! I’ve just ordered your book in the hope it may help me find some answers to my current period problems.
    I’ve had 20years of normal periods without taking any pill. Had 2children by emergency c-sect. And only now, 3and half years after my last child, am I having period problems. Sharp pains on day one and 2 and pain in sex. The consultant is leaning towards endo. I’ve been so frustrated by his comments that “period pains are normal!”. But I know this is definitely not normal for me.
    I’m currently on a prescription of Tranexamic Acid, which has eased pain – but I feel uncomfortable at the fact it’s stopping my normal bleeding, even though it has reduced the pain. I can still feel the central pressure point inside where the pain originates from however.
    Do you comment on the use of this drug in your book? What are you opinions of it?
    So encouraged by your research.

  65. When I eat meat I have extreme heartburn/indigestion and at the very slightest gag I projectile vomit. I also get a bloated belly from meat. I eat Dairy on rare occasions and this doesn’t happen with Dairy. I am mostly eating plant based only and no meat with very little Dairy. I am worried about this lifestyle effecting my PCOS, but I can’t continue on with the meat as these symptoms make me absolutely miserable. I went my whole life with these symptoms never knowing it was the meat and had to take antacids daily and had extreme irritable bowel and stomach pain as well as gas, etc. As an adult, I found out I have a lot of nutritional deficiencies (iron, b complex, magnesium, d, zinc) and I bet the digestion issues are why. My guts must be tore to parts from this abuse. Sorry for the long background, but here is the question: theoretically, in a case like mine, do you think trying to eat high protein, low carb as is promoted for PCOS would do more harm than good? (I have tried to adjust to the meat, but I’m a year back in after leaving it for two years and still no improvement) in my case, would plant based be the healthiest option for my PCOS? I have Candida problem really bad, I don’t know how to heal a leaky gut and Candida on plant foods only which is inevitably higher carb. So frustrated! I also get acne breakouts from the meat!

  66. Can Vitex be used for Endometriosis? I haven’t been officially diagnosed by my dr feels I likely have it based on my symptoms – frequent cysts, ovulation pain, short cycles. I was on birth control pills for over 15 years and after I had my last baby and stopped them was when I started to have all of these problems. I have regular cycles but they are 21 days so that’s extremely frustrating…not a lot of the month where I feel great. I’m 38 years old. Any advice would be great.

    • Just ovulation pain? But at no other times of the cycle? I wouldn’t immediately think of endometriosis.
      Please have a look at my posts: Iodine for Ovarian Cysts, and my What Dairy Does to Periods. That might lead you in the right direction. Also, technically 21 days is a normal cycle length. Have you read my book?

      More generally, no, Vitex is not my first choice for endometriosis

      • Thanks for your response. I have ovulation pain and sometimes cyclical cysts (always on the same side and always go away) and then general bloating my entire cycle. The odd part is the only time I feel non-bloated and have little pain of any sort is actually the week I have my period. I had started DIM and Ultimate Flora probiotic with some relief of my symptoms but had read a previous post of yours around Vitex and controlling hormonal issues so wondered if that would compliment the other two supplements. I had started taking Vitex at the end of my last cycle and seems to have actually made things worse along with increased breast tenderness…so made me wonder if I should wait it out. However it seemed odd that something to help made things worse almost right away.

          • Yes. I looked at your post about dairy…very insightful. I drink milk primarily just in my coffee but do eat cheese. If I cut out milk and the majority of cheese, do you generally see that being sufficient. Since it’s not the lactose exactly that causes the problem is it generally ok to eat other products that have small amounts of dairy like dark chocolate, bread etc?

          • It’s usually necessary to cut it out almost completely just for the first couple of months, including yoghurt. But butter is okay. Also goat and sheep cheese are okay. Good quality dark chocolate doesn’t have dairy.

        • It’s simply not as effective as the other options I discuss here. (Because endometriosis is not an hormonal condition–it’s an inflammatory disease.)

  67. Lara; would taking Myo-Inositol, D-Chiro-Inositol and Goat’s Rue together be too much and cause blood sugar too go too low?

    • I don’t often prescribe goat’s rue (except as part of a combination product). My first choices for improving insulin sensitivity are magnesium and berberine.

          • Oh really? I didn’t think it was toxic. I thought it was a myth, because the places you find it promote it for breastfeeding in aggressive amounts.

          • It contains the active ingredient guanidine, which was used to treat diabetes in the early 1900s until it was found to be too toxic, so it was discontinued. (Its derivative metformin is less toxic.)
            The whole plant contains a significant amount of guanidine, I believe, so I’m cautious. At high dose (5g/kg) the herbal medicine is toxic to rats: https://www.ncbi.nlm.nih.gov/pubmed/18055147

  68. Hi, Dr. Lara, I am aware that Berberine could possibly cause a build up of lactic acid in the body, so I was wondering if L-arginine would help prevent this as I understand it helps the body detox lactic acid. What do you think?

  69. Hi Lara,

    I am not sure if I have Endometriosis, but I do have PCOS and I have a story I’d like to share and hear your opinion back on. Ok, so I was always in miserable pain during my period since I started them at 13. I usually bled for ten days or so and it was heavy. At 21 I decided to go vegan, so to substantiate I ate a lot of rice & beans and stuff like that. No fake meat or dairy or anything like that. My periods were great! I would hurt, but usually only the first day or two and I only needed one or two Ibuprofen the entire period and sometimes none at all. Well, at 23 I found out my iron and b vitamins were low, so I decided to start eating meat again. While in the beginning of the transition, I ate less meat and built up to having it regularly. I regretted it instantly. My periods hurt fiercely and they’re so heavy like they were before and I need the Ibuprofen everyday of my period, several times a day and I break out all over my chin/jawline. I hate it! Anyway, whether I have Endometriosis or not, I do need to heal my gut. I have big problems with Candida. But I feel like I am in a hard place, because when healing your gut everyone’s good advice is to avoid grains and legumes and nuts and seeds…but I desperately want to go off of the meat and go back to these foods! My periods hurt and my belly feels tight and bloated when I’m menstruating. I also get pains in my belly button and in my tailbone area. My question is, do you think I can still heal my gut while eating these foods as my main food sources? The second question is, do you think I sound like Endometriosis and/or histhamine intolerance? I only get this problem when I eat meat/dairy, however if I recall these aren’t the only high histhamine foods, so I don’t know what is going on. I hate this, please lend your opinion!

      • No, I did not reintroduce Dairy, just the meat. I am wondering if it increased my Estrogen and I am having a response to it….a negative one….maybe due to Endometriosis? Not sure. I don’t like what is happening.

  70. Greetings,

    I have read there is a direct link to the gut with Adrenal PCOS. What is your opinion on products such as Pure Encapsulations Purebiomood, Probiotics that claim to promote healthy Cortisol/Stress levels? Is this the future of Adrenal PCOS?

    Thank you heaps!

  71. When Estradiol is low and Estrone is high in comparison and you’re in your early 20’s…should one use an Estrogen detoxifier?

  72. Dear Lara, is there something wrong with the blog? Comment count keeps increasing, but I’m not seeing any new comments. Thanks. 🙂

  73. Dr Briden, what is the daily dose of Berberine that you recommend for healing the leaky gut which is so important to auto-immunity and hence, relevant to endometriosis and for how long to take berberine – is 2 months OK? I am also curious about your recommended regimen for Oregano Oil to take in conjunction with Berberine. Lastly, should we be taking Berberine and Oregano Oil alone first for a couple of months, followed by probiotics for repopulating the gut with good bacteria OR should we be taking the probiotics in conjunction with the oregano oil and Berberine? Thank you!

  74. Dr. Lara,

    Is it okay to take Aromatase inhibitors such as Curcumin when you have high 5a-reductase or will it make things even worse? Isn’t it true Aromatase only inhibits the conversion of Estrone and not Estradiol? So in that case it should be fine, correct?

      • Hi, Anne. Thanks. I am aware that it is an anti-inflammatory, but my main question is regarding it’s effect on Estadiol and how inhibiting Aromatase with Curcumin will effect someone with high 5a-reductase…as in if it would worsen that imbalance.

      • Dr. Briden,
        If I am understanding this thread right, then will turmeric possibly help with high testosterone and DHT? Could it then help hair loss (pcos)? Is turmeric safe for those with MTHFR? Thank you for your help 🙂

  75. Dr. Lara, what causes 5a-reducstase to be elevated in women? Is there anything we can do to lower it, without the use of anti-androgens? Such as, can it be elevated due to inflammation or insulin resistance or say stress and could treating these causes reduce the 5a-reducstase?

  76. Dear Lara,

    I have been reading your book over and over again for the last three months, recommending it to all of my friends.
    I have bought most of the supplements that looked relevant to my problems, but it does not seem to work.
    Recently I have visited a gynaecologist.

    The Doctor prescribed me a Duphaston (dydrogesterone).

    She has guaranteed that this will regulate my period and might regulate my elevated LH.
    It looks like I have autoimmune PCOS.

    However I can not find anything about this medicine (dydrogesterone) on your blog or in your book.
    Is it beneficial?

    Thank you for your book,

    Best wishes,


    • Hi Lena, great question about dydrogesterone (duphaston). It is the most progesterone-like of all the progestins, which is why it can be used during fertility treatments. Also, it does not suppress ovulation. Some doctors give dydrogesterone in situations where others would use micronised progesterone (natural progesterone), but I think that micronised progesterone is a better choice for most women.

      So, if the questions is: Can a progesterone supplement work to suppress LH and help to regulate the period? Short answer is Yes. But without knowing the details of your case, I cannot say for sure whether it will help you. Have you had all the blood testing that I suggest in Chapter 7? Including tests for insulin and zinc and vitamin D and thyroid and gluten?

      • Dear Lara,

        Thank You for your reply. Duphaton has been prescribed to me as the only progesterone solution that the gynaecologist could offer. Otherwise she was offering a pill, which is out of question. There was no option of micronised progesterone. I wanted a progesterone cream, but it is not an accessible in Europe. I have been to endocrinologist as well which has said that my thyroid activity is normal (from the blood tests), my insulin levels are normal (56.90 pmol/l), selenium (110), vitamin d( 125.50nmol/L), magnesium (0.86 mmol/l), iron (16.99 μmol/L) – everything was in the range except LH. She said that my endocrine system is not effecting my ovaries, rather they are not working because of some other, autoimmune reason (my cycle is 58days). I have not measured Zinc but I take the supplement. I had quit the gluten for a year before and it made no difference after coming back to it. My periods were irregular, before, during and after the diet. I am not sure if there is a test to measure sensitivity for it if you are not celiac?

        My concern is if in a long term duphaston is worth giving a try or should I try to substitute it with a natural progesterone?

        Can coffee and sugar be effecting my elevated LH? Even if my sensitivity to sugar is normal?
        I am considering that I have an autoimmune ovarian condition.

        Thank You for your comments again,

        • I believe micronised progesterone is available in Europe as the brand Prometrium.

          Coffee would not be affecting your LH, but Yes, sugar could be. Your insulin is a bit border-line. As I explain in my book, the cut-off for insulin is 60 pmol/L, and you are very close to that. Insulin resistance causes high LH.

          • Actually I have found some studies about coffee affecting LH. I was trying to understand how to lower it and many results were mentioning connection between these two things.
            Could you please share your opinion on this popular opinion that caffeine does affect LH by rising it:

            “Caffeine’s effect on LH is pretty straightforward”.
            Eating or drinking caffeine-containing foods and beverages can react with LH and cause adverse effects.

            Caffeine inhibits the action of adenosine, which in laboratory studies affects luteinizing hormone and follicle-stimulating hormone (31, 32), which could in turn affect menstrual cycle length.

            Here it shows rising in prolactin levels in animals:

            I am concerned about caffeine,
            but for now I will cut sugar out.

            Thank You.

          • How interesting! Thanks Lena. I couldn’t find the original research cited by the the Livestrong article. Could you? It actually says that it increases the LH surge, which would be a good thing. When it comes to LH, there’s a big difference between baseline LH and pre-ovulatory LH surge.

  77. I wish I had seen your site and read this article a few years ago, prior to having a partial hysterectomy and the surgeon performing an unauthorized ovarian drilling (I have PCOS). Worst mistake of my life since it has resulted in a multitude of other issues including premenopause at 42, constant heat waves (not really a flash), dry skin, bone numbing depression, etc.

  78. Thank you, Lara. I have read all your related posts, but am still left bewildered. Could insulin resistance be causing my adrenal androgens?

    • Generally, no, insulin resistance does not cause elevated serum DHEAS (adrenal androgens). Yours was a urine test, which I’ll be honest, I do not routinely order, so I am not confident to interpret. It might be worth also having a serum DHEAS test just to pin down that it is indeed adrenal androgen index.

      • I will definitely make sure to get the DHEAS by blood! Previous by blood I had my DHEA tested and it came back as 21 ng/dL with reference range <6.6 ng/mL H. Is there anyway to make a guess about weather or not this is likely adrenal or ovarian when Insulin Resistance is present?

        The 24 hour urine Testosterone looks suspicious of being high to me, but I don't know. It was 23.1 μg and reference range was 5.0-35.0 μg. Being that a reference range is just a guide, do you feel being closer to the higher end on the reference might show high Testosterone?

        And, I called the lab and they told me my Insulin Resistance was considered moderate, not mild. I am starting to believe I am ovarian, not adrenal. I was confused, becaude my Endo told me he tested my DHEAS, but my record says he did not, he tested DHEA.

  79. Hi, Lara. I had a 24 hour urine test with DHEAS very elevated at 4958 μg. Testosterone says normal at 23.1 μg. Androsterone is high at 5868 μg. My “Enzyme Phenotype Assessment” says Androsterone/Etiocholanolone Ratio: 2.64. HGH 803 pg. Estradiol 3.7 μg. I was on day 11 of my cycle during collection. Do you think my Estradiol is low and do you think I fit Adrenal PCOS?

    By Blood on cycle day 8 my FSH was 4.4 and my LH was 5.1…is this good or bad?

    There is also mild IR…does this mean I have two types of PCOS? Should I use Licorice & Peony?

    Thank you

    • It seems like my adrenals and/or ovaries aren’t responding to my brain. Would Licorice & Peony, Vitex & Tribulus be good choices, for me, then?

      • Can you recommend some 5a-reducstase inhibitors? My Estradiol was 3.7 μg on cycle day 11 and my Estrone was 20.2 μg DHEA (not DHEAS) was 4958 μg and Testosterone 23.1 μg. Am I candidate for DIM? And either way, can you tell me a few supplements that inhibit 5a-reducstase besides GLA, Saw Palmetto and Licorice? Thank you!

  80. Hello Dr. Lara. Was wondering what your opinon is on Traditonal Chinese Medicine for Adrenal PCOS & Endometriosis. Thanks.

  81. Is it ok to take Rhodolia, Ashwaghanda, Holy Basil, Schizandra chinensis, Fenugreek, Licorice and Peony, Evening Primrose Oil, Fish Oil, Oregano Oil together?

  82. Hi, Lara

    How is Tribulus and Vitex used for ovulation? Is there certain cycle days to use them on? Currently I don’t ovulate and my Estradiol is extremely low. It might be due to over stimulus of my adrenals, so I am going to try Rhodolia, but since my Estradiol is so low, I am not sure this is enough to bring it up. Anyway, I am 26.

    • Yes, with my patients I sometimes cycle Tribulus and Vitex to stimulate ovulation BUT only after first ruling out all the different reasons for failure to ovulate. Please see Chapter 7 of my book.

      • Hi Lara, what is your view of prolonged water fasting (20 days and more, but at least 10) as a natural treatment of endometriosis? It is present in miracle remission cases of the disease and is discussed as the ‘Ideal diet” (and we know diet is important if not crucial) which resets the endocrine and gastro-intestinal system. The view is that thus it promotes the immune system and resets hormonal processes and hormone production. Also what is your view on doing a water fast in conjunction with hormonal therapy (i.e. Zolodex, Lupron, etc) or doing a water fast following or preceding a hormonal therapy – does timing matter? There is the view also that water fasting immediately after a laparoscopy / surgery allows the body to heal and “eat up” the pathological endometrial cells dislocated and growing outside the uterus. This is a novel view of treating the disease which is linked to the view that endometriosis might be a secondary immune deficiency symptom if not a primary auto-immune disease. What is your view on this as a natural remedy? Thank you!

  83. To cut a long story short – I see that my question very much relates to the previous question by a reader on the recurrence following a surgery.

    Do you think that conventional medical treatments like Zoladex must be undertaken or that it is preferable that they are undertake following a laparoscopic surgery (1st time such) to prevent recurrence. Are the hormonal conventional medicinal treatments, specifically Zoladex, critical to preventing recurrence after a surgery, provided the patient will be abiding strictly the Endo diet plus functional medicine approaches to disease management through food and supplements. Also provided that they have been at least until the reason for the surgery (a cyst) surgery, largely asymptomatic. My unbearable pain only appeared after the growth of a 7.5 cm/ 3 inch endometrial cyst following (3 months after completion of) an IVF high-estrogen stimulation (twice) over the course of a year. The laparoscopy was done 2 months after the appearance of the cyst which grew large and was causing excruciating pain. Up until the growth of the cyst, I had no pain. After surgery (2 weeks later) pain is gone but I am afraid of a recurrence, progression of the disease, and appearance of pain as a symptom of the disease going forward. Do conventional medicinal treatment like Zolodex first, followed by Endo diet/functional medicine makes sense, or should I skip Zolodex and stay on Endo diet/hormone balancing/immune system reset/functional medicine course? What are pluses and minuses? Thank you!

  84. Dear Dr. Brindern,
    I am very interested in the link between endometriosis and the immune system and functional medicine through diet, herbs, supplements including water and juice fasting (which have been shown to reverse many other autoimmune conditions via a reset of the immune system). I was just diagnozed with endometriosis 2 wks ago during a laparoscopic surgery to remove a big cyst that formed after 2 IVF stimulations which I undertook to freeze my eggs (I was 39 and with no partner at the time). Results from the stimulations were fabulous and showed well functioning ovaries and my FSH/LH hormones were great. I undertook the stimulations unknowing of my condition, which the doctors were not aware of either, and that has obviously led to a massive attack of estrogen in the body. The endometriosis diagnosis was a surprise to me as until the appearance of the endometrial cyst 3 months past the IVF type stimulations, I have been asymptomatic for endo – no pain, no irregular or heavy periods, no pain during sex, no backpain, etc. I was diagnosed, however, with IBS (a symptom) 7 yrs ago. However, after multiple functional and system tests the IBS was attributed to a highly stressful period in my life at the time which was taken to have triggered it. I am a good eater – for years I have taken no processed food whatsoever, pretty much am off red/white meat, but have not put a conscious emphasis on Omega-3 foods either, whether that is fish or vegetables, was a vegan for 2 yrs. I was on minimal diary, eggs, no junk food, no soda drinks for years. I ate/eat mostly plant based whole grain diet close to the source. BUT I eat gluten a lot and take a lot of coffee and alcohol (red/white wine only but a few times during the week).

    After the diagnosis 2 wks ago, I have immediately adopted – very strictly – the Endo diet and have started taking some of the recommended supplements. I cut out all gluten, coffee and alcohol. I would also like to do a waterfast or a mostly-green-juice fast for 10 days or longer (like Joe Cross from Fat, Sick and Nearly Dead) to reset the immune system. I would like to go the path of functional medicine and take all the steps for treating it as an autoimmune condition – repairing the gut, detoxing, reducing toxins going forward, stress, etc. I also know I need to balance my hormones through food, supplements, sport, sleep, relaxation techniques.

    My doctor who is a good traditional medicine surgeon, however, wants to put me on a 3 month Zoladex injection following the surgery and is warning me that not taking the Zolodex right now will be a grave mistake — i.e. the endometriosis centers cannot dry up past the surgery which can then lead to a recurrence. I am mostly afraid that the Zoladex, while it will switch off the estrogen production for 3 months and give a 3 month relief, it may also cause a further disbalance of the hormones and confusion of the immune system, as well as create other problems in the body which I believe functions as a WHOLE. I wonder what your recommendation would be for patients who have just undergone laparoscopic surgery for the first time, have been asymptomatic (at least so far), would be living strictly on the Endo diet going forward and emphasizing the functional medicine path in endometriosis management. I have not had kids and pregnancy (naturally or through IVF) is high up on my priority list too. I need to prime and keep my body for pregnancy and balance my system, not disturb it further.

    My question is: can taking the Zoladex for 3 months hurt, if it is done in conjunction with the Endo diet and taking the Endo recommended supplements (plus I guess other natural supplements to manage the side effects of the Zoladex/artificial menopause like hot flashes, calcium absorption deficiencies, etc.). I do plan to do a water or greenjuice fast to attempt to reset the immune system but I need to decide now urgently whether I take the Zoladex first and do the fast only after.

    I would also appreciate your views on water fasting or fasting on highly nutritious, alkaline (green) vegetable juices with some fruit (like Joe Cross) to reset the immune system, as well as the the stomach system (i.e. help the leeky gut syndrome). In many of the miracle stories reversing auto-immune diseases (from MS to Orticaria, RA, etc), prolonged water/juice fasts (supervised preferably) have been quoted as the miracle cure that has reset the entire system.
    Thank you advance for your thoughtful work!

    Appreciate your response which is a help to many women! I live in the U.S. but am living in Europe this year and your blog and responses to readers all the way from NZ is incredibly informative and so helpful!
    With gratitude, A

  85. Hello a comment in your March 15, 2016 article ‘Endometriosis 5 Natural Treatments that really work’ deeply concerns me. I would like your source information for the 50% of endometriosis lesions excised grow back, is this specific to Canada only? From my reading, research when a endometriosis excision specialist performs true excision (surgeon is truly trained in endometriosis excision procedures pioneered by Dr. Redwine my understanding is that the success rate is closer to around 90%, there are only approximately 100 out of 52,000 gyns in the US doing effective endometriosis surgery, I am not sure of number in Canada), I have read and heard from other endometriosis patients many medical professionals in women’s health say they are removing endometriosis expertly but are only burning (also known as ablation) top layers of endometriosis cells since this often leaves remaining endometriosis cells behind yes those grow back; there also are gyns excising some of the endometriosis cells but not all thus endometriosis cells are not completely excised or removed so endometriosis symptoms can worsen after a period of having none to little symptoms. My research on endometriosis when I decided on my surgeon lead me to the conclusion that many surgeons who have not been specifically trained in endometriosis excision only look for coffee grinds looking type endometriosis cell lesions not knowing that endometriosis cells lesions can be any color red, purple, black, brown, white even clear etc and come in all different shapes and sizes.
    Center for Endometriosis Care (CEC) in Atlanta, Georgia has great reference material on their website

  86. I’ve tried a ton of supplements for Endo. so far, and what’s helped me the most is Calcium D-Glucarate and TMG. Probiotics and Berberine cured my decade long struggle with candida, and for good.However, I’ve read that vitamins B and C encourage estrogen production…this is very worrying as I take these as well. Can this be true?

    • It’s not accurate to say that vitamins B and C cause estrogen excess. Also, please remember that the most important treatment for endometriosis is to avoid inflammatory foods such as dairy and wheat, and to take natural anti-inflammatories like turmeric.

  87. Dr. Briden,

    Do you recommend using menstrual cups if you have endometriosis? I have heard they can help lessen flow and even cramps for some women, but I have also read some concerns with the cups possibly making endometriosis worse? Are you aware of any scientific evidence for or against using menstrual cups at this time?

    Thank you!

  88. Dear Lara,

    My mom takes Levothyroxine for hypothyroid. She also has an enlarged heart possibly due to Lupus…not sure if she has Lupus, but is ANA positive. She has several stomach Ulcers, Raynauds, Fibromyalgia and frequently takes Ibuprofen and muscle relaxers. Is it safe for her to take Berberine for a respiratory and sinus infection antibiotics hasn’t helped? Also, are there any strains of Probiotics that may help or any other safe alternative? The only meds she takes are the ones listed. I know you don’t know her personally, but I just want to know if Berberine should be safe with these conditions and meds. Thank you!

  89. Dr. Lara

    I need your advice. I have Adrenal, inflammatory PCOS. I was prescribed a bunch of vitamins and I have several deficiencies, however I can’t keep any vitamins down (they make me feel nauseous, give me diarrhea and make me really tired) except ONE capsule of the multivitamin (but the serving is 3 Caps twice daily) and I don’t see much benefit to the one pill. Even the one pill gives me diarrhea, but it’s tolerable. I can also take a B-Complex alone, but that also gives me diarrhea. I have heard that maybe I need a better quality supplement, but the brand is Pure Encapsulations which is highly recommended. I have been able to take other supplements in the past such as I took an over the counter herbal sleep aid (it was Passionflower, Chamomile, L-Theanine or something like that. No vitamins in it) and Flaxseed oil as well as Probiotics, so I am thinking I just can’t stomach the vitamins for some reason, but could take other supplements. However, I’m worried, because I have deficiencies in D3, B12, B3 & B6 as well as my iron is low and suspected magnesium deficient. Do you have any recommendations on how to take control of my health without vitamins? My problem areas are I don’t ovulate (but I do have a regular period which is strange) and I am midly insulin resistant as well as high DHEAS. The goal for me is to correct Insulin Resistance, Reduce Androgens and to increase Estrogen and Progesterone by ovulating. Feeling very hopeless and scared.

  90. Dear Dr. Lara,

    I am working on Stress, Inflammation, Insulin Resistance, Gut Permeability and Androgens. I have put together the supplements I want to take, but I was just wondering if they can be safely taken together or if there are any that I shouldn’t take for longer than an allotted amount of time? Oh, and do you think the Reishi and the Evening Primrose Oil together would be too much anti-androgen? Is this too many herbs all together? I feel like I need it. Thank you for listening.

    B Complex
    Evening Primrose Oil
    Gaia Adrenal Health (Rhodiola, Holy Basil, Ashwaghanda, Wild Oats Milky Seed, Schisandra Berry)
    Goat’s Rue


  91. Hi, Lara. For Candida issues, what dose do you recommend of Oregano oil? Also, I see a lot of people complaining that Oregano oil has burned up or put holes in their stomach. How do you prevent this?

    • I’ve never heard of oregano oil burning holes in the stomach, and I prescribe it quite often. Also, I don’t often think in terms of Candida anymore. I think more in terms of dysbiosis and generally treating the microbiome. If thrush or chronic yeast infections are a problem, then I give a course of the probiotic strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 that I discuss in my book.

  92. Hi Lara,

    Thanks for your post. When I tried to get pregnant the first time with (up-until-then) undiagnosed endometriosis, I went on a super strict diet (no alcohol, caffeine, dairy, sugar, wheat, soy or red meat) and got pregnant within 6 weeks. That chimes with your statement that it relates to inflammation.

    I was also wondering what brand of supplements you usually recommend? I am reluctant to just go the shop and pick out any old supplement.

    Thank you!

  93. Hello Dr. Lara. I have adrenal pcos. I was wondering if when Licorice & Peony are taken together at a 1:1 ratio if the Peony cancels out the Potassium/High Blood Pressure related side effects of the Licorice? I see many women using this combo with success, but I thought Licorice was unsafe. Thanks 🙂

    • No, peony doesn’t cancel out the high blood pressure side effect of licorice. So, it must be used with caution, but most women are fine.

      • Dear Dr. Lara,

        I have a few questions. You say the cause of Adrenal PCOS is stress. I understand and agree, but what is the best way to treat? I don’t remember where I’d gathered this, but I recall reading some place that for people with HPA dysfunction there is Amino Acid deficiencies or imbalances or something to that effect. I am a fan of Dr. McCullough’s blog as well and I have seen you both recommend things such as PS 100 and L-Theanine as well as Rhodiola.
        My questions are, what is the best approach to the stress supplement wise? Would it be the Amino Acid route? Would it be the herbal route?
        Is Amino Acid deficiency the cause of this over stimulation to stress or is it just a treatment? Is Amino Acid Powder a good stress supplement?
        My next question is, what is the best Anti-Androgen for adrenal PCOS? Is Licorice the best? Thank you loads!

          • Thank you. When there is a lot of inflammation present, would Rhodolia be a better choice over phosphatidylserine for stress? I don’t understand if phosphatidylserine is anti-inflammatory or how to make the choice.

  94. Hi Lara! Thanks so much for your book and your blog, I have been learning so much! I wanted to understand a bit more about prolactin tests. I had one done and did not fast before doing so (I didn’t read your suggestion to fast until after the test was done). My results were 5.5. My doctor insists I didn’t need to fast before the test. Can you help me understand why fasting is important and advise if I should request another test?

    Also, just for background I had the test done due to long follicular phase and short luteal phase. I also had my thyroid checked and that came back normal as well. The doc also ordered progesterone test but I haven’t ovulated since my appt. so haven’t gone in to test yet.

    Any insight you could provide would be great! Thank you again for your commitment to women’s health and being such an advocate for knowledge!

    • Hi Ali, a high protein meal can falsely elevate prolactin levels, so I always test fasting to remove that uncertainty. Since you were on the low end of normal, you don’t need to retest.

  95. Hi Dr. Lara,
    Continuing from my tweet regarding my request for Micronized Progesterone from a GYN (nurse practitioner). I told her my limited understanding was that it is different than the synthetic ingredients in birth control. To her credit she acknowledged not knowing and said she would do her own research. I didn’t feel comfortable explaining my understanding being that I’m new to this as well, having just finished reading your book and learning about it for the first time. She said, “why would I rx you 100mgs of micronized progesterone when this xyz birth control has .35mgs?”– suggesting they are the same thing. I didn’t know how to respond. So I walked out without the rx I wanted but I also refused the bc rx as well. I said I was open if nothing else worked and she said she was open to my approach but let me know she couldn’t guide me on dosing for the other stuff like Vitex, etc because she didn’t know enough about it. I know I can get the Progesterone without an rx here in the U.S. but I would prefer to have the guidance of a prescriber. Also, if prescribed than my insurance will cover it 100 percent.

    I’m 35 years old, I have severe PMS, very painful periods, heavy bleeding(including what looks like uterine lining) and I recently started having shorter cycles making this all re-surface much closer together. I used to have 24-26 day cycles. I just had a 17 day cycle and a 21 day before that. This has happened after a colonoscopy (with Propofol for sedation) in January 2016, and was diagnosed with a form of microscopic colitis called collagenous colitis. Could this mild form of an IBD along with my other symptoms be a sign of endometriosis? I wonder if I have low progesterone, which is why I wanted the NP GYN to test my hormone levels and then rx the progesterone. She was hesitant about testing and so I explained that I felt frustrated because I couldn’t get help assessing or treating my situation.

    • First of all, in answer to your question about progesterone versus the progestin levonorgestrel in Mirena. They are completely different molecules, so of course they would be dosed differently. I’m a bit shocked that a nurse practitioner did not know that (not that shocked really….). Here is an image demonstrating how progesterone differs from another progestin drospirenone (progesterone is equally different from levonorgestrel).
      progesterone versus progestin
      Please also read: The Crucial Difference Between Progesterone and Progestins.
      As for IBD and potential endometriosis, No, the presence of IBD is not direct evidence of endometriosis. But certainly endometriosis is a question with any case of “very painful periods”. Please consider strictly avoiding dairy, as I discuss in the post and in my book. And Yes, natural progesterone could be helpful. I understand why you’d like some professional guidance. Is there a naturopathic doctor in your area?
      Finally, I’ll say 100 mg is a big dose of progesterone. I would almost never start that high.

      • Hi Dr. Lara,
        Yes, I’m not sure why she made it seem like it was a choice between birth control and 100mgs of micronized progesterone. I didn’t request any specific dose and she made it seem like it was an either-or proposition. If and when I go that way, what is a good starting dose? I will try a non-dairy diet. Are eggs okay? I just started doing B6, Magnesium and Flax Oil. Is Fish Oil better than Flax? I’m a vegetarian but I’m open to fish oil if it’s better.
        I’m going to to see a new MD who uses bioidentical therapy. She takes my insurance. I’d love to see a naturopath and will invest in that if this other doc can’t help.
        Thanks so much, Sara

        • Generally, yes, I think fish oil is preferable to flaxseed oil. And since you’re vegetarian, please also consider a zinc supplement. You can talk to your new doctor about both fish oil and zinc.

  96. Laura,

    can endometriosis cause amenorrhea if there is scarring? My estrogen levels are at 38.7 pg/ml and my progesterone is very low at 0.3 ng/ml. MY DHEA is 139.6 ug/ml and testosterone serum is 14 ng/dl and free is 0.9 pg/ml. I have been having nearly every symptom in the book, insomnia, reverse sleep wake cycle, hair loss (scalp, eyes, eyebrows), liver issues, extreme sharp abdominal and pelvic pain, jaw pain, eye pain (swelling, stinging, blurred vision, pressure, light sensitivity), tingling arms, loss of muscle tone, severe depression (more than my normal history), acne, loss of collagen, bloating, gastrointestinal issues (mucus and loose stools), back pain (lower by the sacroiliac joint and higher by the scalpula). I have been to so many doctors and none seem to know what to do. Their solution is birth control. one doctor suggested progesterone natural at 50mg, as I had asked you before. I am worried to take it as I have suffered from blood clots in the past as well as depression, and don’t want to go lower mood wise than I am. I had been diagnosed with endometriosis way back before ever starting birth control in my mid twenties, and went on it thinking it was going to help. I went on Yaz, then switched to junel 1/20 and soon after got a blood clot. I went to a hematologist who said everything looked okay and i went back on junel 1.20. I was on topamax for mood at the same time. I know it affects estrogen metabolism, and tapering my hair started falling out. I went off junel and thought it was the culprit but nothing has gotten better. What do you think is occurring? Help.

  97. i should have read this 19 years ago when i was diagnosed to have endometriosis. i undergone complete hysterectomy after the finding.

  98. Hi Lara..i value your work and im also a patient of yous..what probiotics or brands fo 6ou recommend that contain l gasseri?
    Warm regards

  99. Dr. Lara,

    I read your blogs, I bought your book and I’ve looked up the articles you referenced in your book. I feel like I’ve spent more time research endometriosis than anything else. No matter what I do or try though, the pain won’t stop.

    At least 1-2 days a month, I can barely get out of bed and miss work because of the severity of the pain. Can you please look over these supplements and tell me what to increase or decrease?

    Anyways, here are the daily supplements that I currently take (and have been taking for almost 2 years):

    1) Femaprin – Vitex extract (standardized to 0.6% agnusides

    2) Magnesium citrate – 160mg (sometimes 320mg the week before my expected period)

    3) Metagenics EPA-DHA 720 Fish Oil (EPA 860mg / DHA 580mg)

    4) Solgar Evening Primrose Oil 1300 mg

    5) Borage Oil 1300mg

    6) Solgar Zinc Picolinate Tablets, 22 Mg (this supplement is one that I just started per the recommendation in
    your book)

    I should note that last cycle I took 1 zinc tablet 22mg for 7 days before my period and it was more painful than usual — is that normal? Also, I read that picolinate is the best form for absorption, is this true? Or is another form of zinc better? Also, should I cut the pills in half and take 33mg a day (one of the articles that you referenced in your book showed that women who take 30mg do better with this).

    I haven’t added Tumeric to my supplement list yet because some of the curcumin / tumeric tablets have bioprene (which assists in absorption of curcumin), and is also a form of piperine but can cause stomach upset in some individuals. I have a very sensitive stomach so I’m hesitant to take this but if you have a specific brand you could recommend, I’d really appreciate it!

    I’m really hoping that you have a chance to answer my post because I’m at the end of my rope trying to figure out what to do to make the pain go away. In the past, I’ve gone vegan, gave up caffeine, and the pain was still there. What am I doing wrong? I’ve never been the pill or anything else that is synthetic, I don’t want to get surgery and I certainly don’t want to get a hysterectomy because I’m only 32 years old. I’ve been dealing with this pain for 20 years and I just want it to stop!

    I really wished you lived in the US because I would love to be one of your patients and get a chance to talk to you about my symptoms. Even if you offered Skype sessions that people could pay for through Paypal or something, I would love to become one of your patients. It can’t hurt to ask, but you don’t happen to offer Skype sessions, do you?

    Anyways, thank you for taking the time to read this and thank you so much for what you do to bring awareness to this issue!!

    I hope to hear from you soon.

    • Hi JJ, as I say in the post, I find dairy to be a major factor–possibly the most important. How long since you went off dairy (went vegan)? Are you off all dairy, even yoghurt and cheese? In truth, you probably don’t need to be vegan–just to avoid dairy and probably gluten. So you should be able to eat lamb, chicken, fish. Those foods are important for general health.

      There are plenty of good turmeric products that don’t have pepper, like this one: https://www.iherb.com/Thorne-Research-Meriva-SR-Curcumin-Phytosome-120-Veggie-Caps/18125

      • I wanted to respond to your question about being vegan…I WAS vegan (no dairy, no gluten, FODMAP veggies and fruits etc.) for about 5-6 months and at the same time gave up caffeine.

        I’m no longer vegan and back on caffeine because when the pain was still there, I figured it was not worth it to give those things up since I enjoyed eating them and there was no relief anyway.

        I only buy my meats, eggs, milk, cream and cheese from a local organic farmer (nothing commercial). These animals are pasture raised and pasture finished (no soy feed, artificial foods etc.). That was the only way that I was going to go back to eating meat (if the animals lived a good life, ate what they were naturally meant to eat, could roam freely etc.).

        Unfortunately, the farmer does not sell any goat or sheep products. I won’t lie, I haven’t given up dairy again for a long time because of the fact that I was buying from this farmer and I knew the product was good. I will have to ask if the milk is from “Jersey” or “Holstein” cows.

        Again, thank you for all that you do!

        • I would seriously think about stopping dairy again. Unfortunately, organic dairy still contains the inflammatory casein.
          I understand that you tried it already. But in my experience, it’s important to line up a couple of key treatments together–such as dairy-free AND turmeric.

  100. Hello! Glad to have found your site. How much berberine do you recommend taking? I’m sure it depends on the person but is there a recommended dose to start with? I have endometriosis, suffer from painful and heavy periods. Thank you!

  101. Since most people’s gluten comes from store bought white or wheat flour which has lost all of it’s nutrients, I wonder if freshly ground wheat would have a different outcome when it comes to gluten sensitivity. I recently learned tons about what and how it quickly oxodizes if not freshly milled. Has anyone tried doing this in this situation?

  102. Hi Lara..as always i love your blogs and articles..your so advanced for our time..maybe thru your passion..
    My question is what kind of probiotics or brands to you recommend to contain the gasseri strain?
    kind regards kristina

    • True A2 milk doesn’t contain A1 casein, but you do have to read the label carefully. In Australia, normal milk brands have started putting “A2 protein” on their labels, but they are the same A1-A2 mix that they always were.

  103. nothing really worked Lara. I tried all of those mentioned and either I am not able to dose it properly, or they are not working for me

    • ESR is often elevated, but not always.
      In future (hopefully soon), researchers will discover blood markers (inflammatory markers) to diagnose endometriosis.

  104. I had excision surgery in 2014 after 13 years of complaining of pain, and took birth control for a year. I started seeing a naturopath and stopped the birth control and have regulated my hormones somewhat with DHEA, Pregnenolone, and Myomin. I have a normal cycle now but the pain has recently returned pretty severe. I am searching and searching for natural answers. Do you recommend no dairy, or just cow-dairy? Is goat/sheep allowable? What about grass fed butter?

    • With my endometriosis patients, I usually start by removing all dairy except organic butter is okay. Then after a few month of no-pain, reintroduce goat and sheep products.

  105. Is Endometriosis An Autoimmune Disease?
    The article that is often cited by Eisenberg and colleagues is an excellent summary of the
    research science into autoimmunity and endometriosis. What it concludes is that there is
    indeed co-existence of endometriosis and other autoimmune diseases (such as SLE,
    rheumatoid arthritis and autoimmune thyroid disease), however this may simply be due to the
    fact that endometriosis affects 1:10 women and the co-existence of the two issues are by
    chance alone. To date, the evidence falls short for saying that endometriosis is autoimmune.
    What is clear is that there is a complex interplay in the bodies defence mechanisms for
    preventing endometrial like cells implanting outside of the endometrium and causing
    inflammatory lesions and their sequelae, the exact role that the bodies own immune system
    has in this process is unknown. Just as it is too simplistic to think that retrograde menstruation
    is responsible for all endometriosis (and it is clear that this is not the sole cause), the role of
    the immune system and endometriosis is not yet understood. It is particularly important that
    this article notes that unlike other autoimmune diseases, endometriosis does not have a
    measurable autoantibody and does not respond to any known treatments for autoimmunity.
    There have been studies done with existing drugs (anti TNF and pentoxifylline) that show no
    change in symptoms. Given that hormones drive endometriosis and changes in hormone
    profile may treat some women with endometriosis, any autoimmune treatments would have to
    be compared with these for side effects and their impact on a woman’s symptoms. No such
    studies have yet been undertaken.
    So, to date there is no evidence that endometriosis has an autoimmune basis, with no auto
    antibody identifiable and the lack of response to existing treatments that have shown
    substantial benefits in other true autoimmune diseases. This also means that drugs such as
    steroids (such as prednisone) and methotrexate that are used for autoimmunity will not be
    beneficial for women with endometriosis. It is true we do not yet have all the answers in this
    field and ongoing research is important to try and define the exact role that the immune
    system has on and with endometriosis. If only we had all the answers, so let’s continue to
    study and participate in research into this formidable opponent that is endometriosis.
    Associate Professor Jason Abbott
    Medical Director Endometriosis Australia

    • Hi Donna, thanks so much for sharing Dr Abbott’s thoughts about the possible endometriosis-autoimmune connection. I have a great deal of respect for his work, so that is certainly a helpful contribution to this discussion.

    • I had another look at Eisenberg’s full paper, because I remembered it did discuss evidence of autoantibodies.
      It says:

      “[There is].. an increased incidence of autoantibodies in women with endometriosis. These include antibodies to a variety of phospholipids, histones, polynucleotides and even lupus. Some of these autoantibodies are organ-specific anti-endometrial and anti-ovarian antibodies.

      and later in the paper… “These autoantibodies recognize endometrial antigens that may be the autoantigens which elicit the immune response.”

      and then finally: “Antiendometrial antibodies which have been described are alpha-2 Heremans Schmidt glycoprotein, serum transferrin, and laminin-1”

      I’d be happy to share the full paper with you, if you’d like to have a look. Please email me.

  106. The correct definition of endometriosis is “When tissue SIMILAR to that lining the uterus (endometrium) grows outside the pelvis causing pain and or difficulty becoming pregnant. It is not an autoimmune disease.

  107. I just love your posts!
    Wish doctors knew what you do.
    I have huge problems with endometriosis, I have found that sources of GLA is the only thing that works for me.. I use evening primrose oil and black currant seed oil.
    But I am already on the anti-inflammatory diet and probiotics, and have previously taken turmeric and berberine. Diet means so much!

  108. Thanks Lara.

    In the intro, you said you thought endometriosis might be an autoimmune illness. Can you expand on that?



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