Hyperbaric Oxygen Treatment for Endometriosis

Hyperbaric Oxygen Therapy and Endometriosis: A Reframed Overview

Hyperbaric oxygen therapy (HBOT) is being investigated as a biologically targeted adjunct for endometriosis based on its ability to directly modify tissue oxygen tension—an upstream driver of inflammatory signaling, angiogenesis, and lesion persistence. Rather than acting on hormones or pain pathways alone, HBOT addresses the hypoxic microenvironment that enables endometriotic tissue to survive and propagate, positioning oxygen modulation as a distinct and mechanistically novel therapeutic avenue.

Understanding Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy entails breathing 100% oxygen in a pressurized chamber at levels above atmospheric pressure. In this environment, oxygen dissolves more effectively into the bloodstream and tissues, leading to a significant rise in tissue oxygenation. HBOT has long-standing applications in wound healing, radiation injury, decompression sickness, and chronic infections.

Oxygen and Endometriosis Biology

Endometriosis lesions frequently inhabit hypoxic, or low-oxygen, microenvironments that drive inflammation, angiogenesis, fibrosis, and pain signaling. Within endometriotic tissue, hypoxia-inducible factors (HIFs) are upregulated and support lesion survival and progression. By elevating tissue oxygen levels, HBOT may help counteract these hypoxia-driven pathways.

How HBOT Might Influence Disease Processes

Research indicates several potential benefits of HBOT in the context of endometriosis. It may reduce both local and systemic inflammation, downregulate hypoxia-inducible factors, inhibit angiogenesis within lesions, improve mitochondrial function alongside cellular repair, and enhance immune modulation. In animal models, exposure to hyperbaric oxygen has been shown to decrease the size and activity of endometriotic implants and to lower inflammatory cytokine levels.

Evidence to Date

Early clinical observations and limited studies suggest that HBOT may alleviate pelvic pain and improve symptoms in individuals with endometriosis. Some reports describe diminished lesion vascularity and reductions in inflammatory markers following treatment. Despite these encouraging signals, large-scale randomized controlled trials in humans remain limited, and HBOT is not regarded as a standalone therapy.

Integrating HBOT Into a Treatment Plan

• HBOT functions best as a complementary therapy rather than a substitute for excision surgery or medical management.
• It may be considered for select patients within an integrative plan, particularly when persistent inflammation, impaired healing, or complex pain syndromes are present.
• Treatment protocols vary, but they typically comprise multiple sessions delivered over several weeks.
• Administration should occur in accredited medical facilities under physician supervision.

Safety Profile and Treatment Screening

• Potential risks include ear or sinus barotrauma.
• Temporary vision changes can occur.
• Oxygen toxicity is a concern with prolonged exposure.
• Claustrophobia may affect tolerance.
• Patients should undergo careful screening before starting treatment.

Key Points

Hyperbaric oxygen therapy offers a promising adjunctive option for targeting hypoxia-driven inflammation and tissue dysfunction in endometriosis. While preliminary findings are encouraging, additional clinical research is needed to refine protocols, identify ideal candidates, and clarify long-term outcomes. When thoughtfully integrated into care, HBOT may aid healing and symptom relief for select patients.