Supplements and Herbal Medicines for Endometriosis and Adenomyosis: What Evidence Exists?

Living with endometriosis or adenomyosis often means juggling pain, heavy bleeding, fatigue, fertility concerns, and the side effects (or limits) of standard treatments. It’s completely understandable that many patients look into supplements, probiotics, and herbal medicines—especially options that claim to “reduce inflammation,” “balance hormones,” or “support implantation.”

The challenge is that the evidence is scattered: some research is in cells or animals, some in other conditions (like PCOS or diminished ovarian reserve), and only a small amount directly studies endometriosis or adenomyosis in people. This article pulls together findings from multiple recent papers to answer the questions patients most commonly ask about potential supplements & herbal medicines—what they might do, how strong the evidence is, and how to approach them safely.

Why supplements are even being studied for endometriosis/adenomyosis

A recurring theme across modern endometriosis research is that the disease isn’t “just extra tissue.” Lesions behave more like an active inflammatory environment, with signals that promote inflammation, blood-vessel growth (angiogenesis), oxidative stress, and abnormal tissue survival. A recent mechanistic review described several pathways that repeatedly show up in endometriosis biology—such as NF-κB, COX-2/prostaglandins, PI3K/Akt, and oxidative-stress regulation (Nrf2/ARE)—and argued that many plant compounds target these local signaling loops rather than suppressing estrogen system-wide the way many hormonal medications do.

That doesn’t prove that supplements treat endometriosis or adenomyosis—but it helps explain why researchers keep testing anti-inflammatory, antioxidant, and anti-angiogenic approaches as possible add-ons to standard care.

Do any herbs or supplements actually shrink lesions or change the disease?

For most supplements, the honest answer is: we don’t yet have strong human evidence showing consistent lesion shrinkage in endometriosis. Where we do see “lesion size” effects, it’s commonly in animal models. There is some debate about the quality of animal models when it comes to endometriosis and adenomyosis.

One experimental study in mice tested an oral extract of Paeonia lactiflora root (white peony). In that induced endometriosis model, the extract was associated with smaller lesion diameter and lower levels of inflammatory/angiogenic signals in abdominal fluid—specifically TNF-α (a key inflammatory cytokine) and VEGF (a driver of new blood vessels). In real-world terms, this supports a plausible idea: if a therapy reduces inflammation and blood-vessel signaling, lesions may have a harder time sustaining themselves.

But it’s crucial to translate this carefully: mice with surgically induced lesions are not the same as humans with years of disease, and dosing/safety in humans isn’t established. Even in that animal work, higher doses were associated with toxicity. So this research level is hypothesis-generating, not a recommendation for human use.

For adenomyosis, the most “disease-monitoring” type of evidence in this set of papers is a detailed single-patient case report using a traditional Korean herbal formula (modified Bojungikgi-tang) alongside regular ultrasound monitoring. Over about 12 months, that patient’s pain and bleeding scores improved, hemoglobin normalized, and ultrasound descriptions suggested improvement in adenomyosis features. This is encouraging as an example of how integrative care might be tracked (symptoms plus labs plus imaging), but a case report cannot tell us whether the herb caused the change—especially because the patient also used a hormonal contraceptive (reduced but continued), and adenomyosis symptoms can fluctuate over time.

Bottom line: evidence for actual lesion or adenomyosis regression from supplements/herbs is currently limited and mostly low-strength (animal data or single cases), not robust clinical trials.

Can supplements or herbs help symptoms (pain, heavy bleeding), even if they don’t “cure” the condition?

This is where patients often feel the most urgency—and where the evidence is both promising and frustratingly indirect.

The mechanistic review on medicinal plants highlighted several commonly discussed compounds—curcumin (turmeric), ginger constituents (like shogaol), licorice-derived isoliquiritigenin, and milk thistle compounds (silymarin/silibinin)—as having anti-inflammatory or antioxidant actions that overlap with endometriosis pathways (for example, dampening NF-κB signaling or COX-2/prostaglandin activity). The review also noted that the most concrete human trials it discussed were largely in primary dysmenorrhea (painful periods in general), not confirmed endometriosis. That matters, because dysmenorrhea overlaps with endometriosis pain—but it isn’t the same disease, and results may not carry over.

For adenomyosis specifically, heavy bleeding is often as disruptive as pain. The case report described substantial improvement in bleeding burden (tracked with a menstrual bleeding score) along with recovery from anemia—again, meaningful for patients, but not definitive proof.

Practical interpretation: some supplements/herbal medicines may be reasonable to discuss as symptom-focused adjuncts (especially for pain or inflammation), but expectations should be realistic: evidence in confirmed endometriosis/adenomyosis populations is still very thin.

What about fertility—can supplements improve IVF outcomes or implantation?

This is a major reason many patients search for potential supplements & herbal medicines, particularly when planning IVF.

“Endometrial receptivity” signals (early-stage evidence)

The mouse study of Paeonia lactiflora is notable not only for lesion changes but also for implantation-related findings. In that model, endometriosis reduced uterine expression of LIF (leukemia inhibitory factor)—a gene associated with implantation—and lowered implantation rates. After treatment with the extract, LIF expression and implantation sites increased.

That’s biologically interesting because it connects an herb to an implantation-relevant pathway. But it remains preclinical and doesn’t tell us whether a similar effect occurs in human uterine tissue or whether it translates into higher live birth rates.

Supplements for ovarian reserve (relevant to some, not all)

A separate meta-analysis evaluated oral supplements—vitamins, Coenzyme Q10 (CoQ10), and DHEA—in women with diminished ovarian reserve (DOR), often in IVF/ICSI contexts. Across 16 studies (over 2,700 participants), supplementation was associated with improvements in several fertility-related markers and outcomes, including lower FSH, slightly higher AMH/AFC, slightly more oocytes retrieved, and a higher clinical pregnancy rate. Subgroup analyses suggested CoQ10 might perform better than DHEA in that dataset, and that using supplements for more than 2 months was linked with better changes in some measures.

For endometriosis/adenomyosis patients, this evidence may be relevant if you also have a DOR diagnosis. But it’s not specifically an endometriosis fertility treatment—and not every patient with endometriosis has low reserve.

Practical interpretation: fertility supplements have the best pooled evidence here in the context of DOR (not endometriosis itself), while “implantation-enhancing” herbs remain largely at the animal-data stage.

Are probiotics helpful for endometriosis inflammation or hormones?

Patients often ask whether probiotics can reduce “inflammation” or improve hormones in endometriosis. One strong clinical trial in this set tested a specific probiotic combination (Lactobacillus helveticus + Bifidobacterium longum) for 8 weeks—but in PCOS, not endometriosis.

In PCOS participants, the probiotic improved blood markers tied to oxidative stress and inflammation (higher antioxidant capacity and SOD activity; lower malondialdehyde and slightly lower CRP) and changed some hormone-related markers (higher SHBG and lower free androgen index). However, it did not clearly improve visible PCOS symptoms measured over that short time frame.

This is useful mainly as a cautionary tale: even when lab markers move in a favorable direction, patients may not feel a major symptom difference—at least not quickly. And because endometriosis/adenomyosis weren’t studied, you shouldn’t assume the same results apply.

Safety and “natural” doesn’t always mean low-risk

Across these papers, a consistent message emerges: supplements and herbs can have real biological effects—which means they can also have real side effects or interactions.

• The mouse study of Paeonia lactiflora included dose-toxicity signals at higher doses in animals, reinforcing that “herbal” is not automatically safe.
• The DOR supplement meta-analysis noted practical risks: DHEA can cause androgenic side effects (acne, hair changes, mood changes) and isn’t appropriate for everyone; excessive vitamins can be harmful; and supplements can interact with medications.
• Herbal formulas can vary by manufacturer and preparation, and quality control can be uneven.
• Higher doses of inadequately studied supplements, which includes herbals/botanicals and vitamins, are not "better" at this stage of our knowledge and may actually hurt you with toxicity.

If you’re pursuing IVF or surgery, it’s especially important to disclose supplements because some may affect bleeding risk, anesthesia metabolism, or lab results.

Practical takeaways (how to use supplements more wisely)

• What is my goal—pain control, bleeding reduction, or fertility support? Different goals point to different evidence. Some approaches are symptom-focused; others are fertility-adjunctive.
• What evidence applies to me? A supplement studied in DOR or PCOS may not apply to confirmed endometriosis/adenomyosis, and an animal study is not the same as a human trial.
• What’s the plan for monitoring and stopping? If you try something, decide in advance what “success” means (pain scale, bleeding score, hemoglobin/ferritin, IVF cycle parameters), and set a time point to reassess.

What we still don’t know (and why results vary so much)

Even pulling these studies together, there are major gaps:

We still don’t have enough high-quality human trials in confirmed endometriosis or adenomyosis to say which supplements consistently improve pain, bleeding, lesion burden, or live birth. Many findings come from mechanistic reviews, animal models, or single-patient reports. Bioavailability is another real-world barrier—curcumin is a classic example where lab effects may not translate well because oral absorption can be poor unless specialized formulations are used.

Most importantly, endometriosis and adenomyosis are not uniform conditions. Symptom patterns, lesion type, co-existing issues (IBS, pelvic floor dysfunction, DOR, PCOS), and prior treatments all influence whether a supplement seems to “work.”

If your top goal is identified (pain, bleeding/anemia, IVF outcomes, or daily functioning) and you know what you’re currently taking (hormonal meds, NSAIDs, anticoagulants, IVF supplements), this can form a focused list of discussion points for your clinician—without overpromising what supplements can do. It is easy to go down rabbit holes and escalate problems, especially if you combine supplements and herbals that may interact negatively and hurt you. So, be wary of miracle supplement mixes that overpromise, underdeliver, cost a lot and can hurt you.