Coping with endometriosis as a chronic disease is an important component of management. According to guidelines for the management of endometriosis, evidence from two systematic reviews suggests that high frequency transcutaneous electrical nerve stimulation (TENS), acupuncture, vitamin B1, and magnesium may help to relieve dysmenorrhea (1,348,351). Whether such treatments are effective in endometriosis-associated dysmenorrhea is unknown. Many women with endometriosis report that nutritional and complementary therapies such as reﬂexology, traditional Chinese medicine, herbal treatments, and homeopathy improve pain symptoms. Although there is no evidence from randomized controlled trials to support the effectiveness of these treatments in endometriosis, they should not be ruled out if the woman feels they work in conjunction with more traditional therapies or that they could be beneficial to her overall pain management and quality of life. Patient self-help groups can provide invaluable counseling, support, and advice. ESHRE provides a comprehensive international list of self-help groups on their web site (1).
1.
Kennedy S, Bergqvist A, Chapron C, et al. On behalf of the ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 2005;20:2698–2704.
www.endometriosis.org/support.html 2.
Sanfilippo JS, Williams RS, Yussman MA, et al. Substance P in peritoneal ﬂuid. Am J Obstet Gynecol 1992;166:155–159.
3.
Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997;24:235–258.
4.
Vigan`o P, Parazzini F, Somigliana E, et al. Endometriosis: epidemiology and aetiological factors. Best Pract Res Clin Obstet Gynaecol 2004;18:177–200.
5.
Haney AF. Endometriosis: pathogenesis and pathophysiology. In: Wilson EA, ed. Endometriosis. New York: AR Liss, 1987:23–51.
6.
Koninckx PR, Meuleman C, Demeyere S, et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991;55:759–765.
7.
Meuleman C, Vandenabeele B, Fieuws S, et al. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertil Steril 2009;92:68–74.
8.
Liu DTY, Hitchcock A. Endometriosis: its association with retrograde menstruation, dysmenorrhoea and tubal pathology. Br J Obstet Gynecol 1986;93:859–862.
9.
Moen MH. Endometriosis in women at interval sterilization. Acta Obstet Gynecol Scand 1987;66:451–454.
10.
Kirshon B, Poindexter AN, Fast J. Endometriosis in multiparous women. J Reprod Med 1989;34:215–217.
11.
Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod 1991;6:544–549.
12.
Moen MH, Muus KM. Endometriosis in pregnant and non-pregnant women at tubal sterilization. Hum Reprod 1991;6:699–702.