Do Dietary Supplements Alleviate Pain in Endometriosis?

Endometriosis is a chronic condition where tissue similar to the endometrium, which normally lines the inside of the uterus, grows in other parts of the body such as the ovaries, fallopian tubes, or more rarely, the peritoneum and intestines. This anomaly leads to significant painful symptoms.

In Italy, it is estimated to affect nearly two million women of reproductive age, although diagnosis is often delayed, averaging around seven years. The most common and debilitating symptom is chronic pelvic pain, which can intensify during sexual intercourse (dyspareunia) and particularly during menstruation (dysmenorrhea). These disturbances can lead to "pain catastrophization," an emotional and cognitive reaction that profoundly impacts patients' quality of life, especially in young women. It is important to note that there is no "diet that cures endometriosis."

The guidelines from major European and Italian scientific societies for the treatment of endometriosis do not include the use of dietary supplements. Conventional pain management relies on anti-inflammatory drugs, hormonal therapies, and, in some cases, surgical interventions.

Research on Supplements and Endometriosis Pain

Numerous studies have explored the effectiveness of various dietary supplements in an attempt to alleviate endometriosis-related pain. Research has focused on substances with potential anti-inflammatory action, such as N-acetyl-cysteine and mixtures of antioxidant vitamins (vitamins C, E, D). Some of these studies have reported an improvement in pain; however, the validity of such results is limited by factors such as the small number of participants, the absence of placebo-controlled groups, and other methodological shortcomings or the quality of publications. Therefore, their results are not considered definitive.

For instance, a U.S. study conducted on adolescents with endometriosis, which compared the intake of vitamin D3, fish oil, or a placebo, showed an overall improvement in pain across all groups, but without significant differences between the active supplements and the placebo.

A rigorous analysis of placebo-controlled studies, conducted by researchers from the Policlinico Hospital and the State University of Milan, examined supplements such as garlic, turmeric, and melatonin, in addition to those mentioned above. Their conclusion is that, currently, there is no convincing evidence for the efficacy of these products in reducing endometriosis pain. This aspect is also relevant considering their cost.

The Role of Magnesium

Magnesium is often recommended for premenstrual syndrome and other gynecological conditions, including endometriosis, due to its supposed muscle-relaxing properties on the smooth muscles of the uterus and fallopian tubes. Nevertheless, a review of the scientific literature has not revealed conclusive clinical studies supporting this widespread practice.

A 2025 online survey conducted in the UK involving over 2,000 patients with confirmed endometriosis showed that, among more than 800 women who had taken magnesium, less than a third reported experiencing benefit for controlling their painful symptoms.

In summary, while research continues, current scientific evidence does not support the use of dietary supplements to cure or significantly alleviate endometriosis-related pain, and medical guidelines do not recommend them.