Endometriosis can be extremely painful, so the enthusiasm for the newly FDA-approved drug to treat the pain, Orilissa, is understandable. However, the drug comes with a serious potential side effect. Alternative: A natural protocol that reduces the pain and inflammation of endometriosis (when tissue from inside the uterus grows outside the uterus)—but doesn’t compromise the rest of your health.

Orilissa—its chemical name is elagolix—is a pill that is taken once or twice a day and has just been approved for moderate-to-severe endometriosis pain. Studies show that it reduces endometriosis menstrual pain, pain between periods and pain during sexual intercourse. However, it can be taken for only two to six months, depending on the dose, because it creates a risk for irreversible bone loss.

Why would a pain drug cause bone loss? Orilissa works by blocking the effect of gonadotropin-releasing hormone, which stimulates the ovaries to produce estrogen and progesterone. Since the inflammation and pain of endometriosis are triggered by estrogen, blocking its production results in less pain. However, estrogen is also important for bone health—which is why extended use of the drug can cause bone loss. Other side effects of low estrogen include night sweats, hot flashes and mood problems such as anxiety and depression.

The good news is that inflammation can be reduced naturally without the side effects of medications, says Andrew Rubman, ND, naturopathic doctor and medical director of the Southbury Clinic for Traditional Medicines in Southbury, Connecticut. This is especially important for women who are trying to get pregnant…who already are pregnant (Orilissa cannot be taken during pregnancy)…or whose pain is not severe enough to require medication. Natural inflammation reducers also won’t interfere with medication if it becomes necessary.

Diet changes that can reduce the pain of endometriosis…

  • Eat an egg every day. Eggs have cholesterol, the source material for the steroidal hormone cortisol, a hormone that helps control inflammation. (You may think of cortisol as an inflammation producer, but that’s because as levels of cortisol increase, another hormone called cortisone, which needs to stay in balance with cortisol, decreases—encouraging inflammation.) Best: Boil the egg or poach it in water because frying the cholesterol produces oxides, which are inflammatory. And don’t worry about creating any heart issues by adding this bit of cholesterol to your diet because inflammation is the trigger that makes cholesterol form plaques on artery walls.
  • Eat wild-caught cold-water fish such as salmon and sardines, rich sources of anti-inflammatory omega-3 fatty acids. You can also get omega-3s from fish oil supplements. A typical recommended daily dose is 1,000 mg of combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). (Interestingly, Dr. Rubman reports that his patients who move to Florida and stop eating fish from cold water start having more inflammation issues.)
  • Get some seeds into your diet, especially the inflammation-fighters chia and flaxseeds. Both also are high in omega-3 fatty acids.
  • Get plenty of antioxidants from brightly colored fruits and vegetables, especially dark blue and purple berries…beets…and green, leafy vegetables. Also include cruciferous vegetables such as broccoli, cabbage and kale.
  • Three supplements that can help the liver bind and remove inflammatory compounds are vitamin B, dandelion root extract and methylsulfonylmethane (MSM). These are generally safe for most people, but check with your doctor if you are being treated for a medical condition or have allergies (such as to ragweed in the case of dandelion supplements). Dosages should be prescribed by your doctor based on the severity of your endometriosis. Typical daily amounts: 50 mg vitamin-B complex, taken twice a day…2 grams (g) to 6 g of MSM, divided into two or three doses…about 30 drops (1 milliliter) dandelion root extract once a day.

Exercising regularly to reduce body fat and limiting intake of caffeine and alcohol also help keep estrogen levels lower.

If natural therapies and drugs fail to relieve your pain, endometrial tissue outside the uterus may be surgically removed. Women who have this surgery often find that their bodies respond better to anti-inflammatory foods and supplements afterward.

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