Endometriosis And Inflammation: What The Research Actually Shows MyOva

Endometriosis And Inflammation: What The Research Actually Shows

"It's just a bad period." "It's stress." "Your scan looks fine, so what's the problem?" If you live with endometriosis, you've probably heard at least one of those, and you've probably also spent years knowing your body was telling you something different.

You're not imagining it. The pain, the fatigue, the bloating and the brain fog are real, and there's a reason the word "inflammation" keeps coming up when researchers describe the condition. Major reviews call endometriosis an inflammatory disease [1], and lesions can release inflammatory signals and even make their own oestrogen.

But here's what the supplement aisle won't tell you. Knowing a condition is inflammatory is not the same as knowing a particular food or supplement treats it. So here is the plain answer: inflammation is a real part of endometriosis, UK and European guidelines put pain relief and hormonal treatment first [2, 3], diet links come from observational studies, and placebo-controlled trials of popular supplements have not shown a clear benefit for pain [4]. The rest of this guide shows you the evidence behind each of those statements, so you can make decisions with your GP rather than with a marketing page. (If you want the food side in full, our guide to anti-inflammatory eating for hormonal health goes deeper, and our endometriosis myths piece clears up the rest.)

A knitted hot water bottle on a rumpled linen bed throw beside a steaming mug of tea and an open notebook with a pen, in soft morning light

In this guide:

In short: Endometriosis is described as an inflammatory disease. Lesions release inflammatory signals, but findings vary between studies and patients.

Endometriosis affects about 1 in 10 women and people assigned female at birth in the UK, which is around 1.5 million people. The average wait for a diagnosis is 8 years and 10 months [5]. That's nearly nine years of being told it's normal. No wonder so many women arrive at the topic of inflammation already exhausted and sceptical.

A major review in Nature Reviews Disease Primers opens by describing endometriosis as a common inflammatory disease in which tissue similar to the womb lining grows outside the uterus [1]. Lesions aren't inert. Lesion cells can produce inflammatory molecules, including prostaglandins and cytokines such as IL-1β, IL-6 and TNF [6].

Measuring that inflammation is messier than the headlines suggest. In a 2017 study of 107 women having laparoscopy for infertility, researchers measured 48 cytokines in peritoneal fluid, the fluid that bathes the pelvic organs. Four were higher in women with endometriosis, including IL-8, and one (IL-13) was lower. TNF-alpha and IL-6 weren't among the raised ones [7]. Other reviews report a longer list of raised cytokines, but note that some changes may be a result of the disease rather than the cause [8].

So "inflammatory" is a fair description of the biology. But it's a research finding, not a number you can track at home, and it doesn't tell you which food or supplement to buy.

Is Endometriosis an Immune System Problem?

In short: Studies since 1991 report reduced natural killer cell activity in endometriosis. Whether that causes the disease or follows it is not proven.

Natural killer (NK) cells are white blood cells that help the body spot and destroy abnormal cells. In 1991, a Belgian team studied 34 women and found that NK activity, and the ability of those cells to kill the woman's own womb-lining cells, was reduced in women with endometriosis. The lower the activity, the more severe the disease [9].

That finding has shaped the theory that a less effective immune response may let misplaced tissue survive. It's an interesting theory. It isn't settled. Immune reviews note that some of the changes seen could be secondary to the disease rather than the starting point [8].

What does that mean for you? It means "supporting your immune system" is not a proven endometriosis strategy. No supplement has been shown to correct NK cell activity in women with the condition. Be wary of anyone who tells you otherwise.

Can Endometriosis Lesions Make Their Own Oestrogen?

In short: Lab research shows lesion cells can make oestrogen locally, and prostaglandin E2 can switch that process on, forming a feedback loop.

This is one of the best-supported mechanisms in the field. A review in Endocrine Reviews describes how endometriosis lesion cells carry the machinery to make oestradiol themselves, including the enzyme aromatase, and also produce inflammatory molecules [6]. An earlier study found that prostaglandin E2 raised aromatase activity 19 to 44 times in cells taken from lesions, which suggests inflammation and local oestrogen production can feed each other [10].

That's lab work on cells and tissue, so treat it as a model of what may be happening rather than a measurement of what's happening in your pelvis. But it fits with why hormonal treatment sits at the centre of the guidelines, which we'll come to below.

How Might the Gut Be Involved?

In short: Small studies hint at gut bacteria differences in endometriosis, but results are inconsistent and no clear gut pattern has been established.

You've probably seen the gut and endometriosis link described as settled. It isn't. A small study of 14 women with advanced endometriosis and 14 controls found similar overall gut diversity, though more women with endometriosis had a stool profile dominated by Escherichia/Shigella bacteria [11]. A systematic review of 28 clinical and 6 animal studies found the most consistent differences in the vagina and cervix rather than the gut, and said the human studies were too inconsistent in method to draw firm conclusions [12]. A 2025 scoping review of 36 studies came to a similar conclusion: the bacterial profiles varied, and there's no sound evidence yet for a specific gut pattern in endometriosis [13].

The "estrobolome", the collection of gut bacteria that can influence how oestrogen is recycled, is a reasonable hypothesis and it's discussed in the review literature [12]. But a hypothesis isn't a protocol. Claims that endometriosis is driven by "leaky gut" go further than the evidence does.

Why Can Endometriosis Pain Continue After Surgery?

In short: Pain often doesn't match what scans or surgery show. Nervous system sensitisation, recurrence and other causes can all play a part.

If you've had surgery and still hurt, you may have been told there's nothing more to find, or that it's in your head. This is what I wish someone had told me: neither is the full picture.

A review in Human Reproduction Update described changes in how the nervous system handles pain in women with chronic pelvic pain and endometriosis, and noted that pain severity often exceeds what the extent of disease would predict [14]. In a study of 49 women, signs of sensitisation were found in 83% of those with endometriosis and 82% of those with pelvic pain alone, compared with 15% of controls. The authors concluded that classifying pain by lesion type and location isn't enough [15].

Surgery itself is not a guaranteed fix either. A Cochrane review found it's uncertain whether laparoscopic surgery reduces pain overall, with very low certainty evidence [16]. In one study that followed 176 women for 2 to 5 years after excision, pain improved significantly, but 36% needed further surgery, and endometriosis was confirmed again in 68% of those repeat operations [17].

Put together, persistent pain can have several contributors, including recurrence and a nervous system that has become more sensitive to pain signals. None of that means the pain isn't real. It means your pain deserves a plan that looks beyond the lesions alone.

Does Diet Affect Endometriosis?

In short: Large observational studies link some foods to endometriosis risk, but they show association, not proof, and no diet is a proven treatment.

The strongest diet data come from studies of who gets diagnosed, not from trials of what eases symptoms once you have it. Here's what the main ones found:

  • Italian case-control study (504 cases, 504 controls): higher green vegetable and fresh fruit intake was linked to lower odds of endometriosis, and red meat and ham to higher odds. There was no significant link for fish [18].
  • US nurses' study (1,199 confirmed cases): the highest trans fat intake was linked to a 48% higher risk of diagnosed endometriosis, and the highest long-chain omega-3 intake to a 22% lower risk [19].
  • Larger US nurses' analysis (2,609 cases): eating a citrus fruit daily was linked to lower risk (hazard ratio 0.78), while cruciferous vegetables weren't linked to lower risk [20].

That last result is a good reminder that "eat more plants" isn't a magic formula. These are links in large groups, they can't prove cause and effect, and they don't tell you what to change if you already have endometriosis. The European guideline says no recommendation can be made for nutritional approaches as treatment because the benefits and harms are unclear [2].

So where does that leave you? A varied diet with plenty of plants that you can actually sustain is a sensible, low-risk aim for general health. Just don't cut out whole food groups hoping for relief without talking to your GP or a registered dietitian first.

Do Anti-Inflammatory Supplements Work for Endometriosis?

In short: Not so far. Placebo-controlled trials of curcumin, resveratrol, fish oil and vitamin D haven't shown a clear pain benefit in endometriosis.

Let's be blunt. NICE advises that the available evidence does not support the use of herbal medicines or supplements for treating endometriosis [3]. A 2026 systematic review pooled 9 placebo-controlled trials (545 women) of supplements including vitamin D, curcumin, resveratrol and fish oil. It found no significant difference from placebo for pelvic pain, rated the certainty of the evidence very low to low, and advised against recommending supplements for endometriosis pain for now [4].

Here's what the research has looked at for each ingredient, and at what level of evidence:

Ingredient What the research looked at Evidence level
Curcumin (turmeric) Lab work on cells lowered some inflammatory signals [21]. In a placebo-controlled trial of 68 women (500 mg twice daily for 8 weeks), pain did not differ from placebo [22] Cell studies; one human trial with no clear benefit
Resveratrol A small uncontrolled study alongside the pill reported lower pain scores [23]. A placebo-controlled trial of 44 women (40 mg for 42 days alongside the pill) found it was not better than placebo [24] Human; one uncontrolled study, one trial with no benefit over placebo
Green tea (EGCG) Reduced lesion growth and blood vessel formation in mice and cell models [25, 26] Animal and lab only
Ginger Trials have looked at period pain in women without endometriosis [27]. In endometriosis, research is in rats [28] Human for period pain; animal for endometriosis
Boswellia Studied for inflammation in the lab. We found no trials in women with endometriosis Lab and animal only
Reishi Studied for immune markers in healthy adults [29]. We found no studies in endometriosis Human (healthy adults only)
Peony, schisandra, rosemary Lab and animal work only. We found no trials in women with endometriosis Lab and animal only
Fish oil and vitamin D A 6-month placebo-controlled trial of 69 young women found neither differed from placebo for pain [30]. A small pilot (33 women) of omega-3 against olive oil found no significant difference either [31] Human trials with no clear benefit

One caution on reading that table. The trials were small and short, and "no clear benefit in these trials" isn't the same as "proven not to work for anyone". But it does mean nobody can fairly tell you a supplement treats endometriosis. What can be said is that it hasn't been shown.

Infographic titled Endometriosis and Inflammation: Evidence at a Glance, rating four areas: lesion inflammation and local oestrogen as stronger evidence, pain relief and hormonal treatment as stronger evidence, diet links as mixed, and supplements as weak evidence

What Do UK and European Guidelines Recommend for Endometriosis?

In short: Guidelines put pain relief and hormonal treatment first, with surgery for some. Supplements, herbs and diets are not recommended as treatment.

The NHS lists painkillers such as paracetamol and ibuprofen, hormone treatments and surgery as the main treatments, plus support for pain, fatigue, fertility and mental health [32]. NICE says to consider a short trial of paracetamol or an NSAID, and to offer hormonal treatment such as the combined pill or a progestogen [3]. The European guideline recommends hormonal treatment as an option to reduce pain, and says analgesics may be offered [2].

On non-medical approaches, ESHRE says clinicians should discuss strategies for quality of life and psychological wellbeing, but that no recommendation can be made for any specific one to reduce pain, because the benefits and harms are unclear [2]. That includes diet, exercise, acupuncture and physiotherapy. It doesn't say they're pointless. It says the evidence isn't there yet.

Your diagnosis is a starting point, not a verdict. If your current treatment isn't working or doesn't suit you, that's a conversation to have with your GP or gynaecology team, and it's fair to ask about every option on the table.

Where Does MyOva Endoplus Fit In?

In short: Endoplus is a food supplement, not a treatment. The research above does not show its botanicals reduce endometriosis symptoms.

MyOva makes Endoplus, so you deserve the straight version. It contains turmeric, ginger, boswellia, reishi, green tea, rosemary, resveratrol, peony root and schisandra, plus vitamin B6. Vitamin B6 contributes to the regulation of hormonal activity, to normal psychological function and to the reduction of tiredness and fatigue. The botanicals are included on the basis of traditional use, and as you've just read, trials haven't shown that these ingredients ease endometriosis pain.

Endoplus isn't a treatment for endometriosis and it doesn't replace medical care. If you choose to try it, think of it as an optional extra that your GP knows about, not an alternative to the treatments above.

MyOva Endoplus supplement
Daily Food Supplement
Endoplus

Turmeric, ginger, boswellia, reishi, green tea, rosemary, resveratrol, peony and schisandra, with vitamin B6, which contributes to the regulation of hormonal activity. Two capsules a day. Vegan.

Safety first. Speak to your GP or pharmacist before taking any herbal supplement if you take other medicines, including hormonal contraceptives or blood thinners, because herbal products can interact with them [33]. Endoplus is not recommended in pregnancy or breastfeeding unless a doctor advises it. The UK Committee on Toxicity has published statements on liver injury linked to turmeric and curcumin supplements [34] and to green tea catechins [35], so check first if you have a liver or bile duct condition, and stop and seek advice if you have symptoms such as yellowing of the skin or eyes, dark urine or persistent abdominal pain. Food supplements shouldn't replace a varied diet or medical treatment.

When Should You See Your GP, and What Should You Ask?

In short: If period or pelvic pain disrupts your life, see your GP, bring a symptom diary and ask what the next step is, including referral.

With an average diagnosis delay of nearly nine years [5], being persistent isn't being difficult. It's collecting data. Here's what helps:

  • Keep a symptom diary. Note pain scores, bleeding, bowel and bladder symptoms, pain with sex, fatigue and how each affects your day, across at least a couple of cycles.
  • Say what it stops you doing. "I miss work" or "I can't exercise" gives your GP more to act on than "it's painful".
  • Ask what happens next. That could mean pain relief, hormonal treatment, imaging or a referral to gynaecology.
  • Bring up supplements. If you take or want to take any, tell your GP or pharmacist so they can check for interactions.

Endometriosis UK (endometriosis-uk.org) offers information and peer support if you want to talk to people who get it.

Frequently Asked Questions

Is endometriosis an inflammatory disease?

Major reviews describe it that way [1]. That doesn't mean every symptom is down to inflammation, and it doesn't mean anti-inflammatory foods or supplements treat it.

Does an anti-inflammatory diet help endometriosis?

No diet has been proven to treat endometriosis. Observational studies link some foods to risk [19, 20], but the European guideline makes no recommendation for nutritional treatment because the evidence is unclear [2]. Talk to your GP or a dietitian before cutting out food groups.

Can supplements reduce endometriosis pain?

A 2026 systematic review of placebo-controlled trials found no significant difference from placebo for pelvic pain [4], and NICE says the evidence does not support supplements for treating endometriosis [3].

Why is my pain worse than my scan or surgery suggests?

Pain doesn't always track how much disease there is. Research shows changes in how the nervous system processes pain in many women with endometriosis and chronic pelvic pain [14, 15]. It's real, and it's worth raising with your GP.

Can I take supplements alongside my endometriosis medication?

Check with your GP or pharmacist first. Herbal products can interact with prescribed medicines [33], and turmeric and green tea supplements have been linked to liver injury in rare cases [34, 35].

The Bottom Line

The research on this is actually pretty clear when you separate the mechanisms from the marketing. Endometriosis is an inflammatory, oestrogen-sensitive condition, and understanding that is useful. But the proven options are pain relief, hormonal treatment and, for some, surgery, and supplements and diets haven't been shown to treat it.

Hormonal literacy isn't complicated, it's just rarely taught. Know what the evidence says, track your symptoms, and take the pattern to someone who can act on it. Your body is trying to tell you something, and you are allowed to be believed.

Related Reading

This article is for educational purposes only and does not constitute medical advice. MyOva products are food supplements, not medicines, and are not intended to diagnose, treat, cure or prevent any disease. If you think you may have endometriosis, or your symptoms are changing, speak to your GP or a qualified healthcare professional before making changes to your treatment or supplements.

References

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  3. National Institute for Health and Care Excellence. Endometriosis: diagnosis and management. NICE guideline NG73. Published 2017, updated 2024. nice.org.uk/guidance/ng73
  4. Salmeri N, Ragusi A, Buffo C, Somigliana E, Viganò P, Vercellini P. Dietary supplements for endometriosis-associated pain: a systematic review and meta-analysis of randomized placebo-controlled trials. Gynecol Obstet Invest. 2026;91(1):101-114. doi:10.1159/000545414
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  29. Chen S-N, Nan F-H, Liu M-W, Yang M-F, Chang Y-C, Chen S. Evaluation of immune modulation by β-1,3;1,6 D-glucan derived from Ganoderma lucidum in healthy adult volunteers: a randomized controlled trial. Foods. 2023;12(3):659. doi:10.3390/foods12030659
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  33. NHS. Herbal medicines. nhs.uk/conditions/herbal-medicines/
  34. Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment. Statement on the potential risk to human health of turmeric and curcumin supplements. COT/2024/07. December 2024. cot.food.gov.uk
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Leila Martyn

Leila Martyn

Leila is the founder of MyOva, a UK-based hormonal health brand for women with PMOS (PCOS), endometriosis, perimenopause, PMDD and fertility challenges. Drawing on lived experience and scientific research, she shares evidence-based guidance to help women understand their hormones and cycles.

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