Endometriosis Awareness Month provides an essential opportunity for complementary, integrative and holistic health professionals to deepen their understanding of one of the most common, yet frequently misunderstood, chronic health conditions affecting women.
Endometriosis is not a niche or rare disorder. It affects approximately 1 in 10 women and those assigned female at birth of reproductive age, representing an estimated 1.5 million individuals in the UK alone.
For practitioners, clinics, spas, retreats and training schools, this means that a significant proportion of clients, students, and patients you encounter will either have endometriosis or be struggling with symptoms without yet having received a diagnosis.
This article will explore:
- The underlying mechanisms and clinical presentation
- Current conventional medical approaches
- The wider impact on physical and emotional wellbeing
- The crucial role complementary and integrative practitioners can play within multidisciplinary care
In Part 2, we will explore lifestyle, nutritional, mind-body, and integrative strategies in depth, alongside practitioner guidance and professional considerations.
What Is Endometriosis?
Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the womb (the endometrium) grows outside the uterus, commonly affecting:
- Ovaries
- Fallopian tubes
- Pelvic lining
- Bowel
- Bladder
This misplaced tissue behaves similarly to uterine lining tissue, responding to hormonal fluctuations and triggering inflammation, pain, and scar tissue formation.
The condition is widely recognised as complex and multifactorial, involving inflammatory, hormonal, neurological and immune components.
For holistic health professionals, this systemic nature is particularly important, as it explains why endometriosis is associated not only with pelvic pain but also fatigue, digestive symptoms, immune dysfunction, and psychological distress.
Why Diagnosis Remains So Challenging
Despite its prevalence, endometriosis remains significantly underdiagnosed and frequently misunderstood. This is why it is so important that Endometriosis Awareness Month exists in order to raise awareness of this life-changing condition.
One of the major challenges is that definitive diagnosis requires laparoscopic surgery, during which a camera is inserted into the pelvis to identify endometrial lesions.
This invasive diagnostic requirement contributes to delays in diagnosis, which can extend for many years.
Recent NICE guidance has sought to improve diagnostic pathways by recommending:
- Earlier use of specialist ultrasound
- Faster referral to specialist services
- Improved clinical awareness among healthcare professionals
However, systemic delays remain a major issue, with many patients experiencing prolonged suffering before receiving appropriate support.
For complementary practitioners, this means:
Many clients may present with symptoms suggestive of endometriosis without having a formal diagnosis.
These individuals often feel dismissed, unheard, or frustrated — highlighting the importance of compassionate, informed, and responsible practitioner support.
Clinical Symptoms: Beyond “Painful Periods”
Endometriosis symptoms can vary widely between individuals, but commonly include:
- Severe menstrual pain
- Chronic pelvic pain
- Pain during intercourse
- Infertility
- Fatigue
- Gastrointestinal symptoms such as bloating, constipation, or diarrhoea
Endometriosis is also strongly associated with infertility, affecting up to 30–50% of women experiencing fertility challenges.
Importantly, symptom severity does not always correlate with disease stage. Some individuals with minimal disease experience severe pain, while others with extensive lesions may experience few symptoms.
This unpredictability can create profound emotional distress and frustration.
The Inflammatory Nature of Endometriosis
Endometriosis is increasingly recognised as a chronic inflammatory condition.
Inflammation plays a central role in:
- Pain generation
- Tissue damage
- Disease progression
- Immune system involvement
Research highlights that endometriosis involves a complex inflammatory pattern influenced by hormonal and immune mechanisms.
This inflammatory component is highly relevant for complementary practitioners, particularly those working in:
- Nutritional therapy
- Herbal medicine
- Functional medicine
- Lifestyle medicine
- Mind-body approaches
This is because many integrative strategies focus on supporting inflammatory regulation.
Conventional Medical Treatment Approaches
It is essential for complementary health professionals to understand conventional treatment pathways in order to work safely and collaboratively.
Standard medical treatments include:
Pain management
Including anti-inflammatory medications and pain relief.
Hormonal treatments
Designed to suppress the hormonal stimulation of endometrial tissue.
However, NICE guidance specifically advises that hormonal treatment should not be used to improve spontaneous pregnancy rates in women trying to conceive.
Surgical intervention
Laparoscopic surgery may be used both to diagnose and remove endometrial lesions.
In severe cases, hysterectomy may be considered.
Emerging Medical Treatments
Recent developments in pharmacology offer additional options for symptom management.
For example, newer medications work by blocking hormones that drive endometriosis progression, offering an alternative to traditional therapies.
These developments highlight the rapidly evolving nature of endometriosis treatment and reinforce the importance of practitioner awareness.
The Whole-Person Impact: More Than a Physical Condition
Endometriosis affects every dimension of health:
Physical
Chronic pain, fatigue, hormonal disruption.
Emotional
Anxiety, depression, loss of identity, frustration.
Social
Relationship strain, social withdrawal.
Professional
Reduced productivity and workplace challenges.
For complementary and integrative practitioners, this whole-person impact aligns closely with the principles of holistic health.
Endometriosis is not simply a gynaecological condition.
It is a life-altering chronic illness.
Why Complementary Health Professionals Play a Vital Role – Endometriosis Awareness Month is crucial for everybody in the complementary medical and integrative health sectors
Many individuals with endometriosis seek complementary care.
Research shows that 76% of women with endometriosis use self-management strategies, with dietary changes being among the most common approaches.
This reflects:
- The limitations of conventional treatments
- Desire for holistic support
- Need for improved quality of life
Complementary professionals often provide support in areas where conventional medicine has limited tools, including:
- Lifestyle support
- Emotional wellbeing
- Stress management
- Sleep optimisation
- Nervous system regulation
This places CMA Members in a uniquely valuable position.
However, it also carries important professional responsibilities.
Practitioners must:
- Work within their scope of practice
- Avoid making medical claims
- Support, not replace, medical care
This professional integrity is central to The CMA’s standards.
Professional Responsibility and Ethical Practice
It is vital that complementary practitioners recognise:
Endometriosis is a medical condition requiring medical diagnosis and supervision.
Your role is not to diagnose or treat endometriosis medically.
Your role is to support the individual holistically.
This may include:
- Supporting stress resilience
- Encouraging lifestyle optimisation
- Supporting emotional wellbeing
- Helping individuals feel heard and empowered
But always alongside medical care.
Why Awareness Matters Now More Than Ever
Endometriosis Awareness Month exists because awareness remains insufficient.
Many individuals suffer for years before receiving answers.
As complementary, integrative and holistic health professionals, CMA Members can play an important role in:
- Increasing awareness
- Providing compassionate support
- Improving quality of life
Not by replacing conventional medicine — but by complementing it.
This is the essence of integrative care.
Endometriosis Awareness Month: What Every Complementary, Integrative and Holistic Health Professional Needs to Know (Part 2)
Lifestyle Medicine and Endometriosis: Why It Matters
As discussed in Part 1, endometriosis is a chronic inflammatory, immune-mediated and hormone-sensitive condition. This makes lifestyle medicine (evidence-based therapeutic approaches using lifestyle interventions to prevent, manage and support health conditions) particularly relevant.
While lifestyle approaches do not cure endometriosis, growing evidence shows they can significantly influence:
- Symptom severity
- Pain perception
- Quality of life
- Emotional wellbeing
For complementary and integrative practitioners, this represents an important opportunity to provide safe, ethical and valuable support.
Nutrition and Endometriosis: Supporting the Inflammatory Terrain
Diet is one of the most commonly explored self-management approaches among individuals with endometriosis.
Research published in Frontiers in Nutrition found that dietary modification is widely used by those with endometriosis, with many reporting perceived improvements in symptoms and wellbeing.¹
While evidence is still emerging, certain dietary patterns show promise for supporting overall health in this population.
Anti-inflammatory dietary patterns
Endometriosis involves chronic inflammation. Diets rich in whole plant foods naturally contain compounds that support inflammatory regulation, including:
- Polyphenols (plant compounds with antioxidant properties)
- Fibre
- Vitamins and minerals
A systematic review published in Nutrients found that diets rich in fruits, vegetables, and fibre may be associated with lower endometriosis risk and improved symptom management.²
This aligns with broader evidence demonstrating the role of plant-rich diets in reducing inflammatory burden.
Gastrointestinal health considerations
Many individuals with endometriosis experience digestive symptoms, including:
- Bloating
- Altered bowel habits
- Food sensitivities
These symptoms may relate to inflammation, altered gut microbiota (the community of microorganisms living in the digestive tract), and nervous system involvement.³
Complementary practitioners such as nutritional therapists may play a valuable role in supporting digestive health through general dietary optimisation.
However, it is essential to avoid restrictive or unsupported dietary approaches that could compromise nutritional status.
Physical Activity and Movement
Exercise is increasingly recognised as an important component of endometriosis support.
Regular physical activity may help by:
- Supporting inflammatory regulation
- Improving mood
- Enhancing pain tolerance
- Supporting hormonal balance
A systematic review published in Reproductive Biology and Endocrinology found that physical activity may reduce endometriosis-associated pain and improve quality of life.⁴
Importantly, exercise recommendations should be individualised.
Some individuals may benefit from gentle forms of movement such as:
- Walking
- Yoga
- Stretching
Others may tolerate more vigorous exercise.
Practitioners should encourage sustainable, enjoyable movement rather than rigid exercise prescriptions.
The Nervous System Connection: Stress, Pain and Endometriosis
Endometriosis is not purely a structural condition. It also involves nervous system sensitisation.
This means the nervous system becomes more responsive to pain signals.
Chronic stress can amplify this process.
Research published in Frontiers in Psychology highlights the significant psychological burden of endometriosis, including increased risk of anxiety and depression.⁵
This makes mind-body approaches highly relevant.
Meditation, Relaxation and Mind-Body Medicine
Mind-body approaches are designed to regulate the nervous system and support psychological wellbeing.
These may include:
- Meditation
- Mindfulness
- Breathing practices
- Relaxation techniques
A systematic review published in Pain Research and Management found that mind-body interventions may reduce chronic pelvic pain and improve quality of life.⁶
These approaches align closely with the expertise of many CMA Members, including meditation teachers, yoga therapists, and mind-body practitioners.
Importantly, these approaches do not replace medical care but may provide valuable supportive benefits.
Sleep: An Often Overlooked Factor
Sleep disruption is common in individuals with endometriosis.
Pain, stress and hormonal disruption can interfere with restorative sleep.
Poor sleep, in turn, worsens:
- Pain perception
- Mood
- Immune function
Supporting sleep hygiene (healthy sleep habits) is therefore a valuable area of practitioner focus.
This may include encouraging:
- Regular sleep routines
- Relaxation practices
- Stress management
Emotional Support and Validation
One of the most important roles complementary practitioners can play is emotional support.
Many individuals with endometriosis report feeling dismissed or misunderstood.
Providing:
- Compassion
- Validation
- A listening presence
can have profound therapeutic value.
Research consistently demonstrates the psychological impact of endometriosis, including reduced quality of life.⁷
Holistic practitioners are often uniquely positioned to support emotional wellbeing.
Professional Practice Guidance for CMA Members
Complementary practitioners must always work safely and ethically.
It is essential to:
Stay within your scope of practice
Do not diagnose endometriosis unless medically qualified to do so.
Encourage medical care
Clients with symptoms suggestive of endometriosis should be encouraged to seek medical assessment.
Avoid medical claims
Do not claim to treat, cure or reverse endometriosis.
Instead, focus on:
- Supporting wellbeing
- Supporting lifestyle
- Supporting quality of life
This protects both the client and the practitioner.
Implications for Training Schools
For CMA Training School Members, Endometriosis Awareness Month provides an opportunity to strengthen curriculum content.
Students should understand:
- The prevalence of endometriosis
- Its whole-person impact
- The importance of multidisciplinary care
- Scope of practice and ethical boundaries
This prepares future practitioners to work safely and effectively.
Implications for Clinics, Spas and Retreats
Clinics, spas and retreats frequently work with clients seeking support for hormonal health, stress, and chronic pain.
Creating environments that support:
- Nervous system regulation
- Rest
- Emotional wellbeing
may be highly beneficial.
However, marketing must remain responsible and compliant.
Avoid claims suggesting treatments can cure endometriosis.
The Role of Approved Suppliers
Approved Suppliers also play an important role in supporting practitioner awareness.
This includes providing:
- Educational resources
- Evidence-informed products
- Ethical marketing
This supports practitioner credibility and client safety.
The Integrative Model: Complementing, Not Replacing
The complementary medicine model is based on supporting the whole person.
It works alongside medical care.
Not instead of it.
This integrative approach is increasingly recognised as essential in chronic health conditions.
Endometriosis is a clear example of where this model is valuable.
Looking Forward: A Call to Awareness, Compassion and Professional Excellence
Endometriosis Awareness Month is not just about awareness.
It is about improving care.
Improving understanding.
Improving lives.
As CMA Members, you are part of a professional community dedicated to ethical, responsible, integrative health support.
By deepening your knowledge and practising safely, you contribute to raising standards across the profession.
And most importantly, you help individuals feel supported, heard and empowered.
CMA CPD Reflection Section – Endometriosis Awareness Month
Reflective Practice Questions:
- How confident do you feel in recognising symptoms that may suggest endometriosis?
- How can you ensure you remain within your professional scope when supporting clients?
- What lifestyle support strategies fall within your professional role?
- How can you improve your knowledge in this area?
CPD Value: 1 Hour
Further reading:
Please take time to look at the Complementary Medical Association’s extensive library of conditions and other clinical spotlight articles.
Bonocher, C. M., Montenegro, M. L., Rosa e Silva, J. C., Ferriani, R. A., & Meola, J. (2014). Endometriosis and physical exercises: A systematic review. Reproductive Biology and Endocrinology, 12, 4. https://doi.org/10.1186/1477-7827-12-4
Coxon, L., Horne, A. W., & Vincent, K. (2018). Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms. Best Practice & Research Clinical Obstetrics & Gynaecology, 51, 53–67. https://doi.org/10.1016/j.bpobgyn.2018.01.014
Culley, L., Mitchell, H., Baumgarten, M., & Raine-Fenning, N. (2013). The social and psychological impact of endometriosis on women’s lives: A critical narrative review. Human Reproduction Update, 19(6), 625–639. https://doi.org/10.1093/humupd/dmt027
Evans, S., Fernandez, S., Olive, L., Payne, L. A., & Mikocka-Walus, A. (2019). Psychological and mind-body interventions for endometriosis: A systematic review. Journal of Psychosomatic Research, 124, 109756. https://doi.org/10.1016/j.jpsychores.2019.109756
Facchin, F., Barbara, G., Saita, E., Mosconi, P., Roberto, A., Fedele, L., & Vercellini, P. (2015). Impact of endometriosis on quality of life and mental health: Pelvic pain makes the difference. Journal of Psychosomatic Obstetrics & Gynecology, 36(4), 135–141. https://doi.org/10.3109/0167482X.2015.1074173
Huijs, E., & Nap, A. W. (2020). The effects of nutrients on symptoms in women with endometriosis: A systematic review. Reproductive BioMedicine Online, 41(2), 317–328. https://doi.org/10.1016/j.rbmo.2020.04.014
Mazza, E., Troiano, E., Mazza, S., Ferro, Y., Abbinante, A., Agneta, M. T., Montalcini, T., & Pujia, A. (2023). The impact of endometriosis on dietary choices and activities of everyday life: A cross-sectional study. Frontiers in Nutrition, 10, 1273976. https://doi.org/10.3389/fnut.2023.1273976
Parazzini, F., Viganò, P., Candiani, M., & Fedele, L. (2013). Diet and endometriosis risk: A literature review. Reproductive BioMedicine Online, 26(4), 323–336. https://doi.org/10.1016/j.rbmo.2012.12.011
The following links are suggested as helpful information:
- NICE. Endometriosis: diagnosis and management.
https://www.nice.org.uk/guidance/ng73 - Endometriosis UK. Facts and Figures.
https://www.endometriosis-uk.org/endometriosis-facts-and-figures - BMJ. Endometriosis treatment guidance.
https://www.bmj.com/content/389/bmj.r883 - NICE guideline update.
https://www.nice.org.uk/news/articles/nice-updated-guideline-to-improve-the-diagnosis-of-endometriosis - Habib N et al. Lifestyle and diet in endometriosis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9528818/ - Endometriosis UK. Diagnosis.
https://www.endometriosis-uk.org/getting-diagnosed-0 - Frontiers in Nutrition. Dietary interventions in endometriosis.
https://www.frontiersin.org/articles/10.3389/fnut.2023.1273976/full