Endometriosis and the herbal medicine approach to treatment

Endometriosis is a heterogeneous and oestrogendependent inflammatory disease characterised by morphological and biologically active endometrium (composed of endometrial-type glandular tissue and stroma) that is present in sites outside the uterine cavity. The disease is complex, with tissue implantation occurring as a result of a phenomenon known as retrograde menstruation. Although this is considered central to the pathogenesis of endometriosis, 90% of women who experience this event do not have endometriosis. However, the remaining 10% of this population do. Alterations in the immune system (increased TNF-α, PGE2 and reduced NK cells), excess inflammation and high oestrogen levels play a role in establishing endometrial implants. Given the multifactorial nature of the condition a range of herbal medicines has been identified to treat the different clinical symptoms and underlying cause of endometriosis. The following review will examine the pathophysiology of endometriosis and the herbal medicine approach to treatment.