Herbs for Endometriosis - Pain Management
When aspirin, NSAIDS, and opiates can’t touch the pain - sometimes herbs can.
I have likely had endometriosis all of my life. Given my symptom history and how endometrial lesions develop, that’s the most likely scenario. It took me about 23 years to get a diagnosis, so it’s hard to say, but regardless, I’ve had intense pain since my very first menstrual cycle. It’s changed over the seasons and cycles of my life, getting worse, then better, then worse again, but menstrual pain has been a constant. This kind of pain can be a life stealer, and along with being incredibly shitty to experience, it can prevent us from engaging fully in our community and purpose. Addressing menstrual pain in general, and endometriosis pain in particular is something I’m passionate about for myself, my students, and my clients.
Drugs vs. Herbs
A common feature I’ve seen in my time as a teacher, practitioner, as well as clinic director at the Colorado School of Clinical Herbalism, is that in many cases, the classical pain-killing drugs we rely on for addressing menstrual pain don’t work as well, or sometimes at all when it comes to endometriosis.
I’ve seen several cases where folks needed to go to the ER to get morphine drips to manage acute pain episodes because ibuprofin+oxycodone+THC patches just didn’t cut it, and the client was still in extreme pain.
This is a common tale, and while no one has a perfect answer as to why endometriosis pain can be so difficult to address, it does seem to have something to do with the multi-system involvement. It’s not just the musculoskeletal cramping, but also the general inflammatory picture around each endometrial lesion, and the way that affects the adjacent tissues (digestive system, lymphatics, bladder, etc.).
To address a multifactorial pain picture, you need a multifaceted pain formula. The complex nature of whole herb extracts lend themselves to this quite well. When aspirin, NSAIDS, and opiates can’t touch the pain - often an herb, or several herbs in formula, can. And when you have 10/10 pain, that’s magical.
Anodyne/Analgesic Herbs
Simply put, these are herbs that help relieve pain. Often these herbs are also anti-inflammatory or have an antispasmodic action, but in many cases, we don’t know their full mechanism of action. What we can see (and by “we” I mean herbalists from now back into the shadows of the ancients) is that they provide relief. Below are 3 of my favorites for endometrial pain.
Garrya wrightii, Silk Tassel, Sedona, AZ.
Kat Mackinnon
Silk Tassel - Garrya wrightii
Garryaceae, Silk Tassel Family
AKA, Cuauchichic, Quinine Bush
Herbal Energetics: Cold and Dry
Herbal Actions: anodyne, analgesic, antispasmodic, bitter, astringent, mild sedative
Dosing information: 1:5 tincture, 30-90 drops. Tea can be nauseatingly bitter.
Indications: Spasmodic muscular pain and inflammatory pain, in smooth or skeletal muscle. Effective for everything from menstrual cramps, digestive pain with gripping, and sprains or wounds. A strong, general anodyne, excellent for the basis of any pain formula. Seems to have a mild sedative effect, excellent for the inevitable nervous agitation associated with pain and injury
Other Notes: This one tastes bad. No, really. Gotta warn you. There is a reason white folks called it quinine bush - it has weird, bitter-tasting alkaloids similar to the ones of various Cinchona species that were the original source of quinine. Can be nauseatingly bitter for some folks, so it's best to mix it with something less bad-tasting.
Piscidia piscipula - Jamaican Dogwood
Kat Mackinnon, 2024
Jamaican Dogwood - Piscidia piscupula
Fabaceae, Pea Family
AKA, Fishfuddle, Fish poison
Herbal Energetics: Cool and Dry
Herbal Actions: anodyne, antispasmodic, anti-inflammatory, sedative
Dosing information: 1:5 tincture, 10-90 drops per dose. It can be a lower dose herb for some people – start with low dosing, work your way up to avoid digestive symptoms and dizziness.
Indications: Useful for muscle pain and spasms, as well as for nerve pain (this gets relevant real quick for endometriosis, because endometrial lesions can GROW THEIR OWN NERVE SUPPLY. Anyway. Yikes. Thank god for J-Dog here). Can also work to calm the mind as well as relax the body, so useful for a pain picture that comes with insomnia, anxiety, and general nervous tension.
Other Notes: May cause nausea, dizziness, and excess salivation in higher doses - supposedly. I have yet to see more than mild digestive upset as a side effect, and I’ve both taken and seen 20+ folks take 2-3 tablespoons at once for intense pain. I’m not saying you need to take that much - more that if you’re reasonable with dosing, and pay attention to what your body is feeling, you should be able to avoid giving yourself negative side effects.
Gelsemium sempervirens - Yellow Jessamine in flower
Yellow Gessamine - Gelsimium sempervirens
Gelsemiaceae, Trumpet flower Family
AKA Yellow Jasmine, Carolina Jasmine
Herbal Energetics: Cool and Dry
Herbal Actions: analgesic, sedative, antispasmodic, antipyretic, anti-neuralgic
Dosing information: Tincture, 1:5, 3-5 drops per dose, ideally in formula. LOW DOSE HERB - high potential for side effects, including neurotoxicity. If this was a tool, it would have a strong motor and sharp blades - strongly recommend you get someone who knows what they’re doing to show you how to use it.
Indications: Spasmodic and neuralgic pain, dysmenorrhea, endometriosis, insomnia. I have a deep and abiding gratitude and love for this herb, because of the relief I’ve seen it provide to those with complicated and seemingly intractable pain pictures associated with endometriosis. All herbs are magic, but when you can add 90-120 drops of something into a 1 oz pain tincture and have it increase the effectiveness by 2-3x, that’s a whole other level of witchy fabulousness.
Other Notes: The term “Low Dose Herb” can be a loose one. What I mean here is that without some guidance and supervision, you could profoundly hurt yourself with this plant. It has a variety of alkaloids including strychnine-like compounds that can be neurotoxic. Dangerous in higher doses, can cause nausea, vomiting, depressed respiration, tremors, and convulsions. Sap can cause skin irritation. I feel comfortable writing about it for a number of reasons, one of which is that it’s incredibly difficult to get on the open herb market in anything but a homeopathic preparation.
About The Author
Kat Mackinnon, RH (AHG) is a clinical herbalist, teacher, and botanist in Colorado, with a focus on bioregional herbalism in the Mountain West.
Disclaimer: Kat Mackinnon RH (AHG) is a certified herbal medicine practitioner, not a licensed healthcare professional. This class series is intended for informational and educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment.