Pain relief is a principal concern of anyone with the difficult and painful menstrual flow that so often is a symptom of endometriosis. Several medications that attack this pain are available without a prescription. Aspirin and ibuprofen (Advil, Motrin, others) are the popular OTC painkillers. However, allergies to these drugs and too frequent use at too high doses can cause side effects. These medications reduce the effects of Prostaglandins (hormone-like compounds involved in the production of pain and inflammation) that increase rapidly as menstruation approaches. They are therefore often most effective when taken just before, as well as during, your period.

Good nutrition helps fight any disease. Most approaches are designed to reduce the effect of estrogen on endometrial tissue. B vitamins, especially B6, promote the liver's ability to change estrogen to estradiol, a form of the hormone less prone to promote endometrial growths. Vitamin E has been called an estrogen antagonist and may break down the hormone when it is present in excessive amounts. Whole wheat, citrus fruit, and yams are reported to raise estrogen levels and perhaps should be avoided. Fish oils are said to reduce prostaglandin production. Before making any of these dietary adjustments, it's wise to check with your doctor, and none should be made too radically. Diet is probably useful only in early endometriosis.

Exercise is also advisable, since it tends to reduce menstrual flow and, therefore, the irritation and inflammation where foreign endometrial tissue is growing.

Eat a diet consisting of 50 percent raw vegetables and fruits. In addition, eat only whole-grain products (no refined flour products) and raw nuts and seeds.

Include "green drinks" made from dark green leafy vegetables in your diet.

Use kelp to add iron to the diet. The heavy monthly bleeding that is common in women with endometriosis often leads to iron deficiency.

Avoid alcohol, caffeine, animal fats, butter, dairy products, fried foods, foods that contain additives, all hardened fats, junk foods or fast foods, red meats, poultry (except organically raised and skinless), refined and processed foods, salt, shellfish, and sugar.

Fast for three days each month before the anticipated beginning of the menstrual period. Use steam-distilled water and fresh live juices.

Use a heating pad, hot water bottle, or a hot bath to help relieve pain. The warmth relaxes the muscles that cramp and cause pain.

For some women, ice relieves pain better than heat. (It reduces tissue swelling.) Place an ice pack or a plastic bag of crushed ice wrapped in a washcloth on your lower abdomen.

If you are taking medication for endometriosis, report any new or worsened symptoms to your doctor immediately, especially problems such as difficulty breathing or chest or leg pain. These symptoms may indicate the presence of a blood clot. Frequent checkups are needed to monitor possible side effects such as thinning of the bones.

Use pads rather than tampons during menstruation. Tampons may make reflux menstruation more likely. They can also aggravate pain and cramping.