Herbs seem to promote tissue healing through a blend of effects. In addition to using phytoestrogens and other hormone-balancing plants, therapy aims to augment circulation to and from the areas of damage. Nutritive herbs provide building materials for the cells. Particular hepatic herbs may be chosen if a woman needs to eliminate toxins. Finally, it is important to improve immune-system function so that white blood cells will cluster around and eat up debris or imperfect cells.

Herbs that are useful for the treatment of endometriosis are: dandelion, Oregon grape root, pasque flower, chasteberry, false unicorn, cramp bark or blackhaw bark, black cohosh, motherwort, vervain, yarrow, hops, valerian, and borage.

Here is a summary of the beneficial effect sought from a herbal treatment and the herbs that are involved:

1. Herbal Hepatics and the Liver: These herbs focus on hormone metabolism, improving the bile-bowel functional relationship, and treating gastrointestinal toxicity, flora, and pelvic blockage. Choose from Rosmarinus (rosemary leaves and flowers), Taraxacum (dandelion root and leaf), Carduus marianum (milk thistle seeds), and Verbena officinalis (vervain herb). Other hepatics, cholagogues, and alteratives may replace any one of these, as necessary.

2. Cleansing: There may be a need for elimination beyond reliance on the hepatics listed above. This includes fasts alternating with rebuilding diets containing kelp, seaweed, sprouted seeds, and easily digested whole foods to speed recovery. A castor oil pack is effective in assisting recovery when placed over adhesions or the site of greatest pain.

3. Anti-inflammatories and Nervines: The primary symptom of pain impedes healing and must be treated with effective herbal nervines and analgesics while the more comprehensive state of health is slowly improving. The anti -inflammatory herb Matricaria recutita (chamomile flower) is useful here. Muscle relaxants such as the Viburnum spp. (cramp bark), Valeriana (valerian root), and Humulus (hops flower) are effective, though Humulus has a cold quality in common with other bitters. The heat-producing Zingiber officinahs (ginger root) relaxes muscles. The dried herb of Anemone pulsatilla (pasque flower herb) prepared as a tea, capsule, or tincture is a standard remedy in Europe for reproductive pain and infection. No ill effects are reported from using these herbs.

4. Lymphatic Circulation: This will assist delivery of the other herbs to improve the blood and lymph drainage. Gahum aparine (cleavers), Calendula (calendula flower), and Echinacea spp. (purple coneflower root, seed) all work against a possible secondary infection due to stasis (stagnation), and Echinacea's effects on collagen repair in connective tissue adds to its alterative and immune-system normalizing functions.

5. Tonic Diuretics: Elimination through the kidneys allows the body's mechanisms for self-regulation to work optimally, while preventing buildup of stimulating herbs. Sohdago virgaurea (goldenrod herb tea) prevents overtaxing the kidneys.

6. Digestive Aids: Two types, demulcents and bitters, act in their respective ways. Demulcents such as Althaea officinahs (marshmallow root) soothe inflammation and reduce pain by reducing stimuli to pain sensors in the digestive mucosa. This has a reflex soothing effect through spinal nerve pathways to muscles other than digestive structures, which may be in spasm. Bitters such as Verbena (vervain) or Achillea (yarrow herb) change the intestinal flora, or tone the bowel wall while stimulating general digestive function.

7. Skin Alteratives: Smilax ornata (sarsaparilla root) gives tone rather than stimulation of the immune system. It is considered by herbalists to be a tonic for lymphatic circulation and hormonal balance, with an affinity for clearing skin conditions. Larrea mexicana (chaparral) and Berberis aquifohum (Oregon grape) are two stronger skin alteratives with an effect on immunity.

8. Expectorants: Mildly expectorant diaphoretics may overlap with the benefits of alteratives by warming the circulation. Herbs chosen for strengthening elimination through the respiratory organs may have other benefits. British medical herbalist Sue Godwin writes that Cimicifuga racemosa (black cohosh) may play a role in dissolving adhesions while carrying out its better-known actions of clearing lungs, relaxing muscle, calming nerves, and normalizing reproductive cycles. Cimicifuga is useful for its antispasmodic role in the treatment of endometriosis.

9. Astringents: Both metrorrhagia (bleeding between periods) and internal bleeding (endometrial or from ruptures) are affected. Fresh plant tincture or preparation of Capselia bursa-pastoris (shepherd's purse) will decrease abnormal bleeding, as will Hamamelis Virginia (witch hazel bark), Agrimonia cupatoria (agrimony herb), Hydrastis canadensis (goldenseal root), and Vinca spp. (periwinkle herb). Since goldenseal is endangered and good quality agrimony is hard to find in many regions, fresh Capsella bursa-pastoris (shepherd's purse) tincture may be the best bet. Other herbs which are used as astringents include American Cranesbill, Beth Root, Burr Marigold, Lady's Mantle, and Periwinkle.

10. Nervine Tonics: These reduce tension and take the edge off pain since the symptoms can be so difficult to manage. These synergize with analgesics and include Leonurus cardiaca (motherwort herb, also a bitter), Scutellaria spp. (skullcap herb), and flower essences. Flower essences are a gentle way of using the essences of plants in water. They are believed to affect one's thoughts and emotional states.

11. Uterine Tonics: The uterine tonics tones and strengthen the whole system, both on the tissue of the organs and on their functioning. Examples are Black Cahosh, Blue Cahosh, Castleberry, False Unicorn Root, Life Root, Motherwort,, Raspberry, and Square Vine.

12. Emmenagogues: These stimulate and promote normal menstrual flow. Useful in this function are the herbs such as Blue Cahosh, False Unicorn Root, Life Root, Motherwort, Parsley, Pennyroyal, Rue, Southernwood, Squarewood, Squaw Vine and Yarrow.

13. Hormonal Normalisers: These balance and normalize the functioning of the endocrine glands and aid the proper functioning of the reproductive system. Castleberry is an important herb in this connection. It normalizes estrogen and progesterone activity and is useful for all aspects of menstrual dysfunction.

14. Demulcents: These are used to provide soothing and healing action on the system's mucous membranes. Herbs used include Bearberry, Blue Cahosh, Corn Silk, Golden Seal, Irish Moss, and Marshmallow.

15. Antiseptics: Examples are bearberry, couch grass, Echinacea, garlic, juniper, wild indigo, and yarrow.

16. Alteratives and Lymphatic Tonics: Alteratives and Lymphatic Tonics:  Examples are blue flag, burdock, cleavers, Echinacea, poke root and sarsaparilla.

Amanda M. Crawford, author of 'Herbal Remedies for Women' recommends two herbal formulae that are useful for endometriosis. According to her, Herbal Formula 1 decreases excess estrogen during the luteal phase of the cycle. Herbal Formula 2 balances progesterone and shrinks and heals endometrial lesions. Herbs in both formulae share complementary effects throughout the month; these relax painful spasms, stimulate liver function, build healthy immune-system response to cellular debris, or nourish a woman undergoing the physiological demands of self-healing.