Bridging gaps in endometriosis care: a scoping review of complementary, alternative and/or integrative medicine for pain and quality of life

INTRODUCTION: Endometriosis is an inflammatory disorder characterized by ectopic endometrial-like tissue, affecting approximately 10% of women. It significantly impairs quality of life through symptoms such as dysmenorrhea, pelvic pain, and infertility. Conventional treatments often inadequately manage the complex pain associated with the disease. Complementary, alternative, and integrative medicine (CAIM) approaches are proposed as supplementary strategies addressing broader symptomatology. EVIDENCE ACQUISITION: This scoping review employed a comprehensive search of PubMed and PsycINFO databases from inception through April 25^th, 2025. Studies assessing CAIM treatments on endometriosis-associated pain or quality of life were included. Screening and data extraction were performed independently by multiple reviewers, following PRISMA-ScR guidelines. EVIDENCE SYNTHESIS: A total of 107 studies across diverse CAIM domains were analyzed, including acupuncture, Chinese and natural medicine, nutritional supplements, physical therapy, dietary interventions, relaxation techniques, psychotherapy, and combined therapies. Acupuncture, Chinese and natural medicine, and nutritional supplements had the most substantial evidence base, featuring randomized controlled trials and meta-analyses indicating significant pain relief and quality of life improvements. However, significant heterogeneity in study designs, diagnosis confirmation methods, intervention specifics, and outcome measures limited direct comparability and generalizability. CONCLUSIONS: CAIM therapies demonstrate potential as adjunctive treatments for endometriosis-associated pain and quality of life enhancement. Future research should examine additive benefits of CAIM therapies combined with conventional treatments, supporting integrative care addressing endometriosis-related pain, sensitization, mental health, inflammation, and myofascial dysfunction.