* Check female hormone levels (by a simple lab test) as these conditions are all hormone-related. The key is to stabilise the hormonal situation causing the cyclic upset
* Make sure the pain is not due to irritable bowel syndrome, a frequent cause of unnecessary hysterectomy (Obstet Gynecol Surv, 1994; 49: 505-7)
* Use Vitex agnus castus, a non-hormonal herb that regulates female hormones naturally. It can control all hysterectomy conditions, including fibroids (Frauenarzt, 1991; 32: 867). Other hormone-regulating plants are the phytoestrogens rhubarb, alfalfa, ginseng, fennel and celery (J Alt Complement Med, 1993, 11: 13-6)
* Cut down on foods that stimulate oestrogen (dairy products, red meat, chicken and refined sugar).
Excessive period pains and bleeding
* Acupuncture relieves menstrual pain in 90 per cent of women (Obstet Gynecol, 1987; 69: 51-60)
* Chinese mixed herbs (Angelica sinensis, Corydalis ambigua, Paeonia lactiflora and Ligusticum walichii) reduce menstrual pain by 93 per cent (Beijing J Trad Chin Med, 1988; 30-1), as does dong quai (Am J Chin Med, 1997; 25: 205-12)
* The Japanese herbal medicines Shaku-yaku-kanzo-to and Toki-shakuyaku-san, used alternately within the cycle, can improve the pain and heavy bleeding of endometriosis and fibroids (Clin Exp Obstet Gynecol, 2003; 30: 95-8)
* Take omega-3 fish oils (Am J Obstet Gynecol, 1996; 174: 1335-8)
* Supplements: vitamin E (500 IU/day; niacin (200 mg/day) B1 (100 mg/day), B6 and magnesium (200-600 mg/day). Magnesium has an antispasmodic effect (Clin Obstet Gynecol, 1978; 21: 139-45)
* Homoeopathic Cobaltum nitricum can correct frequent, irregular bleeding (Gesichtete Homoeopathische Arzneimittellehre, 4th edn, Heidelberg: Haug Verlag, 1977)
* Avoid high-sugar foods and drinks which exacerbate period pain (Am J Obstet Gynecol, 1993; 168: 1640).
* Watch and wait, as they may resolve on their own, particularly if you're approaching the menopause
* Try KBG, a traditional Chinese herbal mixture of five plants (Cinnamomum cassiae, Paeonia lactiflora, Prunus persica, Poria and Paeonia suffruticosa), which can successfully reduce bleeding and shrink fibroids (particularly those that lie under the outer membrane of the womb) (Am J Chin Med, 1992; 20: 313-7)
* Try the mix of 18 European herbs (including barberry, goldenseal and dandelion) called Nature's Sunshine Special Formula No 1
* Homoeopathic Parathyroidinum and Cobaltum nitricum shrink fibroids (Allg Homoeop Zeitung, 1958; 203: 419-35; Cahiers Bioth'er, 1971; 29: 1-14).
* Watch and wait, as up to half resolve on their own (BMJ, 1993; 16 January)
* Consider Candida. In the 1980s, Dr Karen Lamb showed that women with endometriosis are more likely to be allergic, sensitive to food and environmental chemicals, and prone to chronic candidiasis (Ann Allergy, 1987; 59: 360-3)
* Get off the Pill, which has been linked to endometriosis
* Try fish oils, which can reduce the severity of endometriosis (Fertil Steril, 2001; 76: 717-22).