Boswellic acids, the active compounds derived from the resin of Boswellia serrata (frankincense), have been traditionally used in Ayurvedic medicine for their anti-inflammatory properties. In the context of endometriosis, a chronic inflammatory condition characterized by the presence of endometrial tissue outside the uterus, there is emerging but limited scientific evidence supporting the use of Boswellic acids. Several in vitro and animal studies have demonstrated that Boswellic acids can inhibit pro-inflammatory enzymes such as 5-lipoxygenase, reduce leukotriene synthesis, and modulate cytokine production, which are all relevant pathways involved in the pathophysiology of endometriosis.

A few preclinical studies (e.g., rodent models of endometriosis) suggest that Boswellia extracts can reduce lesion size and markers of inflammation, as well as alleviate pain-related behaviors. However, high-quality human clinical trials are lacking. A 2022 systematic review on herbal interventions in endometriosis noted Boswellia as a potentially beneficial adjunct due to its anti-inflammatory and analgesic effects, but emphasized the absence of robust randomized controlled trials in women with endometriosis.

In summary, while there is a scientific rationale and some preliminary evidence for the use of Boswellic acids in endometriosis, current support is limited mainly to preclinical data and small pilot studies. Further clinical research is needed to confirm efficacy and safety in humans.