Written by Nourished Not Deprived Practitioners

Can we manage Endometriosis through food?

What is Endometriosis?
Endometriosis or also known as “endo” is a condition where endometrial tissue grows outside of the uterus. This condition can affect 1 in 10 women and can cause difficulty in multiple areas of one’s life.(1) 

Normally, endometrial tissue (tissue that lines the uterus) grows and breaks down as part of a normal menstrual cycle. This is what causes a woman to bleed monthly!
With endometriosis however the same process happens, but in other tissues like your ovaries, fallopian tubes and tissue surrounding the uterus, causing issues.

Since this tissue is outside of the uterus, it can’t exit your body as it normally would. This causes little lumps called nodules (abnormal lumps) to form.

These nodules cause inflammation and scarring which can pull pelvic tissues and organs towards each other,  leading them to stick together (ouch!).
As you can imagine this would be extremely painful and can be quite debilitating for a female to endure.

What causes Endometriosis?
The bottom line is there is no known cause, but, there are many complex theories, some of which I have outlined below:

  1. Retrograde menstruation- this is when menstrual blood containing endometrial cells flows from fallopian tubes into the peritoneal (pelvic) cavity.
  2. Transformation of cells in abdominal wall and organs- this is where peritoneal cells change into endometrial like cells.
  3. Lymphatic and vascular metastasis- this is the transport of endometrial cells through lymphatic vessels and blood vessels to other parts of the body.
  4. Müllerian rests- this is the process of embryonic cells transforming into endometrial-like cells due to increase of estrogen at puberty.
  5. Genetics- some people are just born with it!
  6. Malfunctioning Immune system – your immune system may not be able to clear endometrial-like cells.

What are the symptoms of Endometriosis?

  • Painful periods- severe cramping and frequent periods
  • Painful intercourse 
  • Painful urination- can be a burning, tingling or stinging feeling
  • Painful bowel movement- pain when opening bowels
  • Fatigue
  • Lower back pain
  • Nausea, bloating, diarrhoea, and constipation
  • Chronic pelvic pain- pain below your belly button and around your hip area for a long period of time such as over 6 months
  • Uterine bleeding- heavy bleeding in menstrual periods
  • Infertility

How are you diagnosed with Endometriosis?
The only way to officially be diagnosed with endometriosis is through a surgery called a Laparoscopy.
A Laparoscopy is when a small telescope is inserted inside the abdomen through a small cut.

To be classified with endometriosis you need 2 out of 3 of the following characteristics:

  1. Endometrial stromal cells
  2. Endometrial epithelial cells
  3. Signs of chronic bleeding in or adjacent to endometrium-like tissue

Now the more exciting part… how on earth can we manage Endo through our diet!?
Similar to PCOS dietary recommendations (you can read about this in our PCOS blog from last week) there is no strict diet for Endometriosis. So if you are reading somewhere on the internet that *YOU CAN CURE ENDO WITH THIS DIET*, I’m sorry to say, they are lying (although I wish they weren’t).
However, there are various guidelines that we can follow to help improve your symptoms.
We have placed these guidelines below:

Increase your fruit and vegetable intake!
Fruit and veg are great for general health but more specifically for endo as  they can reduce inflammation. There is even some evidence that fruit and veg can impact genes that lead to endo, reducing the risk of its development. (5)

Here are some of our tips to adding more fruit and veg to your day:

  • Adding some extra salad or cooked veg to lunch or dinner
  • Snacking on some dried fruit
  • Try fruit cups!
  • Does pureed fruit tickle your fancy? 
  • Try hiding some veg in your meals (ie. grate carrot or zucchini into bolognese sauce).
  • On your way out the door and need a snack? Grab that apple in the fridge.
  • Try a smoothie! Blend in different fruits!

Increasing good fats
Saturated and trans fats have been shown to increase inflammation in those with endometriosis, so trying to limit these and/or swap these for unsaturated fats is a great idea. (5)
Try the following:

  • Swap Regular milk and cheese → reduced fat or light option
  • Swap Butter→ avocado or margarine
  • Swap Coconut or palm oil→ Olive, canola or vegetable oils
  • Trim fat off meats
  • Choose lean meats e.g. chicken, fish, lean minces
  • Swap creamy sauces→ tomato-based sauces

Brownie points: Include Omega 3s!
Omega-3s have anti-inflammatory effects which is very helpful for someone experiencing endo! (5). Foods you can include are salmon, mackerel, oysters, sardines, walnuts, flax and chia seeds.

Fibre
Fibre is super important for helping regulate hormones, as it helps to remove excess estrogen and lowers the amount of estrogen our body can absorb. (5)
Fibre is found in fruit, veg, wholegrains and legumes.

Some swaps you can make to add more fibre in are:

  • White bread → brown bread
  • Normal pasta → whole wheat pasta (Vetta and San Remo smart pasta are good alternatives)
  • Chips → popcorn
  • Choose Wholegrain options 
  • Add psyllium husk, oats or flax seeds to smoothies

Vitamin D and Magnesium
Increasing both vitamin D and magnesium (if deficient or not consuming enough) can be helpful for reducing the development of endo. Vitamin D reduces inflammation. (5-6)

How to get enough vitamin D:

  • Get out in the sun!
  • A supplement might be necessary (but you should discuss this first with your healthcare provider)

Magnesium can relax smooth muscle which can help manage retrograde menstruation. (6)

How to get magnesium:

  • Green leafy veg
  • Wholegrains 
  • Legumes (beans).

Antioxidants
Antioxidants play a role in reducing inflammation by reducing free radicals in the body which cause disease. (5) Antioxidants include vitamins A, C and E and the key to eating enough is having a VARIETY of food:

  • Vegetables
  • Fruit
  • Wholegrains
  • Beans
  • Lean meat, poultry and fish
  • Dairy foods

Annnnd that is a wrap folks! Phew!

Hopefully you have learnt a thing or two about Endometriosis and how to manage your symptoms more appropriately through diet.

Endo can be a horrible ailment to endure, and here at Nourished we see women go through the ebbs and flows of how Endo can affect one’s life. Know that you are not alone in this, and if you feel you need support for what is going on for you, help is available and we are always here as a helping hand.

We hope you enjoyed the read and if you want more information on Endometriosis and how we can change your diet to help, feel free to contact us!

We hope you are having a lovely day wherever you are in the world, and don’t forget to… stay hydrated!

References:

  1. DOI: 10.1210/er.2018-00242.
  2. DOI: 10.1016/j.fertnstert.2012.06.029
  3. DOI: 10.1056/NEJMra1810764
  4. https://www.advancedgynaecologymelbourne.com.au/endometriosis/stages#:~:text=The%20ASRM%20classification%20system%20is,try%20to%20quantify%20endometriotic%20lesions%20
  5. DOI: 10.1016/j.rbmo.2012.12.011
  6. DOI: 10.1093/aje/kws247
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