ENDOMETRIOSIS can cause women years of misery – partly because there is no cure.
And that can lead sufferers to cut out whole food groups for fear of triggering some kind of agonising inflammatory response.
But because endometriosis can appear in different parts of the body, it’s a condition that’s totally different for every woman.
So, is there really a diet that can help ease the symptoms?
A recent study found that bacteria in the gut microbiome may help drive or prevent the progression of the disease.
But Dr Lucy Chambers, senior scientists at the British Nutrition Foundation told The Sun that at the moment, “it’s only a hypothesis that the gut microbiota is involved in endometriosis and (it's) far too early to give any dietary advice based on the available research".
“For a handful of health conditions, such as Irritable Bowel Syndrome and Ulcerative Colitis, there is mounting evidence that treatments to change the gut microbiota can be helpful, while for many other conditions, including endometriosis, the evidence is very limited," she said.
We’re beginning that it’s an autoimmune condition and that there’s a link between endo and inflammation, our immune systems and gut health
But that doesn’t mean that food can’t play a role in the management of symptoms.
Henrietta Norton, Harley Street Nutritional Therapist and Founder of Wild Nutrition, told The Sun: "Research has shown links between expression of endometriosis and changes or imbalances in the immune system.
"With 80 per cent of our immune system located within our gut, it makes absolute sense for women with endometriosis to follow a diet that focuses on strengthening the gut, especially when dealing with the inflammatory nature of endometriosis.
"Improving levels of good bacteria through diet and supplementation is important – such as via fermented foods, live yoghurt or a probiotic powder."
Angelique Panagos is a Nutritional Therapist who specialises in hormonal health, and she told us that because endometriosis is such a multifactorial and individual condition, there’s no one-size-fits-all treatment.
As such, she recommends sufferers work with a BANT registered nutritional therapist who can work alongside their doctor/gynaecologist to help work out a personal lifestyle plan.
The key things to work on are balancing hormones, supporting the immune system, reducing inflammation and building a healthy gut microbiome.
While we don’t know exactly what causes endo, “we’re beginning that it’s an autoimmune condition and that there’s a link between endo and inflammation, our immune systems and gut health”, Angelique tells The Sun.
There's also a belief that excess oestrogen may play a role.
The hormone may encourage endometriosis tissue to grow and shed – so limiting the amount of it may reduce the amount of tissue in the body.
With that in mind, Angelique has eight tips for managing symptoms:
1. Eggs and nuts – zinc
Eating zinc-rich foods which can help reduce inflammation and research has shown that zinc levels can be low in women with endometriosis.
You get it from:
- nuts (especially Brazil, pecan, almonds, cashews)
- egg yolks
- kefir or yoghurt
- seeds (especially pumpkin seeds)
- green leafy vegetables
2. Colourful veg – anti-inflammatory
Eat a wide variety of colourful vegetables to help reduce inflammation and therefore reduce pain.
Having a fibrous diet can also help the body get rid of oestrogen, so aim to eat 5-7 portions of vegetables daily.
- red/green/yellow peppers
Henrietta says: "Women with endometriosis do not have strong immune systems. The natural ‘killer’ cells of the immune system do not work as effectively as they should; endometrial patches that should be regarded as ‘invaders’ and destroyed by chemicals released by the immune system, are not.
"Instead, they are left intact to roam and migrate to other parts of the body, further evoking inflammation. "As we know, the immune system of a woman with endometriosis is suggested to be weaker than the norm, therefore it is vitally important to support this system in order to control the inflammatory process."
3. Organic yoghurt and sauerkraut – improves digestion
Pre and probiotic foods are essential for feeding your ‘good bacteria’, which in turn aids healthy digestion, and to lower inflammation.
- plain organic yogurt
- raw cheeses
- If you are sensitive to dairy, try sugar-free coconut or almond yogurt
The key is to have little fermented food each day, but only if they agree with you.
4. Salmon, walnuts, flaxseeds – removes excess oestrogen
Omega 3 fatty acid is anti-inflammatory, and you can get it in foods like:
- wild salmon
- flax and chia seeds
Having two tablespoons of freshly ground flaxseeds each day is beneficial for helping remove spent oestrogen from the body.
5. Broccoli and Brussel sprouts – detoxifying
Symptoms of endometriosis
Endometriosis is where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body.
Each month, these cells react in the same way to those in the womb – building up and then breaking down and bleeding. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape.
That can lead to infertility, fatigue, bowel and bladder problems, as well as really heavy, painful periods.
It affects one in ten women in the UK.
- Painful, heavy, or irregular periods
- Pain during or after sex
- Painful bowel movements
The cause of endometriosis is unknown and there is no definite cure.
According to Endometriosis UK, it takes over seven years on average for women to finally receive a diagnosis.
It's estimated that up to 50 per cent of infertile women has the condition.
Source: Endometriosis UK
Eat foods that naturally support our detox systems.
Angelique refers to them as her "detox warriors" in her book The Balance Plan and these include:
- cruciferous vegetables like broccoli
- Brussels sprouts
Try to avoid:
Eating Sugar and refined carbs
While it might be hard to cut sugar entirely, Angelique says that you want to avoid refined sugar and processed carbs as much as possible.
“Eating a high amount of these can lead to elevated insulin which in turn, can lead to excess oestrogen.”
"Removing foods that can affect the gut and good bacteria, such as refined sugar, is really important. Alcohol should be in moderation if you have endometriosis and the aim would also be to have periods where it's avoided."
Sugar, as we know, also increases fat – which in turn, increases oestrogen production.
Eating a high amount of sugary foods can lead to elevated insulin which in turn, can lead to excess oestrogen
It's also an "anti-nutrient", depleting the body of valuable vitamins and minerals.
"Eating foods with sugar causes your pancreas to produce insulin and can encourage an increase in fat cells and, of course, weight gain," Henrietta explains.
"Fat cells produce something called aromatase enzyme and produces small amounts of oestrogen. Therefore the more fat cells you have the more oestrogen you produce.
"That's why a diet of excess sugar has a link to breast cancer as well. Too much glucose in the bloodstream also encourages the production of prostaglandin 2 (PGE2), the chemical released by our immune system to cause inflammation."
One way or another, we’re surrounded by chemicals. We clean our bathrooms and kitchens with bleach, we smother our skin in potent gels and serums, and we spray deodorants and dry shampoos. Our food is packaged in plastics.
Who knows the impact all of these unnatural substances are having on our health – and especially our hormonal balance.
“Never before have we been so bombarded with chemicals and toxins in our environment which are shown to be endocrine disruptors,” Angelique explains.
“Although we have brilliant and powerful detox systems in our bodies, in my opinion, our goal should be to reduce our exposure so that we don’t overtax our detox systems.
“Consider your water quality and invest in a water filter, look at your cosmetics, creams and household products, avoid plastic where possible and definitely do not heat food wrapped in cling film in the microwave.”
You can buy a BRITA filter from Amazon for under £20.
While it’s becoming clear that gut bacteria plays a massive role in our overall health, we still have a lot to learn about the changing bacterial composition of the gut and disease treatment.
And Emma Cox, CEO of Endometriosis UK, told us that because endometriosis can appear in a different site, it won’t always be manageable with lifestyle interventions.
Eating more red meat or food high in trans fats and drinking too much coffee might make things worse
If you’ve got endometriosis on your bowel or intestine, reducing inflammation might help. But if it’s in a different organ that’s totally unrelated to digestion, you might find that food won’t play a role at all.
“The evidence for all this is extremely weak,” explains Dr Sarah Jarvis, Clinical Director and founder of patient.info.
“In recent years, we have become more and more aware of the role diet has not just on gut health, heart health and weight but also on inflammation within the body and even mental health. So it makes sense to look at whether diet could affect endometriosis symptoms too.
“Scientists have looked into the idea that eating more vegetables and oily fish or other sources of Omega 3 oils could reduce symptoms, while eating more red meat or food high in trans fats and drinking too much coffee might make things worse.
“The studies which have been done so far don’t show strong evidence to support this.
“However, eating a healthy diet with plenty of vegetables, fruit and omega 3s is good for your general health, so it’s certainly worth a try.”
Diet won’t cure endometriosis and it might not be enough on its own to help manage the symptoms but coupled with other interventions like physiotherapy, you might find that you start to feel a little better in time.
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