World Endometriosis Week, running this year from March 3rd to 9th, aims to raise awareness of an often very distressing condition which affects up to 10% of females. It arises when endometrial tissue, which lines the uterus, occurs in other sites such as the fallopian tubes, ovaries, bladder or bowel. Each month this tissue behaves as it would in the womb, thickening and then bleeding, but the blood is trapped.
This eventually leads to the formation of scar tissue, and adhesions that can actually join separate structures together, along with an inflammatory action leading to pain, which may be mild or severe. If it’s less severe, women sometimes believe that it’s just normal period pain and it’s estimated that 50% of sufferers are unaware that they have the condition. But a diagnosis is crucial, especially as it’s thought to be the cause of up to 30% of cases of infertility.
Endometriosis is a chronic condition, but symptoms can certainly be markedly reduced (some women who have made dietary changes report complete relief). The keys that unlock the puzzle are its two driving forces, inflammation and high oestrogen levels.
Both can be efficiently addressed using a tailored diet, which will also boost immune function – endometriosis is also considered an auto-immune disorder – reduce toxicity, support digestive and liver function (the liver is responsible for breaking down excess oestrogen) and aid fat loss (oestrogen is manufactured in fat cells).
Eating foods that lead to insulin resistance – sugars and all refined grains, processed foods – will not only cause weight gain but also increase oestrogen production and inflammation. Sufferers are more likely to be sensitive to the gluten in wheat and pasta, while the fats in animal produce contains inflammatory, pain-causing compounds – in one study the women eating the most meat increased their risk of endometriosis by up to 100% – as do vegetable oils, trans/hydrogenated fats, fried foods, alcohol, coffee and again sugars.
Non-organic meat, especially poultry, can also have traces of antibiotics and hormone-disruptors, while the pesticides in non-organic fruit and veg, chemicals in commercial toiletries and plastics used in food wrapping, bottles etc also disturb hormonal activity. And all of these, together with food additives, overburden the liver.
It has to be said that this is a tricky dietary plan, and some attention will have to be paid to making sure that you get enough protein. Meat and dairy should be grass fed and limited, and pulses like beans and lentils – which would normally be the ideal replacement – also taken in moderation because they are phytoestrogens, though these plant chemicals can actually block the action of the stronger oestrogens made in the body.
Soya is the most phytoestrogenic of the foods and should probably be avoided, but one serving a day of other beans or lentils is fine. The mainstays of your diet should be fish and vegetables, especially oily fish with its Omega 3s and vitamin D for a potent anti-inflammatory and hormone regulating effect, and green veg with their ability to promote the excretion of excess oestrogen.
Women eating the most greens are 70% less likely to have endometriosis. Carbs in the form of vegetables and small amounts of wholegrains are a good idea because fibre is necessary for binding to oestrogen and moving it out of the body. Because it’s been fermented, natural yoghurt can be eaten daily – its probiotics stop oestrogen being reabsorbed in the gut and boost immune function.
Colourful vegetables and fruit, cruciferous veg, garlic, onions, ginger, turmeric and green tea all have oestrogen binding or anti-inflammatory properties. Vitamin B6 (fish, wholegrains, avocadoes, nuts) is vital for hormonal balance and the excretion of excess oestrogen.
The vitamin E and selenium in oily fish, Brazil nuts and sweet potato decrease inflammation, pain and heavy bleeding. The iron in greens and beans, beetroot, dark chocolate, quinoa and a little grass fed meat will replenish that lost in blood (eat a source of vitamin C with plant sources of iron to increase absorption), and magnesium (greens, nuts) promotes mental as well as physical relaxation, easing cramps and constipation. The zinc in seafoods and wholegrains is anti-inflammatory and central to reproductive and immune system health, and healing. Seaweeds are concentrated sources of all the relevant nutrients.
Gentle exercise is vital not only for fat loss but also to boost the detoxification and immune mechanisms as well as production of pain relieving endorphins, lower oestrogen levels and levels of the stress hormones which have an inflammatory action. Many sufferers find yoga, relaxation exercises, massage or aromatherapy helpful, and sufferers given acupuncture reported 62% less pain. If sex is painful, the advice is to try going on top and using a lubricant.
Supplements can be very useful here. Along with a high strength B complex and vitamin D, you could also try Pycnogenol (pine bark extract), shown to steadily reduce symptoms, and Green tea, which helps to stop new adhesions forming.
Taking resveratrol (naturally found in red wine) has been shown to decrease the number of new adhesions by 60% and their total volume by 80%, and 82% of participants reported a resolution of pelvic and menstrual pain. It’s also been shown to significantly improve the chances of conception. Turmeric and ginger can be supplemented for their powerful anti-inflammatory and antioxidant actions, while Agnus castus works to normalise hormone production.
• For more information, contact the Endometriosis Association of Ireland or visit www.endometriosis.ie