In my recent article Understanding Endometriosis, we explore how endometriosis develops. Now let’s look at your risk factors and nutritional approaches to managing endometriosis.
We know that your risk of endometriosis increases with family history.(8). Your risk also increases if you start your period early or drink alcohol beyond the daily NHS recommendations.(9). In terms of diet, consuming trans fats such as store-bought pies, biscuits and cakes increases your risk of endometriosis.(7)
We know that endometriosis lesions contain estrogen receptors(10). Thus, ensuring that excessive estrogen levels are minimized to prevent lesion growth is a sensitive strategy for reducing pain.
Nutritional Approaches to Managing Endometriosis
Eat more fiber:
Regular bowel movements (at least once a day) help the body eliminate estrogen. This prevents it from being reabsorbed after liver treatment. The British Nutrition Foundation recommends that women consume 30g of fiber per day. Given that the average consumption here in the UK is only 17.2g(11)we could potentially do this with some guidance!
If you rolled your eyes at the “increase your fiber intake” message, here are some reasons to increase your intake. You’ve probably heard about your microbiome? These are a collection of bacteria found in and on your body that are essential to your health. Your microbiome has, among other things, an influence on your immune system, your mental well-being and your weight control. Much of this microbiome is found in your gut and is nourished by fiber. In fact, fiber is essential to the ability of gut bacteria to generate energy and grow.
But the benefits of fiber don’t stop there. Compounds found in fiber-rich foods such as vegetables are very helpful in eliminating estrogen.(13.14) . In particular, the brassica family, which includes broccoli, Brussels sprouts, cabbage and cauliflower, is full of these compounds. Additionally, beets, carrots, artichokes, watercress, onions, garlic and leeks all stimulate the liver to aid this process.(2).
Add phytoestrogens:
It may be important to include phytoestrogens in your diet. They mimic estrogen and interact with estrogen receptors to reduce the effect of your natural estrogen when necessary.(15). Phytoestrogens have long been thought to reduce symptoms associated with menopause. These plant compounds are found in soy products, lentils, beans and flax seeds.
Add Omega 3:
If you have endometriosis, you will want to reduce inflammation and pain. Omega-3 fatty acids work similarly to some anti-inflammatory medications, including ibuprofen. Omega 3 is found in fatty fish like salmon, mackerel, anchovies, sardines and herring, so aim for a few servings each week. If you’re vegetarian or vegan, include chia and hemp seeds as well as nuts, although you may want to try with a good quality supplement.
So we discussed nutritional approaches to managing endometriosis in terms of what to include in your diet. What about things you would like to reduce or avoid?
Alcohol, for example, based on the evidence we discussed earlier. Also, caffeine and high glycemic index foods like sugar, mashed potatoes, white pasta, white rice, and white flour products (bread, cakes, cookies, pastries, and wraps). In a small but well-run study, participants saw a significant reduction in symptoms when symptoms decreased and omega 3 foods increased.(16).
Key points to address in your diet:
- High in fiber – aim for at least 30g per day
- Eat a member of the brassica family (broccoli, Brussels sprouts, cabbage and cauliflower) every day.
- Stimulate the liver with beets, carrots, artichokes, watercress, onions, garlic and leeks
- Increase your phytoestrogen intake from soy products, lentils, beans and flaxseed
- Eat at least 2 servings of fatty fish each week or plant-based sources of omega 3 daily
- Eat a low glycemic diet – more information can be found here
- Reduce or eliminate caffeine and alcohol
Additionally, don’t underestimate the power of herbs. Peppermint, ginger, and fennel have anti-inflammatory effects, so add them to foods and make herbal teas.
Finally, exercise. We know that the endorphins released after exercise help us feel better, so this would be a good reason to exercise regularly if you have endometriosis. The evidence that exercise can prevent or even treat endometriosis is mixed. However, an animal study showed that swimming just once a week reduced the size of endometrial lesions, while swimming 3 to 5 times a week led to an even greater reduction in lesion size.(17)
So, grab your apron and swimsuit! You may not be able to cure yourself, but you can reduce your symptoms and regain control of your life.
You can consult the references here: