In my recent article Understanding Endometriosis, we explore how endometriosis develops. Now lets take a look at your risk factors, and nutritional approaches to managing this complex condition.
We know that your risk of endometriosis is increased with family history, for example if you mother or sister have or had endometriosis(8), if you started your periods at an early age or consume more than one alcoholic drink such as a small glass of wine, one pub measure of spirits, or half a pint of lager each day(9). In terms of diet, eating a diet high in fat and particularly rich in trans fats such as shop bought pies, biscuits and cakes increases your risk of endometriosis.(7)
We know that endometriosis lesions contain oestrogen receptors(10). So ensuring that excess levels of oestrogen are minimised, to prevent lesion growth is a sensible strategy to reduce pain.
Eat more fibre:
Regular bowel movements (at least one per day) help the body to remove oestrogen and prevent it from being re-absorbed after liver processing. The British Nutrition Foundation recommends that women consume 30g of fibre per day, though given that the average intake here in the UK is just 17.2g(11), we could potentially do with some guidance!
If you’ve rolled your eyes at the “increase your fibre” message, here are more reasons to up your intake. You’ve probably heard about your micro-biome, a collection of bacteria both in and on your body that is critical to your immune system, your mental wellbeing and weight control amongst other things. Much of this biome is found within your gut and is fed by fibre. In fact, fibre is crucial to gut bacteria’s ability to generate the energy required to thrive and crowd out unwanted bacteria.
Not only does fibre feed gut bacteria and encourage bowel movements for oestrogen clearance but compounds found in fibre-rich foods such as vegetables are really helpful in clearing out oestrogen(13,14) . In particular, the brassica family, which includes broccoli, brussel sprouts, cabbage and cauliflower, are full of these compounds, and beetroot, carrots, artichokes, watercress, onions, garlic and leeks all stimulate the liver to aid the process(2).
Phytoestrogens may be important to include in your diet. They mimic oestrogen, balancing out levels by interacting with oestrogen receptors and can therefore reduce the effect of your natural oestrogen when necessary(15). Long thought to reduce symptoms associated with the menopause, these plant compounds are found in soy products, lentils, beans and flaxseeds (also known as linseeds, take 1tbsp/day sprinkled on porridge or added to sauces).
Add Omega 3:
If you have endometriosis then you’ll want to decrease the inflammation and pain. Omega-3 is a great dietary intervention that is known to work along the same pathway as anti-inflammatory medications including Ibuprofen. It’s found it oily fish such as salmon, mackerel, anchovies, sardines and herrings so aim for a couple of portions every week. If you’re vegetarian or vegan include chia and hemp seeds plus walnuts, although you may wish to try with a good quality supplement such as Cytoplan’s “Omega 3 Vegan”.
That’s what to include in your diet. What about things you might wish to reduce or avoid?
Alcohol for one, based on the evidence we discussed earlier. Also, both caffeine and high glycaemic foods such as sugar, mashed potato, white pasta, white rice and products made with white flour (bread, cakes, biscuits, pastries and wraps). In a small but well managed study, participants saw a significant reduction in symptoms when these were decreased and Omega 3 foods were increased(16).
Key Points to address in your diet:
- High fibre – aim for at least 30g per day
- Eat a member of the brassica family every day (broccoli, brussel sprouts, cabbage and cauliflower)
- Stimulate the liver with beetroot, carrots, artichokes, watercress, onions, garlic and leeks
- Increase your phytoestrogen intake of soy products, lentils, beans and flaxseeds
- Eat at least 2 portions of oily fish each week or plant based Omega 3 sources daily
- Adopt a low glycaemic diet – more info 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 tisanes from them.
Lastly, exercise. We know that the endorphins released after exercise make us feel better so that would be a good reason to exercise regularly if you have endometriosis. The evidence that exercise can either prevent or even treat endometriosis is mixed. However, one animal study showed that swimming just once a week reduced the size of endometrial lesions whilst swimming 3 to 5 times a week showed an even greater reduction in lesion size.(17)
So, grab your apron and your swimming costume! You may not be able to cure yourself but you can reduce your symptoms and take control back of your life.
You can check out the references here: