In my recent article Understanding Endometriosis, we explore how endometriosis develops. Now let’s take a look at your risk factors, and nutritional approaches to managing endometriosis.

We know that your risk of endometriosis is increased with family history⁽⁸⁾. Your risk also increases if you started your periods early, or if you drink alcohol above the NHS daily guidance⁽⁹⁾. In terms of diet, eating 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.

Nutritional approaches to managing endometriosis

Eat more fibre:

Regular bowel movements (at least one per day) help the body to remove oestrogen. This prevents it from being re-absorbed after liver processing. The British Nutrition Foundation recommends that women consume 30g of fibre per day. 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 some reasons to up your intake. You’ve probably heard about your micro-biome? It’s a collection of bacteria both in and on your body that’s critical to your health. Your micro biome has influence on your immune system, your mental wellbeing and weight control amongst other things. Much of this micro-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 and thrive.

But the benefits of fibre don’t stop there. 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. Additionally beetroot, carrots, artichokes, watercress, onions, garlic and leeks all stimulate the liver to aid this process⁽²⁾.

Add phytoestrogens:

Phytoestrogens may be important to include in your diet. They mimic oestrogen, and interact with oestrogen receptors to reduce the effect of your natural oestrogen when necessary⁽¹⁵⁾. Phytoestrogens have long been thought to reduce symptoms associated with the menopause. These plant compounds are found in soy products, lentils, beans and flaxseeds.

Add Omega 3:

If you have endometriosis then you’ll want to decrease the inflammation and pain. Omega-3 fatty acids work in the same way as some anti-inflammatory medications including Ibuprofen. Omega 3 is found in 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.

So, we have discussed nutritional approaches to managing endometriosis in terms of 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: