Pop culture paints the period as a pain. So we’re welcomed into womanhood expecting a level of discomfort. But for some, the pain is so severe, it’s unbearable. It’s endometriosis, and it’s a silent epidemic, which too many of us write off as normal.
A recent US survey revealed most women don’t recognise the symptoms of endometriosis. Which is alarming as the disorder affects 1 in 10 women in our reproductive years. In 2017, there were around 34,200 endometriosis-related hospitalisations in Australia alone. So we’d better start paying closer attention.
What is Endometriosis?
Endometriosis is a condition where tissue grows outside the uterus, and can be found on the ovaries, fallopian tubes, bowel and bladder. Commonly, this results in period irregularities, extreme period pain and other digestive upsets; constipation, diarrhoea, food intolerances, bloated ‘endo-belly’. It causes a chronic inflammatory reaction that can result in the formation of scar tissue within the pelvis and other parts of the body.
Can the symptoms of Endometriosis be managed through diet?
Perhaps. Research is still in its early days here, but these studies strongly suggest nutrition can play a role in reducing the inflammation commonly associated with Endo.
Which foods should be avoided with Endometriosis?
An anti-inflammatory diet can go some of the way to reducing the gastro-intestinal symptoms commonly associated with endometriosis. But much of the work behind an anti-inflammatory diet is figuring out your trigger foods, which can be different from person to person. Obstetrician and Gynaecologist Wee-Liak Hoo encourages adopting your own strategy of dietary exclusion. For some, triggers are more fructose related, and for others it’s gluten or alcohol. To find out the specifics of your triggers, Endometriosis Australia’s clinical advisor Tracy Gaibisso recommends the RA-RA method (Remove, Assess, Reintroduce, Assess). To get started, it can be helpful to explore some of the more common dietary tweaks recommended by nutritionists.
Can a low-inflammatory diet help support the symptoms of Endometriosis?
To explore this diet, start by removing some highly inflammatory foods, such as:
Studies have shown artificial trans fats are associated with an increased risk of endometriosis. These fats- commonly found in fried foods, pastries, microwave popcorn, frozen pizza and stick margarine can lead to a 1.44 x increased risk of an endo diagnosis, compared to those with a lower consumption of trans fats. It’s the fatty acids here that are precursors to the prostaglandins that cause uterine contractions and the painful symptoms associated with endometriosis. It’s worth noting, the total consumption of fat in one's diet doesn’t increase risk here, but the type of fat consumed may.
Red meats (both processed and not)
A recent study revealed women consuming more than two servings of red meat per day had a 56% greater risk of endometriosis, compared with those consuming less than one serving of red meat per week. Increased poultry intake was also associated with higher risk of endometriosis. Due to these findings, the effects of plant-based diets on inflammation is of current clinical interest.
Which foods should I consume if I have symptoms of Endometriosis?
There are emerging, promising bodies of evidence highlighting herbs and foods which provide some serious anti-inflammatory relief.
Increase fruits and vegetables
The Brassica family includes a range of vegetables such as bok choy, broccoli, cabbage, kale, cauliflower, brussels sprouts and collard. A 2020 study highlights their anti-inflammatory benefits, as well as their ability to provide immune system support. Leafy green vegetables are great sources of magnesium, a mineral vital to tackling inflammation and constipation, and vitamin C, which helps increase our absorption of iron, a deficiency common amongst many experiencing endo.
Increase good fats
Ensuring adequate intake of Omega 3 and 6 can provide us with additional anti-inflammatory benefits. By including oily fish like salmon 2-3 times per week, as well as adequate intakes of Vitamin E rich foods like whole grains, egg yolks, nuts, seeds and leafy green vegetables, we can quickly increase our intake of powerful protective antioxidants.
Include Curcumin in your diet, and consider supplements to consume a high dose.
Found in turmeric, this spice is easily added to many dishes, offering a quick opportunity to reap some of its therapeutic benefits. This herb boasts multiple medicinal properties, including anti-inflammatory and anti-aging, and can tackle the direct inflammatory pathways aggravating endometriosis. Given it's required in high doses, it’s best taken as a supplement, prescribed by a health practitioner.
Research around diet and endometriosis continues to tell us symptoms may improve by exploring dietary changes. It’s important to remember that what works for one may not work for the other though, and new research supports exploring additional diets, such as FODMAPs (commonly found in dairy, wheat, rye and certain fruits and vegetables) to provide symptomatic improvement for women experiencing both IBS and endometriosis at the same time. Best managed in conjunction with the support of a health practitioner, diet has the power to provide relief here, and might just be worth exploring as a preventative measure, or when it’s just all too much.