What is endometriosis?

Endometriosis is a condition where endometrial tissue (the lining of the uterus), is found elsewhere in the body. Endometriosis is commonly found in abdominal areas including the ovaries, bladder, vagina, the small and large intestines and on the peritoneum (the lining around the abdominal organs). Because the endometrial tissue is responsive to fluctuating levels of the hormone oestrogen in line with the menstrual cycle, the displaced tissue can also exhibit the same characteristics of growth, shedding and bleeding. This can cause pain, inflammation, large areas of endometriosis and cysts.

How common is endometriosis?

Endometriosis is estimated to effect 10% of women, but as some women have no symptoms it is thought many more women have endometriosis without knowing so.

What are the symptoms of endometriosis?

Symptoms can include:
  • Pain in the abdominal or pelvic region
  • Severe menstrual cramps
  • Infertility
  • Bloating
  • Signs of disrupted menstrual cycle, including: irregular, heavy, painful, and/or long lasting menstrual flow, or absence of menstrual bleeding.
  • Painful intercourse
  • No symptoms

What causes endometriosis?

The precise cause of endometriosis is not yet fully understood. Possible causes and triggers involved in the development of endometriosis include:

Retrograde menstruation: during menstruation, some of the endometrium (tissue lining the uterus) may get directed backwards and become implanted in the pelvic area or other body organs.

Genetics: women with family members with endometriosis may be at higher risk of developing the condition, which may indicate some genetic predisposition.

Immune system: dysfunction of the immune system may make some women less able to keep endometriosis under control.

Environmental: exposure to environmental toxins, notably polychlorinated biphenyls (PCBs), may disrupt immune defences and impair the clearance of displaced endometrial tissue. Exposure to PCBs can be environmental (largely attributed to occupational exposures) or dietary, of which common food sources are fish, fish oil and eggs, dairy products and other animal products.

Hormonal: there are many hormone disrupting chemicals, which may contribute to hormonal disorders, including certain pesticides, plastics, fuels and environmental and industrial chemicals.

Diet: some studies have suggested a link between high or low consumption of certain foods and increased risk of endometriosis. These include: higher intakes of red and cured meat, and low intake of vegetables and fresh fruit.

What is the treatment for endometriosis?

Treatment, which focuses mainly on controlling the condition rather than eradication, includes hormones to balance oestrogen such as contraceptives, pain management and surgical procedures.

Diet and lifestyle strategies to support endometriosis?

There are few clinical trials that look into the effects of diet as an intervention for endometriosis. There are, however, a number of observational studies linking dietary trends to an increased risk of endometriosis. Endometriosis is a condition characterised by hormonal imbalance, inflammation and immune system dysfunction, therefore dietary strategies could be used to promote a healthy balanced diet supportive of these underlying imbalances. Helpful dietary and lifestyle strategies include:

Balance your fats: high fat diets are associated with inflammation and oxidative stress (when tissue is damaged because of an imbalance of antioxidants to oxidants). However including sources of healthy fats in the diet is also important in combination with limiting bad fats. To get a good balance of dietary fats, eat foods rich in Omega 3 fatty acids (found in oily fish, nuts and seeds) and monounsaturated fats (olive oil) whilst limiting intake of saturated fat and trans fats in the form of processed meats, red meats, refined oils, cakes, biscuits, pastries and spreads. Omega 3 fats have anti-inflammatory properties and can help to support hormone function.

Exercise regularly: include a mixture of strength and cardio workouts, to support overall health and hormone balance.

Eat plenty of fruit and vegetable: high plant based diets may help to reduce oestrogen levels. Additionally fruit and vegetables are an important dietary source of vitamins (vitamin C, folic acid, beta carotene), minerals, antioxidants and fibre, which are important nutrients for supporting the immune system and help protect against free radical damage during oxidative stress. Women with endometriosis have been found to have signs of oxidative stress.

Reduce alcohol and caffeine consumption: these are stimulants, which can put the body under increased stress.

Eat foods rich in plant phytoestrogens: these foods have a very weak oestrogenic effect, but by binding to the same part of the cell to which oestrogen binds, they in effect compete with and lessen the stronger impact of the body’s own oestrogen. Dietary sources include flaxseeds, tofu, lentils, whole grains, seeds, vegetables and fruit.

A Nutritional Therapist can help you identify diet and lifestyle factors, which may be contributing to your symptoms.