Dietary Considerations for Endometriosis
Eat For Life Dietetics
There are over 830, 000 people in Australia diagnosed with Endometriosis and approximately 200 million people worldwide. That means there are more people diagnosed with endometriosis worldwide than what there are citizens of Russia or people with red hair!
Diagnosis of endometriosis takes an average of 6.5 years from the onset of symptoms with diagnosis occurring via laparoscopic surgery. Treatment of this condition also occurs via laparoscopic surgery however research shows that food and dietary management can assist with symptom relief and may even slow down the growth of the endometriosis.
What is Endometriosis?
Endometriosis (or Endo, as it is more commonly called) is a disease where tissue similar to the lining of the womb grows outside it, in other parts of the body causing pain and/or infertility. Whilst endo most often effects the reproductive organs it is also frequently found in the bladder and bowel and has even been found in muscles, joints, lungs and even the brain.
People with endometriosis commonly have higher levels of oestrogen present in their bodies, it is unknown why some people produce more oestrogen than others. Oestrogen is a hormone that stimulates growth of endometrial tissue which can lead to increased paid and infertility.
There is no known cure for endometriosis however laparoscopic surgery can assist with fertility and pain by removing endometrial tissue, adhesions and cysts.
What are the Symptoms?
Symptoms can vary person to person although the most common symptoms can include:
- heavy and/or irregular periods
- infertility
- period and ovulation pain
- pain during sex, urination and/or bowel movements
- pelvic pain
- fatigue, especially around your period
- bloating
- bowel issues
- depression and/or anxiety
Dietary Considerations
Let’s take a look at some of the dietary factors that can be considered that may assist with reducing symptoms of endo:
Omega 3’s
Omega 3’s have anti-inflammatory properties that can help to reduce the inflammation and symptoms associated with endo. They are also amazing at supporting heart, joint, brain and egg health (just in case you wanted some more reasons to chowing down on these amazing foods!)
Oily fish such as Salmon is an excellent source of Omega 3’s although if fish isn’t your cup of tea, Extra Virgin Olive Oil, chia seeds, walnuts and eggs are also a great way to get these into your diet.
Fibre
Fibre can assist the body to excrete (get rid of) excess oestrogen. Foods such as wholegrains, nuts and seeds, lentils, legumes, fruit and vegetables are packed full of fibre. Many wholegrain foods contain as much as four times the amount of fibre compared to vegetables so don’t let anyone tell you that carbs are bad – foods like wholegrain bread, rice, quinoa, cereals and oats are all fantastic ways to boost your fibre intake.
Hydration
If we are going to talk about fibre, then we also have to talk about water! Fibre requires fluid to be able to move effectively through the bowel without becoming dry and difficult to pass. Drinking enough water can help to reduce bowel related symptoms such as bloating and constipation that can effect some people with endo.
Staying well hydrated also supports our body to remove waste products such as excess oestrogen. Water requirements will vary person to person, typically aiming for 1.5 – 2.0L of water per day is a great starting point although an easy way to check your hydration is by looking at your wee – If it is a clear or pale yellow colour (think straw) then you are probably well hydrated so keep doing what you are doing. If it is a brighter yellow, orange or brown colour then thats a good sign that you might need to up the water drinking.
Antioxidants
Antioxidants can help our body to reduce the impact of and inflammation caused by free radicals in the body. Reducing inflammation may reduce the pain and symptoms associated with endo. Antioxidants are found in a wide variety of foods, particularly plant based foods.
Variety really is key when it comes to antioxidants – eating a wide variety of different fruits, vegetables, nuts, seeds and wholegrains is a key way to boost your antioxidant intake!
Consider swapping:
almonds to mixed nuts
spinach to mixed leaves
kidney beans to 4 bean mix
strawberries to mixed berries- rice to mixed grains
Colour
Fruit and vegetables are full of vibrant colours that can be added to your plate. They are an excellent source of fibre, antioxidants and packed full of vitamins and minerals necessary for your body to function. Adding a splash of colour to your meals and snacks can help your body to get all the nutrients that it needs.
Consider adding fruit to yoghurt and cereals, adding beetroot to a salad, wrap or sandwich, topping avocado with tomato on toast or crackers, adding vegetables sticks to dips and crackers, using tomato based pasta sauces, adding a handful of spinach to curries, pasta’s and casseroles.
FODMAPs
Many people with endo also experience digestive symptoms. There seems to be a link between endo and IBS diagnosis. The reason for this remains unclear.
A low FODMAP diet is an effective treatment option for IBS, so if you are also experiencing IBS symptoms such as diarrhoea, constipation, bloating, abdominal pain and excess wind then trialling the FODMAP diet may be beneficial for you. The low FODMAP diet reduces the amount of fermentable carbohydrates present in your diet during an initial elimination phase, then reintroduces these fermentable carbohydrates back into your diet during a challenge phase to learn what your triggers are. It is important that this approach is done with a Dietitian who is knowledgeable about this process and can guide you through from start to finish.
Relationship with Food
Last, but definitely not any less important is your relationship with food. There is no current research available on the link between endo and disorder eating/eating disorders however it is important to note that most disordered eating/eating disorders are linked to feeling a need to control our food choices. The online endo space is filled with misinformation like “if you have endo then you must cut out gluten/dairy” or “everyone with endo must follow an anti inflammatory diet.” Diet information and misinformation communicated as a set of black and white rules can lead people into a place of back and white thinking about food, a mindset that control of food is vital to fix what is happening in my body. For some people this can be a slippery slope leading to binge restrict cycles, disordered eating or even eating disorders.
The reality is that there is nothing that you can eat that will be more harmful for you than having an unhealthy relationship with food. Keep this in mind, consider am I making these changes because I want to or because I have been made to feel that I have to? Be kind to yourself in making changes, work on the changes you want to make, remind yourself that change takes time and learn from what feels good for you.
One final reminder to the people living with endometriosis out there, there is nothing that you did to cause it, endometriosis is not your fault.
