Nutritionist Mel Brown gives her expert advice on what foods to eat and what to avoid if you suffer with endometriosis
For women with endometriosis, it can hit them full on every month causing everything from pain on ovulation, to bad period pain to excruciating period pain, sometimes accompanied by vomiting and fainting. Strong pain is enormously tiring too, and heavy bleeding may also cause anaemia. I have just read a study looking at the economic burden of endometriosis from time taken off work and suffice to say it runs into a lot of money to the economy.
But endometriosis is also widely misdiagnosed; after all teenage girls always exaggerate everything specially to get off games, “just take a painkiller and live with it, it’s all part of being a woman”, and the ultimate irony, “it’ll get better when you are pregnant”. Great, just what you want to hear. Women become enormously resigned to the pain, and it can take until there are fertility investigations for endometriosis to be diagnosed, never mind treated.
For those of you who are unsure what endometriosis is . . .
It is defined as the presence of endometrial (womb/uterine) tissue that can grow anywhere in the pelvic cavity, outside of the endometrium and is responsive therefore to all the hormonal fluctuations of a monthly menstrual cycle. This tissue then induces a chronic inflammatory response causing the pain associated with the condition. Blood filled endometrial cysts known as ‘chocolate cysts’ may form on the ovaries, and inflamed lesions cause scarring, which then tugs and pulls on the organs where the endometriosis has formed, like the ovaries, fallopian tubes, bowels and bladder.
How and why some women have endometriosis is a bit of a mystery. In terms of risk to health, as anyone reading this will know, endometriosis affects fertility.
The adhesions can cause scarring in the fallopian tubes, and they become blocked and the chronic long-term inflammation causes high levels of oxidative stress, free radicals that damage the cells, and if the ovaries are affected may affect egg quality and ovarian reserve. It is speculated (but controversial) that high levels of cytokines and NK cells may also be associated with the potential autoimmune component of endometriosis as well.
So, what to do about it?
Researchers have identified several diet and lifestyle risk factors that may be involved. Dairy products (probably due to both the oestrogens and the growth factors in milk), red meat and dioxins, a type of environmental chemical all play a big role seemingly. It is possible that the red meat is a risk factor because it contains high levels of dioxins itself, particularly located in the fat, from the exposure the animal has had in its lifetime.
So, when my clients come to see me, they are often on the way to IVF and this preparatory stage is very important.
Three months preparation is ideal, until egg collection, where we can reduce the inflammation to the developing follicles and give them a fighting chance. I usually recommend a very plant- based diet for my clients, with the only non-plant foods coming from a little white fish and some eggs; the rest is from pulses, seeds and nuts and lots of vegetables. A little organic tofu is fine in my opinion, two meals a week is not going to cause harm, in fact the phytoestrogens in soy may even protect the cells from more pathogenic forms of oestrogen. No dairy products at all though.
There is calcium in plenty of other foods. We go through lots of non-animal options for nutrients. I have many clients who have become vegan recently, so I have compiled a list for IVF, of high protein but fertility-friendly foods that happily replace meat. Flax seed powder and the lovely Arctic Power blueberry powder are all helpful too. I have recently found an excellent tea called Four Sigma Foods Mushroom drink with Reishi mushrooms that may really help too – it’s expensive but well worth a try, as mushroom therapy is very highly regarded with inflammatory conditions, and for severe endometriosis I use other mushrooms like Mesima too.
And if you can, reducing wheat or even gluten may also be very helpful, even in the premenstrual part of the cycle, the second half. Some specialists believe that gluten may play a role in switching on and off oestrogen modulating genes but this is still speculation. I have to say though that you would probably need help with managing these particular quite dramatic dietary changes so you still get all the valuable nutrients you need AND have a good-tasting diet that both you and your partner can enjoy relatively easily.
Reducing dioxins is essential, although they are everywhere. Chlorine is one, and in everything from tea bags to sanitary products as bleach, so just go for unbleached like Clipper tea bags and organic sanitary wear. I always advise my clients not to use tampons, it seems so counterintuitive to the flow of blood, almost like blocking it and sending it backwards, increasing the painful contractions that are trying to get rid of it. But the research does not show that tampon use affects endo but I would suggest always using unbleached, as above, anyway.
Reducing all environmental chemicals is a good idea too.From parabens in toiletries, to the chemicals in cleaning products, scented candles, air fresheners, and plastics. Go BPA free with plastics; use glass bottles, reduce tinned foods, use a bamboo BPA-free sustainable take-out coffee/tea cup like Clipper. Eat organic as much as you can, especially whole grains, eggs, tomatoes and peppers and root vegetables, chicken and salmon (or wild).
In terms of supplements, high dose fish oil like Bare Biology Lionheart Liquid is extremely anti-inflammatory and blood thinning, helping to reduce the painful clots. A plant compound called Resveratrol has been well researched for its benefits on endometriosis, as is N-Acetyl Cysteine and of course turmeric, or curcumin. I may also use probiotics, folate, magnesium and adequate vitamin D to help.
Exercise is beneficial, so don’t stop moving, even during your period
Heat from a hot water bottle or a hot pad that you just stick on under your clothes (From Boots), warm castor oil packs (a very old- fashioned remedy), herbs like agnus-castus and cramp bark (best sorted by a herbalist), acupuncture and reflexology also can really help.
And believe it or not sexual intercourse during a period may actually be helpful; with both female orgasm and the highly anti-inflammatory compounds in semen called prostaglandins reducing the pain. I’ll leave that one with you.
Think of this as a three-month preparatory time so those eggs can be the best quality they can be, and you may reduce the pain as well.