What should you eat if you have endometriosis?

Endometriosis is a condition where tissue resembling the uterus lining grows outside of the uterus, causing painful symptoms. Following a specific diet may help to reduce symptoms, though more research is needed.

Avoiding foods and drinks that cause inflammation and increase oestrogen production may help to tackle the painful symptoms of endometriosis.

In this article, we look at the links between diet and endometriosis, which foods to eat, and which to avoid.

 

The link between endometriosis and diet

Fruit at a market may help with an endometriosis diet

Vegetables and fruits may help to improve endometriosis symptoms.

Little research has investigated the relationship between diet and endometriosis symptoms. However, some people do find that eating certain foods tends to trigger or relieve their symptoms.

2013 study suggested that women who ate more vegetables and omega-3 fatty acids were more protected from symptoms of endometriosis, while those who consumed red meat, trans fats, and coffee may have experienced the opposite effect. However, these results are not consistent across studies, so more research is needed.

2015 literature review published in Brazil, suggested that eating a healthful diet can prevent endometriosis from developing, and perhaps, even worsening. Foods in this diet included:

  • fruits
  • vegetables
  • whole grains
  • omega-3 fatty acids

A person cannot prevent endometriosis, but according to the US Office on Women’s Health, they can reduce their risk of developing it by avoiding foods and chemicals that increase their estrogen levels. These substances include caffeine and alcohol.

It is essential, however, to recognize that dietary and lifestyle changes will not cure endometriosis but may help to improve its symptoms.

To find out whether food is having an effect on their symptoms, a person with endometriosis could keep a food journal. It is essential that they record everything they eat throughout the day, as well as any symptoms they experience.

A person may need to keep the diary for some time, as a clear pattern may not emerge right away.

 

Diet for endometriosis

olive oil may be used in an endometriosis diet

Healthful fats, such as olive oil, may benefit people with endometriosis.

A person with endometriosis might consider reducing foods that either cause inflammation or raise estrogen levels, both of which may contribute to the disorder or its symptoms. However, more research is needed to establish the link between endometriosis and diet.

A person with endometriosis may benefit from eating plenty of fruits, vegetables, and whole grains. Plant-based proteins, lean meats, and healthful fats may also help.

Healthful fats are available in many foods, including:

  • avocado
  • olive oil
  • olives
  • nuts
  • salmon
  • other fatty fish

A person with endometriosis should also reduce their caffeine and alcohol intake, as these can increase oestrogen levels.

If a person does not eat fish, it is possible to introduce  omega-3 fatty acids into the diet using supplements.

A person can also increase their fibre intake. Fibre is an essential part of a healthful diet and may help to lower estrogen levels. In addition to providing lots of vitamins and minerals, eating fresh sources of fiber can also provide vitamins, minerals, and antioxidants that can reduce inflammation.

There are also some special diets that may help people with endometriosis. These include:

Gluten-free diet?

Going gluten-free has become a common diet and lifestyle trend over the last several years. It remains unclear whether this diet is effective for people without celiac disease, which makes a person sensitive to proteins found in wheat.

However, a 2012 study suggests that 75 percent of the 156 women who took part in the study reported a decrease in painful symptoms after following a gluten-free diet for 12 months.

FODMAP diet

With the FODMAP diet, a person eliminates certain carbohydrates from their diet to reduce their intake of potentially irritating foods. The aim is to allow the gastrointestinal system to heal.

After a person eliminates these foods, they can slowly re-introduce specific foods to see how the body tolerates them. This kind of diet can be difficult for some people, because it involves eliminating a high number of food types from their diet, including:

  • dairy
  • gluten
  • processed foods
  • added sugars

It is a good idea to track symptoms in a food log to see if they get better after removing certain foods from the diet, or get worse after reintroducing something.

If a woman decides to follow a  FODMAP diet elimination program then she should really see a dietitian so that esential nutrients are not left out of the diet and that it is not undertaken longer than necessary.

 

Other home remedies for endometriosis

woman sprinting

Regular exercise is recommended for endometriosis.

In addition to dietary changes and traditional medical treatments for endometriosis, some people try other home remedies to help manage the condition or its symptoms. Therapies can include:

  • regular exercise
  • acupuncture
  • vitamin B1
  • magnesium supplements
  • Chinese herbs, such as cinnamon twig or licorice root-but seek a qualified herbalist for these

As always, consult with the doctor before starting to take any herbal or over-the-counter supplements.

Introduction to PCOS

 Although Polycystic Ovary Syndrome (PCOS) now affects around 7% of women in the UK of reproductive age, this syndrome still remains a mystery to many, including health professionals. There is still much controversy surrounding its cause and around which interventions work best.

Obesity, especially central adiposity (proportionally more weight being carried around the tummy), is present in around 40% of women with PCOS and a greater degree of obesity is associated with a more severe form of PCOS. There is also a higher incidence of metabolic syndrome (high blood pressure, high cholsterol and a tendancy towards diabetes) amongst women with PCOS than in non-PCOS overweight and obese women. Weight loss in the overweight/obese woman is therefore fundamental to treating the condition.

As nearly 90% of infertility cases attending infertility units are due to PCOS, women with this syndrome can improve their chances of falling pregnant and having a healthy baby if they address certin diet and lifestyle factors. There is no cure for PCOS, but adopting healthy lifestyle practices can control the symptoms caused by the syndrome and so much of the treatment for PCOS is in the sufferers own hands.

 

Background

Polycystic Ovary Syndrome (PCOS) is the most common ovarian function disorder in pre-menopausal women.  Around 1/3 of women in the UK have polycystic ovaries (PCO), but despite having small cysts on their ovaries, they don’t have any symptoms of PCOS. For actual PCOS, where definite symptoms are present, the incidence in women is between 5-10%  and the rate appears to be increasing.

The differing array of symptoms which can present themselves in PCOS often makes an initial diagnosis of PCOS quite difficult. PCOS is often described as being a condition of hormone imbalances and it is believed to have a genetic basis. The development of PCOS may also be affected by the gestational environment and there may be foetal programming involved. It is thought that the rise in obesity may be acting as a trigger to PCOS in women with a genetic pre-disposition

Getting a diagnosis

Defining PCOS According to the American Society for Reproductive Medicine , PCOS is defined by having of any two of the following signs and symptoms:

• Lack of ovulation for an extended period of time

• High levels of androgens

• Many small cysts on the ovaries (normal ovaries have 5-6 follicles, whereas in polycystic ovaries there are ten or more). These cysts are immature follicles, the egg-containing structures in the ovary, one of which should grow monthly to release an egg, but this tends not to happen routinely, if at all in PCOS, resulting in impaired fertility.

To diagnose PCOS in teenagers, all 3 of the symptoms need to be present

Symptoms

The symptoms of PCOS tend to be different from woman to woman and can be present in any combination; the symptoms can also change over time and 20% of women with polycystic ovaries are symptomless.

Symptoms are more severe with weight gain and tend to diminish with weight loss.

The most common symptoms are:

• Weight gain, especially central adiposity; 40-50% of women with PCOS are overweight

• Central adiposity (waist circumference of over 80cms)

  • Metabolic syndrome (11x increase risk in PCOS).  Metabolic syndrome is characterised by symptoms such as high blood pressure, increase in inflammatory and clotting factors as well as insulin resistance

• Hirsutism which can occur in various places on the body, including the face

• Male pattern baldness or thinning hair,

• Oily skin with acne

• Absent or irregular menstrual cycles, leading to infertility. PCOS women with long intervals between periods have a greater degree of insulin resistance

• Depression, anxiety, irritability and mood swings. It is thought that these emotional symptoms are due to a combination of the hormone disturbances that occur, coupled with the fact that PCOS causes a host of upsetting symptoms resulting in stress involved in living with a long term medical condition

•Insulin resistance: 40% of women with PCOS go on to develop insulin resistance and it can lead to conditions such as diabetes and heart disease as a result of other effects in the body such as a rise in LDL and triglycerides and a lowering of protective HDL. Insulin resistance can also result in tiredness, lethargy and sudden drops in blood sugar levels in PCOS sufferers.

Hormonal disturbance

The hormones involved in controlling periods, and ultimately reproduction, are produced in the pituitary gland. In PCOS two of these: luteinising hormone (LH) and follicle stimulating hormone (FSH) are produced disproportionately and this is believed to cause the follicles in the ovary to not develop properly: they tend to remain small and do not mature enough to release an egg. This results in a string of small follicles forming on the ovary, which gives rise to the characteristic ‘string of pearls’ seen by ultra-sound of polycystic ovary. A high circulating level of insulin is common in PCOS and can be detected even in sufferers of normal weight.

Insulin resistance is seen in 10-15% of slim women with PCOS and 20-40% obese women with it. As well as contributing to weight gain, high levels of insulin drive the ovary to produce high levels of androgens; this causes many of the outward symptoms of PCOS such as the acne, thinning hair and hirsutism. However high androgen levels tend to be driven by LH in slim women with PCOS and not and insulin in overweight women.

Treatment

Unfortunately there is no cure for PCOS  but it can be controlled so that its effect on a woman is minimal. Treatment involves:

  • Improving insulin sensitivity to prevent the whole cascade of later problems such as developing Type 2 diabetes and heart disease.
  • Restoring normal ovulation and hence also fertility. (Reproductive outcome is best if BMI is reduced to less than 30 before drugs for ovarian stimulation are given)
  • Preventing androgen levels from rising.

Treatment of PCOS therefore involves the three pronged attack of:

  1. Diet: using a weight control diet if necessary with low GI advice
  2. Exercise: encouraging more physically active on a day to day basis and throughout the day
  3. Ensuring emotional well-being and motivation to change lifestyle

 

If you suffer from PCOS , we can help you with some diet an dlifestyle counselling

 

 

The Four Stage Approach to Lessening #PMS

The 4 stage approach to PMS

Eating a healthy balanced diet and keeping fit and well will help to reduce and even alleviate PMS symptoms. If you need to go on and have other treatment, it will more likely to be successful if you have the foundation of a healthy diet and lifestyle. The ‘four stage approach’ is a tried and tested, healthy eating and lifestyle plan for the treatment of PMS based on scientific research. The first phase must always be followed before the other phases as it forms the foundation without which the other phases will not be effective. The other phases can then follow but do not have to be followed in strict order.

Phase 1: baseline healthy diet

Ensure you are eating a healthy balanced diet i.e. one that is low in saturated and trans fats, low in refined sugar, low in salt, high in fibre and each meal is based on a wholegrain starchy food such as rice, cereal, pasta, and multigrain bread. Make sure you have at least 3 portions of dairy daily and have at least two protein portions a day and at least five fruit and veg daily. Keep alcohol, tea, coffee and other caffeine containing drinks to moderate levels.

 Phase 2: controlling blood sugar swings and mood

Make sure each meal contains a good serving of a starchy food; wholegrain varieties of these are best and there is some evidence that foods with a low glycaemic index may be most helpful in alleviating some symptoms of PMS. Have three meals a day and, if there is a long gap between meals, then have a starchy snack too.

Phase 3: supplements

Not many supplements have been shown to work consistently in research studies, but calcium (1,000mg) and vitamin D (10 mcg) combined have shown some positive results, particularly if you don’t eat much dairy. An evening primrose oil supplement with vitamin E may also be helpful, especially if there is breast pain. You must take supplements continuously for 3-4 months before the full effect is achieved. However, stop taking them if they have no effect.

Phase 4: other lifestyle and health factors

Make sure you properly treat and control medical conditions such as allergies, IBS, anaemia or diabetes, which will otherwise aggravate PMS symptoms.  Carrying extra weight also aggrevates PMS symptoms Being fit and healthy will minimise PMS symptoms, so build in some exercise into your lifestyle and minimise stress.