Endometriosis awareness month

Let’s talk about it.

Endometriosis affects about 200 million women worldwide and about 1 out of every 10 women. Yet the disease is often misdiagnosed or missed altogether. Lack of education and public awareness is part of the reason that endometriosis goes undetected.

Endometriosis often referred to as ‘endo’ is a condition where tissue similar to the lining of the uterus, called endometrium, grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, and other pelvic organs. It can also be found on the bowel, lungs, and other places in the body.

It responds to hormonal changes during the menstrual cycle, causing inflammation, pain, and the formation of scar tissue. It is considered a condition of oestrogen dominance (I’ll discuss this a little more later).

Symptoms of endometriosis often present as:

• Period pain

• Pelvic pain

• Painful sex

• Painful urination or defecation

• Heavy menstrual bleeding

• Infertility

• Gastrointestinal issues

• Depression and/ or anxiety

Oestrogen dominance

Oestrogen has many forms, three primary and the most relevant for today is oestradiol or E2. It is a steroid hormone and the primary female sex hormone. E2 plays a key role in regulating the menstrual cycle, including ovulation and thickening of the uterine lining.

E2 is also essential for the development and maintenance of female secondary sexual characteristics, including the breasts, widening of the hips, and a female pattern of fat distribution.

However, oestrogen has a natural tendancy to overshadow progesterone, this is generally caused by an excess production which can be due to poor oestrogen clearance in the liver or gut, stress, exposure to endocrine disrupting chemicals that act like oestrogen in the body, conditions such an insulin-resistance or PCOS, and lifestyle factors such as weight gain, any of which can increase oestrogen levels or suppress progesterone.

How to nutritionally support endometriosis

1. Consume enough fibre: Aim to meet the recommended daily intake of 25-30g of fibre. It helps to promote a healthy gut microbiome by supporting the body’s detoxification process. Fibre encourages the excretion of oestrogen by binding to the oestrogen and aiding its removal via the bowel.
   Consider starchy vegetables, whole-grains, fruits and vegetables within the skin on, nuts and seeds, dark leafy greens, slippery elm and psyllium husk.

2. Load up on vitamin C: Vitamin C is considered a key nutrient for managing endometriosis symptoms. It acts as a powerful antioxidant that can help reduce oxidative stress, which is linked to the development and severity of endometriosis.
   Eat foods such as citrus, broccoli, red capsicum, guavas, kiwifruit, strawberries, papayas, tomatoes, kale, and snow peas.

3. Choose cruciferous vegetables: Not only are they rich in antioxidants and contain a phytonutrient called DIM (diindolylmethane), which supports hormonal balance by helping to metabolise oestrogen. Examples of cruciferous vegetables include broccoli, cabbage, cauliflower, kale, Brussels sprouts, and arugula.

4. Limit pro-inflammatory foods: Women with endometriosis have been found to experience increased oxidative stress, which is likely to exacerbate inflammation and disease.
   Limit your intake of foods such as trans-fats found in processed and fried foods; high-glycemic foods such as white bread, pastries, cakes and crackers; and some animal proteins. Increase your intake of anti-inflammatory foods such as berries, fruits and vegetables, gluten-free whole-grains, nuts and seeds, herbs and spices.

5. Increase sources of vitamin E: Recent and past studies have shown that vitamin E may mitigate the pain symptoms that range from chronic pelvic pain, dysmenorrhea, to dyspareunia in individuals diagnosed with endometriosis This may be due to its antioxidant properties, which help reduce oxidative stress and inflammation.
   Eat foods rich in this vitamin such as sunflower seeds, almonds, avocado, hazelnuts, peanut butter, dried apricots, extra virgin olive oil, spinach, prawns, broccoli or kiwi fruit.

Lifestyle tips to support endometriosis symptoms:

• Regular physical activity is linked with lower levels of oestrogen and reduced endometriosis risk.

• Use sanitary pads (or similar) and avoid the use of tampons where possible.

• Refrain from sexual intercourse during menses due to potential links with retrograde blood flow and exacerbation of pain.

• Avoid plastics - use glass and stainless steel for food storage. Do not use that has been treated with non-stick surfaces, such as Teflon.

• Buy organic and locally sourced food where able.

• Avoid dioxins - these chemicals have been found to worse endometriosis and are found in many bleached products including: tampons, cigarettes, non-filtered drinking water.

• Encourage self-care, including nourishing activities, gentle exercise, laughing often, phone calls with friends and family.