Endometriosis

Endometriosis: What is it?

Endometriosis is a disease where the tissue that grows inside the uterus grows outside the uterus. This lining is called the endometrium, hence the name endometriosis. According to the World Health Organization, endometriosis can cause severely painful periods, chronic pelvic pain, abnormal bleeding, ovarian cysts, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility. If someone has endometriosis, this tissue grows outside the uterus and can grow in other places in the body, such as the stomach or bladder. This can cause painful cramps wherever the lining tissue may be growing. This lining can cause a great deal of pain, discomfort, and other health problems.

Symptoms

The symptoms of endometriosis are similar in comparison to the period pain and symptoms many women face, such as abdominal pain, irregular bleeding, and pelvic pain. These symptoms can happen frequently, not just before the period. This causes an additional delay in diagnosis. Additionally, many healthcare workers are not aware of the significance of life-altering pelvic pain, as women’s menstrual symptoms have been historically downplayed, which can lead to a delay in diagnosis, treatment, and relief. 

Cause

The cause of endometriosis is unknown. Some research leads us to believe it is genetics, problems with menstrual flow, immune system issues, hormones, and possible abdominal surgeries.

Treatment

Treatment may vary based on the goals of the patient and if they are trying to become pregnant. According to the Office of Women’s Health, treatments are based on individual preferences and effectiveness, side effects, long-term safety, costs, and availability. Treatments often include pain management and hormone control. It can consist of one or more of the following; oral contraceptives, non-steroidal anti-inflammatory drugs, IUDs, ibuprofen, vaginal rings, implants, injections, patches, and/or surgery. Patients may find additional help and emotional assistance in local patient support groups for mental health implications that may arise with endometriosis symptoms.

 

Surgery may also be another option for relief from endometriosis symptoms. A laparoscopy is a procedure in which the surgeon looks into the pelvic region. The laparoscopy can be an excision and/or ablation, which involves removing tissue or cauterizing the tissue, respectively. A hysterectomy may also be a treatment option in which the uterus is removed. However, this procedure ends fertility.

Prevention

Unfortunately, there are no current known prevention strategies for preventing endometriosis. 

Advocacy

Endometriosis is not well understood. According to the Office of Women’s Health, researchers think that at least 11% of women, or more than 6 ½ million women in the United States, have endometriosis. Although it can occur at any age after the first period, it is most common for women in their thirties and forties. 

 

Significant research needs to be done on this topic of women’s health. Significant factors contribute to the lack of knowledge regarding endometriosis. Raising awareness can help people be diagnosed early. Early diagnosis and treatment can slow the natural progression of the disease and reduce the long-term symptoms. It also may allow patients to return to normal life.

How Can Nutrition Help?

Research conducted by a professor at George Washington School of Medicine noted that different factors in plant-based foods, particularly fiber, antioxidants, and vitamin D, may have positive implications for prevention and treatment. As mentioned, a plant-based diet may have aspects that can lessen the symptoms experienced by those with endometriosis. Two studies have shown that increased vitamin D intake has been associated with symptom (pain) relief, and vitamin D deficiency is linked to a higher risk of endometriosis. High levels of vitamin D are only found in a few foods. These include eggs (eat the yolks!), salmon, fortified yogurt, kefir, fortified milk, and mushrooms exposed to UV light. The recommended daily allowance for vitamin D for girls/women from age 1-70 is 600 International Units (IU); however, it may be necessary to consume amounts higher than the RDA to achieve endometriosis symptom relief. Working with a dietitian can help you achieve your vitamin D intake goals! 

Food	Vitamin D Levels (IU)
1 Large Egg (with yolks)	~50 IU
3 oz Salmon	~500 IU
5 oz Fortified Greek Yogurt	~60 IU
1 cup Kefir	~100 IU
Fortified Milk	~120 IU
Mushrooms (exposed to UV light)	~360 IU

Antioxidants are very potent anti-inflammatory nutrients and can help manage endometriosis symptoms. Antioxidants are compounds that neutralize free radicals, which are molecules that can damage cells and cause inflammation. The foods highest in antioxidants are fruits and vegetables like blueberries, strawberries, raspberries, prunes, cherries, artichokes, spinach, beets, radishes, broccoli, potatoes, and cabbage. Nuts and legumes can also have very high levels of antioxidants, including almonds, walnuts, pecans, black beans, pinto beans, and red kidney beans.  

 

Phytonutrients, substances found in plants that can provide health benefits, have also been linked to lowering inflammation. One particular phytonutrient, polyphenols, has very potent anti-inflammatory benefits. Foods high in polyphenols are berries, nuts, and legumes like lentils and beans. Talk to your dietitian about additional supplements and foods that may relieve pain and inflammation.  

 

Lastly, fiber has been shown to decrease inflammation, which may also aid in pain relief for endometriosis patients. A general fiber recommendation for women is that they consume about 25 grams per day. Foods highest in fiber include fruits, non-starchy vegetables, seeds, whole grains, and legumes! Try to incorporate 2-3 of these foods into your daily diet. 

 

Whether you have been diagnosed with endometriosis or suspect you may have endometriosis, diet, and lifestyle can have a significant impact on symptom management and mental health. A registered dietitian can support you along this journey of finding your individualized approach to symptom relief. As stated previously, endometriosis is not very well known within the healthcare world, and it’s important to advocate for your wellbeing. If you or someone you know may have endometriosis and feel like they may be alone in their journey, there are support groups, healthcare professionals, and women’s healthcare workers that can make the journey not feel so daunting. 

schedule with a dietitian today

References

Barnard, N. D., Holtz, D. N., Schmidt, N., Kolipaka, S., Hata, E., Sutton, M., Znayenko-Miller,

T., Hazen, N. D., Cobb, C., & Kahleova, H. (2023). Nutrition in the prevention and

treatment of endometriosis: A review. Frontiers in Nutrition, 10.

https://doi.org/10.3389/fnut.2023.1089891   

 

OASH. (2019, January 30). Endometriosis. Womenshealth.gov.

https://www.womenshealth.gov/a-z-topics/endometriosis  

 

‌World Health Organization. (2023, March 24). Endometriosis. World Health Organization; World

Health Organization. https://www.who.int/news-room/fact-sheets/detail/endometriosis 

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