6 Ways to Support Your Endometriosis Through Diet & Lifestyle

Endometriosis and polycystic ovary syndrome (PCOS) were words my OB-GYN uttered years ago after I casually mentioned my common monthly routine of get period, have debilitating cramps, break out into cold sweat, experience vomiting and diarrhea. Rinse and repeat, month after month. While I ended up not having either condition, I did wonder, what is she talking about?

Definition + Symptoms

Endometriosis is an inflammatory condition that effects an estimated 10% of premenopausal women worldwide. It occurs when the same tissue that lines the uterus (and should only be in the uterus) gets a wandering eye and is found elsewhere in the body, including the ovaries, fallopian tubes, bladder, C-section scars, and bowel. Just as the uterine lining builds and sheds each month in response to our hormones, so does the same endometrial tissue found outside the uterus. The only problem is that it can’t leave the body through the vagina, so it sheds into the pelvic cavity, forming scar tissue that causes chronic inflammation, an immune response, and worsening symptoms. Depending on where the lesions are located, women may experience intense pelvic pain, severe cramping, heavy menstrual flow, pelvic floor dysfunction, IBS symptoms, nausea, depression, anxiety, painful sex, and infertility.

Causes + Diagnosis

The jury is still out on what causes endometriosis; however, researchers have found that it has almost all the indications of an autoimmune condition, and is found to occur in conjunction with other autoimmune conditions such as Hashimoto’s thyroiditis, celiac disease, multiple sclerosis, and inflammatory bowel diseases. Some researchers have attributed this immune and inflammatory response to gut health, particularly lipopolysaccharides toxins (LPS) and small intestinal bacterial overgrowth (SIBO). Other possible contributing factors in the development of endometriosis include genetics, lifestyle, and retrograde menstruation (backflow of menstrual blood and uterine tissue into the pelvic cavity).

According to the Mayo Clinic, endometriosis may be diagnosed via ultrasound and MRI. However, the current gold standard is exploratory laparoscopy surgery, which is unfortunately the most invasive choice.

Treatments

While a cure for endometriosis would be fabulous, we’re not there yet, friends. However, there are plenty of things we can do to lessen disease progression, reduce cyst size, and relieve symptoms. Can I get an Amen?

1. Build a Team

You don’t have to do any of this alone. Connect with a physical therapist who specializes in the pelvic floor, and a registered dietitian who specializes in hormone and gut health. I’m also a huge advocate for mental health, so if you notice stress, depression, and/or anxiety are interfering with your life, then I’d strongly recommend a mental health practitioner too.

2. Up Your Fiber

Fiber is magic for gut health, reducing inflammation, and eliminating toxins and excess hormones like estrogen from the body. Aim for ~40 grams of fiber daily from vegetables, fruits, nuts, seeds, legumes, lentils, and whole grains.

3. Go Mediterranean

The Mediterranean diet is well known as an anti-inflammatory diet, which is the bee’s knees for endometriosis. It’s high in omega-3 fatty foods like salmon, sardines, chia seeds, walnuts, and flaxseeds, as well as incorporates a colorful variety of fiber-rich foods as mentioned above.

4. Supplement

While I’m a “food first” kinda gal, there is great research on specific supplements to support endometriosis. Speak with your dietitian or doctor regarding your individual needs for vitamin D, N-acetylcysteine (NAC), magnesium, fish oil, B-vitamins, curcumin, resveratrol, and berberine.

5. Move your body

Studies show that moving your body can also reduce the impact of endometriosis symptoms, such as IBS and PMS, as well at strengthening the pelvic floor.

6. Get additional Testing

Since endometriosis tends to go hand-in-hand with other autoimmune conditions as well as gut dysbiosis, consider ruling out other autoimmune diseases, and running a breath test for SIBO and the GI Map for gut health.

Small changes create momentum and produce big results. Pick one or two items to work on first. Practice it (progress, not perfection). Every other week or so, add another item from the list and feel your health improve.

I’d love to hear from you. If you’d like support with your endometriosis, I’d love to help. Please send me an email and let’s work together!

With love, Steph

Additional Resources

1. Bellelis, P, Podgaec, S., & Simões-Albrão, M. (2011). Review: Environmental factors and endometriosis. Revista da Associação Médica Brasileira, 57(4), 448-452. doi: 10.1590/S0104-42302011000400022.
2. Chu, M., Ding, R., Chu, Z., Zhang, M., Liu, X., Xie, S… & Wang, Y. (2014). Role of berberine in anti-bacterial as a high -affinity LPS antagonist binding to TLR4/MD-2 receptor. BMC Complementary and Alternative Medicine, 14, 89-98. doi: 10.1186/1472-6882-14-89.
3. Halpern, G., Schor, Ed., & Kopelman, A. (2015). Review: Nutritional aspects related to endometriosis. Revista da Associação Médica Brasileira, 61(6), 519-523. doi: 10.1590/1806-9282.61.06.519.
4. Helbig, M., Vesper, A., Beyer, I. & Fehm, T. (2021). Does nutrition affect endometriosis? Geburtshilfe und Frauenheilkd, 81(2), 191-199. doi: 10.1055/a-1207-0557.
5. Khan, K. N., Fujishita, A., Hiraki, K., Kitajima, M., Nakashima, M., Fushiki, S., & Kitawaki, J. (2018). Bacterial contamination hypothesis: a new concept in endometriosis. Reproductive Medicine and Biology, 17(2), 125-133. doi: 10.1002/rmb2.12083.
6. Liu, L., Chen, L., Jiang, C., Guo, J., Xie, Y., Kang, L, & Cheng, Z. (2017). Berberine inhibits the LPS-induced proliferation and inflammatory response of stromal cells of adenomyosis tissues mediated by the LPS/TLR4 signaling pathway. Experimental and Therapeutic Medicine, 14(6), 6125–6130. doi: 10.3892/etm.2017.5316.
7. Porpora, M. G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E. K., Lundeberg, T… & Parasassi, T. (2013). A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by n-acetylcysteine. Evidence-Based Complementary and Alternative Medicine, 2013, 240702-240709. doi: 10.1155/2013/240702.
8. Vallée, A., Lecarpentier, Y. (2020). Review: Curcumin and Endometriosis. International Journal of Molecular Sciences, 21(7), 2440-2458. doi: 10.3390/ijms21072440.
9. Vennberg-Karlsson, J., Patel, H., Premberg, A. (2020). Experiences of health after dietary changes in endometriosis: a qualitative interview study. BMJ Open, 10(2), e032321. doi: 10.1136/bmjopen-2019-032321.