What is Endometriosis?
Endometriosis is a common women’s health condition affecting 1 in 10 women in which cells from the endometrium (lining of the uterus) appear and flourish outside the uterine cavity, usually on the ovaries. Symptoms can worsen at certain points during the menstrual cycle as cells are influenced by female hormones. Symptoms can include pelvic pain, painful periods, painful intercourse and infertility. Usually this condition is diagnosed after a laparoscopy of the pelvic cavity although pelvic ultrasounds are also used to detect endometrial tissue outside the uterus.
Risk factors for endometriosis include: family history, a diet high in trans-fats, use of intrauterine devices, and unbalanced oestrogen levels.
Symptoms are often managed with hormonal medication to suppress the natural menstrual cycle, plus painkillers to manage the associated discomfort. Occasionally progesterone creams may be prescribed. The most aggressive treatment is surgery, with some women opting for a hysterectomy.
The naturopathic approach to endometriosis is focussed on:
· Reducing inflammation
· Enhancing detoxification (especially of excess oestrogen)
· Reducing symptoms
Inflammation is a huge driver for endometriosis. The Nurses Health Study II found that women who consumed the most trans-fats (hydrogenated vegetable oils often used in processed foods) were 48% more likely to be diagnosed with endometriosis. Women with the highest consumption of omega-3 fatty acids were 22% less likely to be diagnosed with endometriosis. Reducing the amount of omega-6 fatty acids at the same time as increasing omega-3s also helps reduce inflammation. Ideally we would have an omega-6:omega-3 ratio of 3:1 however the western diet is closer to 16:1!
Foods that are high in omega-6 and should be avoided include sunflower, corn, soybean and cottonseed oils. In addition to this opt for grass-fed meat as livestock fed a grain-based diet high in corn and soya produce meat high in omega-6.
Foods that are high in omega-3 include: Oily fish like salmon and mackerel; flax and chia seeds; organic free-range eggs; extra virgin olive oil; and walnuts. Some people may also benefit from supplementing with an omega-3 oil in the short term while they make dietary changes.
Yes, we are talking about poo here! Actually detoxification involves the gut and the liver but it’s vitally important to make sure that we move our bowels at least once every day if we want to facilitate optimal detoxification. We also want to make sure that we are having a normal bowel movement. On the Bristol stool chart below we should be aiming for a 3-4. If you are having anything other than that pop in and have a chat because there are lots of things you can do to support healthy bowel function. Constipation is a common problem in hormonal imbalance across the board and we need to get to the root cause to eliminate this risk factor properly.
Increasing the amount of vegetable-based fibre in the diet is vital if we want to support our gut bacteria as this is what the good bacteria feed on. Increasing our intake of vegetable fibre has been shown to help clear excess oestrogen from the bloodstream. Cruciferous vegetables are particularly good at this so increase your intake of: broccoli, brussels sprouts, cabbage, kale and cauliflower. Supplementing with DIM and the right B vitamins can support detoxification of hormones promoting balance. Endometriosis often involves higher oestrogen over progesterone (which tends to be low), another commonly used herbal supplement which is used to rebalance the hormones is Vitex.
Studies have shown a significant reduction in symptoms in women who move away from eating higher-glycaemic carbohydrates (bread, pasta, rice, cakes, etc.), reduce caffeine and increase their intake of Omega-3 fatty acids. Caffeine can have be a problem for many women with endometriosis with one study showing consuming 150-225mg of caffeine per day (about 1-1.5 cups of coffee) increased the risk of endometriosis by 20% and those who drank more than 225mg of caffeine had a 60% increase.
Turmeric has been shown to reduce inflammation, support blood sugar (important when you’re trying to reduce food cravings), reduce pain and support liver detoxification making it a key supplement in the support of endometriosis.
Food intolerance also play a part here in that if we continue to eat foods which we are intolerant to we add to the picture of inflammation. One of the biggest drivers in endometriosis is gluten and studies have shown a significant reduction in symptoms following a gluten free diet. However, when IgG food intolerance testing is done, we can see a further reduction in symptoms. Other food triggers can be dairy, soya, yeast, eggs, corn, peanuts, cane sugar and also foods in the nightshade family eg tomatoes, potatoes etc. Endometriosis has a strong link with IBS so following the anti-inflammatory protocol above and an elimination has been found to be supportive of both conditions.
Massage therapy can also help reduce symptoms. An Iranian study showed that massage of the back, sacrum and abdomen lead to a significant reduction in painful dysmenorrhea caused by endometriosis. Abdominal massage can also stimulate peristalsis in the large intestine therefore support detoxification. In addition to this abdominal massage can also help to breakdown scar tissue and adhesions.
In all cases risk factors can be individual and an appointment with a Nutritional Therapist can help you uncover the triggers and drivers of your condition and support you with an individualised protocol.
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