The Best Diet If You Have Endometriosis, According to Experts
This year, celebrities like Mandy Moore and Chrissy Teigen opened up about their struggle with endometriosis. In light of more conversations opening up around the disorder, we consulted two health professionals to help get a better sense of what endometriosis is as well as which foods may help improve symptoms. While there's no cure for the common gynecological condition, certain treatments—and yes, even foods—may help to keep symptoms under control.
What is endometriosis?
Endometriosis is an often painful condition that occurs when the endometrium, or the membrane that lines the uterus, grows outside the uterus.
"When you have endometriosis, that lining is peppered in other parts of your body, like the ovaries, the bowel, and even the diaphragm," says Christine Carlan Greves, MD, a board-certified obstetrician and gynecologist at the Orlando Health Winnie Palmer Hospital for Women & Babies.
While your uterus sheds the endometrium every month when you menstruate, other parts of your body can't get rid of it. "This can result in pain in the body when a woman is menstruating," says Greves.
Some women with endometriosis may also have heavy periods, pain during intercourse, discomfort when urinating or having bowel movements, or trouble getting pregnant.
How do you get diagnosed with endometriosis?
The gold standard for diagnosing endometriosis is a laparoscopy. This is a type of surgery that involves looking inside a woman's pelvic area to view the endometriosis tissue. Doctors may even take a sample of the tissue to look at it under a microscope, according to the Office on Women's Health (OWH).
However, there are other ways to check for endometriosis. Your doctor may perform a pelvic exam to feel for large cysts or scars behind your uterus, or use an imaging test like an ultrasound or magnetic resonance imaging (MRI), per the OWH.
Experts estimate that more than six million women in the U.S. are currently living with endometriosis. The condition peaks between the ages of 25 and 35, but it shows up in girls and post-menopausal women, too, says Greves.
How long a woman lives with endometriosis before getting a diagnosis can vary, but research suggests it can take a whopping eight years. One reason it can take so long is that many doctors normalize menstrual pain, which means they may shrug off your complaints as just part of having your period.
If your OB/GYN doesn't take your pain seriously, it's important to find one who does. "If you're noticing that there's something going on with your body that you feel like could use improvement, don't hesitate to mention that to your doctor, because we're here to help," says Greves.
Once you get a diagnosis, there are a few treatment options to consider.
"The easiest thing, as long as someone doesn't have any contraindications, is to take non-steroidal anti-inflammatories [NSAIDs] like naproxen or ibuprofen two days before your period is expected to start," Dr. Greves says. Over-the-counter NSAIDs combat prostaglandins, a class of hormones that spark inflammation in order to deal with injury and illness, and which contribute to pain with endometriosis. "So if you take [NSAIDs] before your period, it's like you're prepared for the battle of pain," Greves explains.
You can also try hormonal birth control pills to stop the process of cycling from happening in the first place. This may prevent the endometrium from causing trouble, she adds.
If your symptoms are severe and hormones aren't helping, surgery may be an option. The surgeon can remove any patches of endometriosis, and after that, you can try hormone treatments again, according to the National Institute of Child Health and Human Development (NICHD).
What's the best diet for endometriosis?
Your diet may have an effect on your endometriosis. "While more research is needed, the evidence suggests that there are some foods that may negatively influence endometriosis symptoms," says Caroline Susie, RD, a registered dietitian who works with women.
For example, endometriosis tends to be more common in women who regularly eat trans fats, which are found in fried and processed foods. One study of more than 70,000 U.S. nurses found that women who ate the most trans fats had a 48% increased risk of being diagnosed with endometriosis compared with those who ate the least. The reason may be that trans fats increase inflammatory markers that have been associated with endometriosis.
You may also want to limit your intake of alcohol and caffeine if you have endometriosis. Both promote inflammation in your body, which can worsen pain, says Susie.
On the other hand, some foods may prove beneficial for women with endometriosis.
While there's no official endometriosis diet, the Mediterranean diet is a great option because it incorporates foods that fight inflammation, Susie says. This diet centers on high-fiber foods like whole grains and vegetables; antioxidant-rich foods like colorful fruits; healthy fats like olive oil, salmon, nuts, and seeds; and high-iron foods like leafy greens and beans. Keep in mind current research on the endometriosis diet is limited and not conclusive—these are just helpful suggestions that may help reduce symptoms.
According to Susie, these five foods may be especially helpful for taming endometriosis symptoms.
Salmon is a fatty fish that's rich in omega-3 fatty acids. According to Harvard T.H. Chan School of Public Health, omega-3s are an essential fat—meaning your body can't make them on its own and must get them from food—with inflammation-fighting abilities. Thanks to an abundance of omega-3s, salmon may help reduce inflammation and pain, making it a smart addition to your diet if you have endometriosis.
Raspberries are an excellent source of fiber—nearly 10 grams (36% of your daily value or DV) per cup, according to the U.S. Department of Agriculture (USDA). Including plenty of fiber in your diet may help lower estrogen levels, Susie says. This can be helpful for women with endometriosis because the disorder is highly dependent on estrogen. Lowering your levels may help ease endometriosis-related pain and inflammation.
Fruits of any kind will offer plenty of antioxidants, but blueberries are an especially hearty source, says Susie. Antioxidants help fight oxidative stress caused by free radicals you encounter in your day-to-day life (like environmental pollution). This perk may be helpful for women with endometriosis. In fact, researchers suggest that women with endometriosis have higher levels of oxidative stress in their pelvic region, which can worsen inflammation and pain. Antioxidant-rich foods like blueberries offer a potential solution: One study in women with endometriosis found that supplementing with antioxidants like vitamin E and vitamin C lowered inflammation and improved everyday pain in 43% of patients.
Many women with endometriosis have heavy periods, which can deplete your stores of oxygen-carrying red blood cells. When this happens, you also lose iron, leading to a condition known as iron deficiency anemia. Fatigue is the most common symptom. Including dark, leafy green veggies like spinach in your diet can help fortify your iron stores and improve symptoms, according to Susie. She suggests pairing your spinach with a food that's high in vitamin C (think citrus, broccoli, and potatoes) to help your body absorb more iron.
As you've already seen, iron and fiber are smart additions to your diet, especially if you have endometriosis. And legumes like chickpeas, green beans, and black beans offer a double-whammy. For example, just one cup of raw green beans provides nearly 3 grams of fiber (11% of the DV) and 1 milligram of iron (5.5% of DV), according to the USDA.
You don't have to put up with endometriosis pain. Combining treatments like NSAIDs and hormonal birth control with certain foods can help keep symptoms at bay. Anti-inflammatory and antioxidant-rich foods, as well as ones that offer healthy sources of iron, fiber, and healthy fats, are especially good to include in your diet. You may also want to consider limiting foods with additives, such as food colorings, preservatives, and emulsifiers. However, it's always best to get recommendations from your physician before trying any DIY endometriosis treatments.
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