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The light at the endo the tunnel. Endometriosis awareness month - March 2024

Endometriosis (or “endo”) is a chronic, estrogen-related inflammatory disease which affects about 10% of women with periods, and is characterised by abnormal endometrial tissue growth.

Symptoms of endometriosis can include heavy periods, low iron, debilitating pain (including period pain, but also joint pain, pain during/after sex, pain when going to the toilet). Many people with endometriosis also experience gastrointestinal symptoms (bloating, diarrhoea, constipation…), fatigue, low mood, and fertility issues.

In other words, endometriosis can have a significant negative impact on quality of life. While there is not, unfortunately, a cure to endometriosis, management of this disease includes lifestyle modification, diet, pain medication, and sometimes surgery.

Woman lays curled up in bed on white sheets

While there isn’t enough high-quality studies for a definitive “diet for endo”, studies in the last 5 years have shown that nutrition does have an impact on the severity of endometriosis symptoms. At present, based on the available literature, my recommendations are as follows. Make sure your diet is rich in :

• Antioxidants. Many foods, such as fruit, vegetables, nuts, seeds and grains

contain various different types of antioxidants. Blueberries, dark leafy greens,

green tea, herbs and spices are examples of foods rich in antioxidants.

Antioxidants help reduce inflammatory damage caused by reactive oxygen

species (ROS).

• Mono- and poly-unsaturated fatty acids, especially DHA and EPA omega 3 fatty acids (in other words, “healthy fats”). Sources includes fatty fish (salmon, sardines, trout, tuna..), fish oil tablets, avocado, olives, walnuts, seeds (especially hemp, chia and flax). Similar to antioxidants found in plants, omega 3s have anti-inflammatory properties.

• Prebiotics (leek, onion, garlic, asparagus, legumes, wholegrains..); as well as probiotics (yoghurt, kimchi, sauerkraut, kefir…), to favour a healthy gut microbiome, which is linked with reduced levels of systemic inflammation.

• Phytoestrogens have been a big topic of controversy in the last few years. There aren’t enough high-quality studies to make definitive conclusions about the effect of phytoestrogens on women’s health, but overall, eating soy products (edamame, soy milk, tofu, tempeh, miso…) seems to have a neutral, or beneficial impact on endo symptoms.

• As for supplementation, fish oil tablets, vitamin D, C, E and B12 supplements have all individually shown some efficacy in reducing endometriosis symptoms in human studies.

A doctor used a pointer to show information about the uterus

Along with making sure your diet is rich in healthy fats, fibre & antioxidants, eating less saturated and trans fats, red and processed meats, and reducing alcohol intake, can also help with endometriosis symptoms.

Other lifestyle factors, such as quitting smoking, improving your sleep quality, practicing yoga, doing infrared sauna etc. can also be beneficial when it comes to chronic pain management associated with endo.

Over half of people with endometriosis also experience IBS (irritable bowel syndrome), and many have low iron levels - symptoms of which include fatigue, breathlessness, pale skin and brain fog.

If you, or someone you know, is suffering from endometriosis, working with a dietitian could be beneficial to help reduce and manage symptoms and feel more empowered. Get in touch.


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