It’s estimated that 1 in 10 women have endometriosis worldwide. It’s a disease where cells similar to the cells that line the uterus are found in other parts of the body.

Symptoms of endometriosis can be different for every woman; some common symptoms include bloating, pain during menstruation, pain during sex, constant pelvic pain, fatigue, heavy or long-lasting periods, difficulty conceiving and gut symptoms such as constipation or diarrhoea.

DOES GUT HEALTH AFFECT ENDOMETRIOSIS?

Women with endometriosis are often diagnosed with irritable bowel syndrome (IBS). In fact, research has shown that a low FODMAP diet – which is commonly used for irritable bowel syndrome can also be beneficial for women with endometriosis, as it can reduce many of their symptoms (1).

Digestive health is important for managing endometriosis; efficiently eliminating excess waste from the body through appropriate water intake and fibre helps to remove toxins, lower estrogen levels (estrogen adds fuel to the disease) and promotes healthy gut bacteria.

So what about our gut bacteria? While gut health is a hot topic and there’s still a lot to be researched in this area, there’s some evidence that women with endometriosis have a much higher concentration of bacterial toxins known as lipopolysaccharides and may also have dysbiosis (an imbalanced microbiome) (2). You can read more about endometriosis and gut health here.

WHAT ABOUT INFLAMMATION?

Endometriosis is an inflammatory disease and is associated with increased levels of inflammatory markers in the blood, which is why anti-inflammatory medications such as ibuprofen can be an effective treatment. 

Lowering inflammation through diet involves reducing the intake of refined carbohydrates and processed food and replacing with wholefoods including healthy fats, vegetables, fruit and wholegrains.

WHAT SHOULD AN ENDOMETRIOSIS DIET LOOK LIKE?

• Consume fish 2-3 times per week from varieties such as sardines, anchovies, wild salmon (fresh or canned), tuna or gemfish

• Eat a fibre rich diet from wholefoods such as vegetables, fruit and wholegrains 

• Eat anti-inflammatory foods daily including whole fruits and vegetables, olive oil and spices such as turmeric and cinnamon

• Avoid processed food, refined sugar and saturated fat

• Limit red meat and avoid processed meat such as bacon and salami 

• Avoid alcohol and caffeine

• There is limited evidence around soy consumption in humans and endometriosis (3, 4). Some studies say it is linked to an increased risk, others state it may be beneficial and reduce the risk.

• If you’re dealing with food intolerances, or your symptoms worsen with certain foods intake see a qualified nutritionist.

References

(1) Moore, J. S., Gibson, P. R., Perry, R. E., & Burgell, R. E. (2017). Endometriosis in patients with irritable bowel syndrome: Specific symptomatic and demographic profile, and response to the low FODMAP diet. Australian and New Zealand Journal of Obstetrics and Gynaecology, 57(2), 201–205. doi:10.1111/ajo.12594 

(2) Viganò, D., Zara, F., Usai, P. (2018). Irritable bowel syndrome and endometriosis: New insights for old diseases. Digestive and Liver Disease, 50(3), 213-219. Doi.org/10.1016/j.dld.2017.12.017

(3) Mvondo, M. A., Ekenfack, J. D., Minko Essono, S., Saah Namekong, H., Awounfack, C. F., Laschke, M. W., & Njamen, D. (2019). Soy Intake Since the Prepubertal Age May Contribute to the Pathogenesis of Endometriosis in Adulthood. Journal of Medicinal Food. doi:10.1089/jmf.2018.0160 

(4) Parazzini, F., Viganò, P., Candiani, M., & Fedele, L. (2013). Diet and endometriosis risk: A literature review. Reproductive BioMedicine Online, 26(4), 323–336. doi:10.1016/j.rbmo.2012.12.011