If you one of the 1 in 10 women diagnosed with endometriosis, you are probably up to your ears in misconceptions from other people around you about your condition.
As a newly diagnosed #endowarrior, and in the spirit of March being Endometriosis Awareness Month, I thought I would bust some of the top myths I hear about nutrition and endometriosis on the daily working with women with this incurable condition.
Let’s get to some serious myth-busting:
1. Diet does NOT play a role in managing endometriosis
Research continues to highlight the role of diet in managing the symptoms of endometriosis. Currently, the role of omega-3 fatty acids, antioxidants found in fruits, vegetables, herbs and spices as well as avoiding high-fat and saturated fat diets to help enhance the management of endometriosis.
Why is this way of eating potentially helpful in endometriosis?
- Omega-3 polyunsaturated fats found in oily fish, chia seeds, walnuts, hemp seeds and flax seeds have an anti-inflammatory properties helping to combat the inflammation part of endometriosis. Find out about getting your omega-3 levels with an omega-3 test kit here.
- Antioxidants also help fight inflammation which has been studied in chronic pelvic pain, for which endometriosis (and adenomyosis) are leading causes of, and has shown to be useful! Load up on different coloured fruits, vegetables, herbs and spices and don’t forget vitamin E from healthy fats too like sesame seeds, extra virgin olive oil and peanut butter.
- Foods high in saturated fat such as takeaways, butter, animal fats and trans fats – these fats have more pro-inflammatory properties. Research from the 1990s demonstrated reducing saturated fat by half can reduce oestrogen by up to 20% which is important for endometriosis as it thrives on this hormone (Prentice et al., 1990). Other research has also supported a modest reduction in total fat and reductions in oestrogen too in pre and post-menopausal women (Wu et al., 1999).
Given the pain and incurable nature of endometriosis, I think it is most definitely worth capitalising on the research and knowledge we do have on dietary management of the condition to improve symptoms, wherever possible.
2. I have to go gluten, dairy and soy free on an endometriosis diet
If I had a dollar for every time I heard a client tell me this for nearly any condition, I would be able to ditch my Hyundai for a Porsche!
This is simply untrue on a general level, here are the exceptions….
There is one study of 156 Italian women with endometriosis, that showed symptom improvement with a 12 month gluten-free diet for women with endometriosis, but, is it because of gluten (the protein found in wheat, barley, rye) or rather is it another component of these foods such as fructan (the carbohydrate and a FODMAP) that women with endometriosis are sensitive too? (Marziali et al., 2012)
In terms of avoiding dairy, lactose intolerance is a common reason. We know that women with endometriosis are more at risk of food intolerances and digestive symptoms such as diarrhoea (Baron et al., 2011). However, it does NOT mean you need to say goodbye to dairy completely! Most people can tolerate yoghurt and cheese because of the reduced lactose load.
Opting for lactose-free dairy foods to ensure you’re getting enough calcium to support healthy bones, is key. Or looking for a calcium-fortified milk alternative with at least 100 mg of calcium per 100 mL – look on the nutrition label.
New research in lactose intolerance also highlights that avoiding all dairy foods can result in tolerance levels decreasing over time and becoming more sensitive. So including some on a semi-regular basis can help maintain and even improve your tolerance! Read more in Dr Megan Rossi’s book Eat Yourself Healthy and also on her blog.
As for soy, it is unlikely that a couple of serves of unrefined soy foods such as edamame, tofu and tempeh are really driving up your oestrogen levels and worsening endometriosis, you would need to be eating a heck of a lot to really be interfering with your hormones!
Research has not shown a relationship between consuming soy foods and developing endometriosis either (Jurkiewicz-Przondziono, et al., 2017).
Best to avoid really refined soy foods like fake meats and plant-based burgers containing manipulated soy proteins.
Read my blog post outlining the facts about soy for a variety of women’s health concerns including endometriosis here.
3. Women with endometriosis can benefit from a low FODMAP diet
It’s true! Women with endometriosis are likely to also have a diagnosis of irritable bowel syndrome (IBS) too! IBS affects 10-15% of the population and affects more women than men. Turns out that many women with endo report worsening bowel symptoms around their period.
Could this be due to both conditions sharing the common factor of visceral hypersensitivity? This is where the amount of gas and contents in the bowel and surrounding pelvic areas may be equal to everybody else’s but the same amount is causing greater pain, stimulating the nerve endings and sending pain signals to the brain!
In a 2017 study, 75% of the women with both endometriosis and IBS had a 50% or more improvement in their bowel symptoms with the low FODMAP diet (Moore et al., 2017).
Read more about the low FODMAP diet for endometriosis here.
You can watch this video from Monash University which is an awesome explanation of how this works and why the low FODMAP diet works to improve the symptoms of IBS.
It is absolutely critical you speak with a dietitian to guide you through the low FODMAP diet, it is not something that I recommend you can attempt solo!
So, there you have it! Some of the most commonly heard myths about diet and endometriosis busted (or fact-checked) by me – a women’s health dietitian & nutritionist!
You can read more of my blogs about endometriosis below:
- Eating for Endometriosis Part 1
- Eating for Endometriosis Part 2
- Low FODMAP diet for endometriosis
- Listen to My Endometriosis Story of my new podcast – Fertility Friendly Food
Ready to see what a difference a targeted dietary approach for endometriosis can do for your symptoms and fertility (current or future)? Then book in today for a FREE 15 minute discovery call.