Diet for Endometriosis – Can It Help?

Endometriosis is a gynecological, autoimmune disorder characterized by an abnormal growth of uterine mucous membrane beyond its boundaries. Endometrium tissue should exclusively line the uterus, but due to abnormalities, it can also appear in the fallopian tubes, ovaries, peritoneum, bladder, and intestines. The definition of endometriosis was introduced in 1921 by J.A. Sampson. According to him, endometriosis in the abdominal cavity arises from the migration of particles of uterine mucous membrane during menstruation. These particles should be removed by the immune system, but this does not happen, which can lead to inflammation of the organs.

– intense pelvic pain both during menstruation and throughout the cycle, – heavy menstrual bleeding, – pain during sexual intercourse (dyspareunia), – severe pain during physical activity, – diarrhea, – nausea, – bloating, – painful urination and bowel movements, – chronic fatigue and exhaustion, – fertility problems. These symptoms have a negative impact on self-esteem, mood, quality of life, and daily functioning. Studies have shown that women with endometriosis have higher rates of depression, anxiety, and emotional stress symptoms. The average time from symptom onset to diagnosis is 7 years. In 20% of women, endometriosis is asymptomatic (L. Culley et al. 2013). Individuals most at risk for developing endometriosis are: – women of reproductive age – most commonly between 25 and 34 years old, – women with shorter menstrual cycles, – girls who had an early first period (before age 11), – women who had a late menopause, – underweight women – both currently and with low birth weight. The development of endometriosis is influenced by genetic, environmental, hormonal, and immunological factors. The occurrence of endometriosis is genetically determined and often occurs in families. In siblings, the likelihood of occurrence is five times higher than in individuals who are not related to each other (H. Stefansson et al. 2002). Environmental factors that impact the development of endometriosis are xenoestrogens, herbicides, pesticides, bisphenol A, detergents, and dioxin (M. A. Martínez-Zamora et al. 2015). Hormones primarily responsible for the progression of the disease are estrogen and leptin (A. Ji-Hie et al. 2015). The immune system produces increased levels of interleukins (IL-6, IL-8, IL-25) – inflammatory factors, in response to the development of endometrium outside the uterus. This leads to a chronic inflammatory state in the body (V. Kocbek et al. 2015; N. Slabe et al. 2013).

– the compilation of detailed data about the presenting symptoms during a discussion with the patient and their analysis, – the increased likelihood of disease occurrence if endometriosis has been present in the family, – the assessment of the abdominal cavity and pelvis, – transvaginal ultrasound (USG), – magnetic resonance imaging (MRI), – laparoscopy and examination of tissue samples. In the case of endometriosis, surgical treatment and personalized hormone therapy are primarily employed.

Nutritional products that may decrease the likelihood of endometriosis are: - vegetables (a source of antioxidants that help eradicate free radicals), - fruits (a source of antioxidants that support bodily functions), - dairy products (a source of calcium and vitamin D3, which are crucial for bone health), - fish oils (a source of polyunsaturated omega-3 fatty acids, which support heart health), - dietary fiber (which improves digestion), - omega-3 fatty acids (which improve brain functions). Nutritional products that may increase the likelihood of endometriosis are: - high-fat content products (which can lead to obesity), - saturated fats (which can lead to heart disease), - trans fats (which can lead to heart disease), - alcohol (which can lead to liver disease).

A well-balanced diet in terms of nutrient content and nutritional intake is a crucial component of endometriosis therapy. However, it is best indicated that a varied diet based on products with anti-inflammatory effects may exacerbate the symptoms of endometriosis, hence it is not advocated, in contrast to a high-fat diet, which has a beneficial impact on the metabolism of the body's fat-soluble hormones.

Limiting the consumption of processed, ready-to-eat products and gluten-containing cereal products (incorporating natural gluten-free grains and regulating the hormonal economy). Restricting the consumption and consumption of red meat and its derivatives (preferably eliminated entirely, but the restriction will also be beneficial). Reducing sugar intake (as well as that in sweets and beverages). Increasing the consumption of vegetables, especially those containing quercetin (e.g. bell peppers, onions, garlic, leeks, red onions), which has anti-inflammatory effects. Increasing the consumption of legumes (e.g. red and green lentils, red beans), but avoiding excessive intake of soy and its processed products, which contain natural phytoestrogens that can exacerbate the symptoms of endometriosis. Increasing the consumption of fruits (e.g. strawberries, raspberries, blackberries, blueberries, black currants, cherries, apricots). Increasing the consumption of products containing omega-3 fatty acids (e.g. flaxseed oil, hemp oil, oil from meadowfoam, pine nuts, chia seeds, flax seeds, avocado, salmon, herring). It is also important to supplement the intake of vitamin D3 and N-acetylcysteine to slow the progression of endometriosis. It is also important to reduce fat tissue in cases of overweight or obesity, which can have a negative impact on the hormonal economy. It is also important to engage in physical activity, which improves well-being, strengthens the immune system, and affects intestinal peristalsis. The limitation of trans fat consumption, the use of a varied diet rich in legumes, vegetables, fruits and products that are a source of omega-3 fatty acids can contribute to reducing the risk of endometriosis and alleviating its symptoms.