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Endometriosis is a common female health problem, estimated to affect around 15% of all women. It is more common in women over the age of 30 who have not had a pregnancy and its prevalence is increasing worldwide. In addition to the debilitating pain that often accompanies the condition, one of the main complications of endometriosis is impaired fertility, and it is estimated that around a third of women with endometriosis have difficulty getting pregnant.

What is endometriosis?
Endometriosis happens when parts of the endometrium (lining of the womb) migrate outside of the womb and implant into other areas such as the ovaries, pelvis, bladder, bowel and fallopian tubes. Rarely, endometrial tissue may even spread beyond the pelvic area. Even though these endometrial implants are then located in the wrong places, they are still responsive to the hormonal changes that happen during the course of a normal menstrual cycle, and at the end of the cycle when bleeding occurs, these endometrial patches bleed too. In a normal period, blood exits the body via the vagina, however there is no available outlet for the endometrial patches that implant outside of the womb; instead the blood becomes trapped causing pain and inflammation, and this can eventually lead to cysts and scar tissue.

Common symptoms of endometriosis

• Generalised pelvic pain
• Heavy or irregular periods
• Painful periods
• Painful sex
• Back pain
• Fatigue
• Nausea
• Gastrointestinal problems (diarrhoea, bloating, pain during a bowel movement or urination)
• Infertility

What causes endometriosis?
There is no single known cause of endometriosis, it is likely a combination of genetic and environmental factors. Some researchers have hypothesised that there may be a problem with the immune system which makes the body less able to identify and destroy endometrial-like tissue that grows outside the womb. Endometriosis is sensitive to oestrogen and the balance of oestrogen in the body seems to have a significant role to play in the condition. Bringing excess oestrogen back into balance and supporting the body’s ability to safely process and eliminate it from the body are crucial aspects of a natural support protocol. Since safe oestrogen processing relies on both a healthy gut microbiome and optimal liver function these are crucial areas of support too.

The good news is that diet and lifestyle changes can be of significant help to women affected by endometriosis. Effective natural treatment protocols commonly centre around the nutritional support of these five key areas and you will see all of these reflected in the diet, lifestyle and supplement considerations:

Key dietary, lifestyle and supplement factors

Dietary factors

✔ Add phytoestrogen-rich foods such as miso, tempeh, tofu, flaxseeds & chickpeas into your diet

✔ Choose organic and free range foods to reduce your overall intake of toxins which in turn takes pressure off the liver

✔ Avoid refined and processed foods; cook meals with fresh wholefoods from scratch. Choose wholegrain versions of carbohydrate foods such as quinoa and oats.

✔ Reduce sugar, caffeine & alcohol

✔ Include good quality protein (poultry, meat, tofu, tempeh, beans, chickpeas, eggs) and fat (nuts, seeds and their oils, oily fish, avocados, olives, grass-fed butter) with each meal

✔ Increase variety of plant foods; aim for 40+ different types of fruits, vegetables and culinary herbs in your diet each week. Include plant foods rich in prebiotic fibres such as chicory root, dandelion greens, Jerusalem artichoke, garlic, onions and asparagus, and resistant starch such as cooked potatoes left to cool and then eaten cold

Have a daily portion of fermented foods such as kefir, kombucha, sauerkraut or kimchi

✔ Increase your intake of omega-3 rich fats found in oily fish, nuts, seeds and their oils and reduce your intake of omega-6 fats found in red meat and dairy products

✔ Include a portion of cruciferous vegetables such as broccoli & cauliflower daily. Broccoli sprouts are particularly valuable to include

✔ Include liver-supportive foods and drinks in your daily diet such as fresh parsley, artichoke, nettle tea and green tea

✔ Drink plenty of fresh filtered water daily

Lifestyle factors

✔ Audit your diet, lifestyle and environment to identify ways you can eliminate toxins wherever possible. Pay particular attention to toiletries, personal care products, cleaning products and to eliminating plastics from your environment

✔ Pay close attention to your sleep hygiene and self-care to ensure you are regularly getting enough sleep and taking steps to reduce stress wherever possible

✔ Regular exercise to support immune function, to keep stress in check and to help the body eliminate toxins via sweat

✔ Sauna regularly to support your body’s detoxification processes

Key nutrients

• Phytoestrogens from kudzu and flax – Weaker oestrogenic compounds found in plants such as kudzu and flax may help to bring oestrogen back into balance

• Broccoli extract  – Cruciferous vegetables such as broccoli contain a highly beneficial plant substance called di-indolylmethane which can help to support the safe processing of oestrogens in the body

• Calcium D-Glucarate – Provides an absorbable source of calcium in a form that may help to support the safe processing of oestrogens in the body

• Magnesium - Supports a healthy stress response, mood balance, nervous system, restful sleep and important for hormonal balance too

• B vitamins - Often nicknamed ‘anti-stress’ nutrients for their powerful ability to balance mood and calm the nervous system. B vitamins are also critical for safe hormonal processing and to support vital liver functions

• Choline and glycine – Important nutrients which help to support healthy functioning of the liver

• N-acetyl cysteine (NAC) & alpha lipoic acid – NAC and alpha lipoic acid help to make glutathione, the body’s master antioxidant

• Vitamin C – An important nutrient for immune function and to support a healthy stress response

• Beta Glucans - Safe, natural substances found in bacteria and fungi that have been found to have a natural ability to modulate immune function. Wellmune® is a commercially available beta glucan extracted from the cell wall of a proprietary strain of yeast which has been shown to have immune-modulating benefits

• Vitamin D – This important nutrient is crucial for immune balance, and yet many people have low levels, especially during the autumn and winter months

• Vitamin A – A vitally important nutrient for immune function

• Omega-3 – Omega-3 fats EPA & DHA are important to support balanced inflammation and are found in rich supply in oily fish

• Live bacteria – Nurturing a healthy gut microbiome is essential to support the safe processing and healthy balance of oestrogen in the body. Choose a supplement containing a high strength of recognised strains of live bacteria such as Lactobacillus acidophilus NCFM and Bifodobacterium lactis Bi-07

Key botanicals

• Green tea – Has powerful antioxidant properties, and so helps to protect the body from free radical damage

• Milk thistle – Plant extract with a long history of use for supporting liver function

• Curcumin – The bright yellow compound found in the popular spice turmeric which has powerful anti-inflammatory and antioxidant properties

Useful resources
What You Need To know About Oestrogen And Endometriosis
21 Best Ways To Detox Your Life
Immune Health - Dietary Lifestyle And Supplement Do's

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