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6 Tips for Managing Endometriosis with Diet and Lifestyle

By Claire Virga, RD, MS, CDN

Endometriosis is a condition that affects one in ten women of childbearing age. Endometriosis occurs when tissue that normally lines the uterus appears in other areas of the reproductive tract or pelvic region causing symptoms such as painful periods, cramping or pelvic pain throughout the menstrual cycle, digestion issues, pain with sex, and infertility.

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Symptoms vary widely and oddly enough, the severity of symptoms does not appear to correspond with the severity of the condition. Unfortunately, it is a very common and painful condition that we still don’t know a ton about!

Endometriosis and Infertility

Research shows that about 25-50% of infertile women have endometriosis and 30-50% of women with endometriosis are infertile. While the connection between endometriosis and infertility is still not completely understood, it is thought that when endometrial tissue grows outside of the uterus, inflammation, scar tissue, and adhesions form that may damage the ovaries and fallopian tubes and create a hostile environment for the movement of eggs and sperm. Scar tissue may restrict blood flow to the ovaries, reducing the quality of a woman’s eggs.

Do diet and lifestyle practices help?

Yes! Even small changes can help. Here are some of the changes that are going to make the biggest difference in managing your endometriosis and boosting fertility too.

1. Make Fiber Your Friend!

Endometriosis is often fueled by estrogen. High levels of estrogen exacerbate the growth of endometrial tissue.  Diets that are higher in fiber are associated with lower levels of circulating estrogen. Fiber helps to reduce estrogen levels by preventing its absorption from the digestive tract and removing excess fiber in feces. Aim to get at least 25g of fiber per day from sources like fruits, vegetables, whole grains, and legumes.

2. Fill Up on Fruits and Vegetables

An antioxidant-rich diet reduces inflammation within the body. Antioxidants are primarily found in plant-based foods like fruits, vegetables, whole grains, and nuts, and seeds. Given that endometriosis is an inflammatory condition, women with endometriosis may be able to help manage symptoms, boost fertility and reduce the growth of endometriosis adhesions by adding more fruits and vegetables to their diet.

The typical American diet is centered around animal protein and carbohydrates. Flip this script by making half your plate either fruits or vegetables. Get in a variety of different colorful fruits and vegetables because each color signifies a different type of antioxidant. The more antioxidants, the better!

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3. Put Away the Plastics

Endocrine-disrupting chemicals or EDCs are chemicals that have the potential to disrupt hormones and mimic estrogen within the body. Given that endometriosis is fueled by estrogen, doing your best to cut down on your use of products containing EDCs can be beneficial.

Avoid using plastic food storage containers and plastic water bottles (invest in a Swell Tumbler - my personal favorite for keeping beverages either cool or hot!). Choose organic produce and hormone-free and organic dairy products when possible. Don’t obsess over this. Do the best you can - making small swaps can have benefits!

4. Ramp Up Your Exercise Routine

Regular exercise reduces circulating estrogen levels. Exercise also helps to lower body fat, which can also reduce estrogen levels. If you aren’t exercising right now, make a small goal (i.e. take a walk for 20 minutes 2x per week), and slowly build upon that.

Moderate exercise has many benefits for women dealing with infertility and undergoing fertility treatment. Exercise relieves stress, boosts energy, and may improve fertility.

5. Get in Omega-3s

Research shows that women who consume more omega-3s in their diet have a lower risk of being diagnosed with endometriosis. Omega-3s exert an anti-inflammatory effect, which may improve painful symptoms. Aim to include at least two servings of fatty fish and seafood in your diet per week. Fish highest in omega-3s include tuna, salmon, herring, mussels, anchovies, sardines, and mackerel.

6. Combat Stress

If you have endometriosis or suspect you have endometriosis, reducing stress can also play a role in pain and symptom management. Stress seems to exacerbate and increase the size of endometriosis lesions.

Dealing with infertility is stressful in itself so make an effort to build stress-relieving practices into your daily routine. Start a meditation practice, connect with close friends, take walks outdoors or find an activity that works for you.

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Claire Virga, MS, RDN is a Registered Dietitian at Rooted Wellness, a private nutrition practice specializing in women's health. Claire is passionate about working with women to optimize their reproductive health and overall well-being through a holistic and realistic approach. Claire has her master’s degree in Clinical Nutrition and Dietetics from New York University. She completed her dietetic internship at Montefiore Medical Center, where she provided nutrition counseling and evidence-based medical nutrition therapy to patients with a wide range of medical conditions. Claire has also worked at Plantable, a meal delivery service providing health-supportive meals and coaching. You can visit Claire’s website here.

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