Endometriosis is a condition where the endometrial tissue, which normally lines the uterus, grows in other sites in the pelvis, such as the ovaries, bladder, bowel and fallopian tubes. Blood filled cysts may form on the ovaries. These patches of tissue respond to hormones in the same way as the uterine lining, growing and shedding each cycle, and can be responsible for pain, inflammation, and infertility.

Some common symptoms:

* Intense period pain, or other pain (eg lower backache)

* Bloating, constipation, diarrhea - IBS

* Infertility or sub-fertility

* Pain with sexual intercourse

* Abnormal menstrual bleeding

* Tiredness and low energy

* Premenstrual syndrome (PMS). This might make you feel moody, emotional or irritable.

* Bladder troubles like interstitial cystitis (IC)

Dietary and Lifestyle Advice

The aim of nutrition therapy is to reduce inflammation and excess estrogen, and common causes of gut irritation for those with symptoms such as bloating, changes in bowel habits, and abdominal pain. It also aims to reduce PMS-type symptoms by increasing foods that promote progesterone health. Nutrition advice for Endometriosis should be individual, as each person that is diagnosed is unique in terms of food preferences, lifestyle, medical history, symptoms, triggers and treatment. This resource is designed to give you basic information regarding nutrition for Endometriosis which is a great place to start. If you would like more specific or individual information you are welcome to make contact.

Bowel Health Advice

• Boost your dietary fibre intake to 30g/day to aid bowel motions and reduce bloating - sources of dietary fibre are varied but include flaxseed, psyllium husk, LSA, oat bran, fruits, vegetables (skin on) and legumes.
• Include functional foods that contain probiotics such as natural yoghurt – great for promoting friendly gut bacteria.
• Reduce caffeine intake - caffeine is not only found in coffee but also tea, coke and chocolate - try decaffeinated beverages or peppermint tea (which doubles as a reliever of bloating).
• Focus on meal regularity - regular meals reduces your speed of eating and portion sizes (as you have not let yourself get too hungry in between meal times).
• Minimise alcohol.  
• Avoid aggravating foods that take longer to digest, such as saturated fats and highly processed foods, trim off visible fats from meat, and avoid fish and chips and other deep fried foods.
• Avoid artificial sweeteners which are known to ferment in the gut and result in bloating (in particular sugar alcohols such as sorbitol, mannitol and xylitol which are found in protein powders, sugar free products and gum or breath mints).
• Aim to exercise daily - exercise increases transit of stools through the colon and will help to prevent bacterial build up by reducing the time bacteria is in the colon.
• Gentle movement such as yoga and walking can also help with stress management.

Anti-inflammatory Nutrition and Lifestyle Advice

• Increase fresh fish intake for its anti-inflammatory benefits - ideally including oily fish twice a week is best, or you could look at supplementing with fish oil, krill oil or flaxseed oil as a safe and effective way to get the health benefits of omega-3.
• Reduce intake of wheat and dairy, common sensitivities in those with Endometriosis (note it is important that you replace dairy products with appropriate alternatives for bone health and include plenty of other fibre sources if removing wheat products - you may find a consult with one of our dietitians or nutritionists helpful for this).
• Increase intake of colourful vegetables – looking at breakfast and lunch meals is a great way to start this - can you add vegetables to these meals? Such as spinach with poached eggs or including an additional handful of vegetables to your lunch time salad/sandwich.
• Consider sleep and stress management as key components of self-care when living with Endometriosis - increased stress levels lead to hormone changes in your body which contribute to inflammation and gut issues. Consider sources of stress in your life; which can you control or reduce and which are non-negotiable? i.e. it might not be possible to reduce hours or change responsibilities at work but could you say “no” a little more in your life? Think of what lights you up and how could you include more of these things?
• Consider consulting with a breathing physio, as pelvic pain can often perturb our breathing patterns which heightens feelings of stress and anxiety, exacerbating symptoms.

Key Nutrients

• Vitamin D and Calcium for bone health - this is particularly important if you are reducing or removing dairy products from your diet or if you are on certain medications such as Zoladex which increases your risk of Osteoporosis if used long term.
  • Calcium has been found to improve menstrual pain, and many restrict dairy because of what they read online. Ensure you're having dairy regularly each day or replacing with dairy alternatives that have been fortified with calcium. Supplementation may be beneficial and a dietitian would guide you on this, as too much calcium from supplements is not recommended.
  • Non-dairy food sources of Calcium include tofu, fortified non-dairy milks, almonds, figs and dark leafy greens.
  • Vitamin D is found in small amounts in foods and our best source of Vit D is sunlight, but it’s inefficient at increasing our levels to a suitable level. Supplementation, on the other hand is very efficient and a dietitian prescribing you a dosing regime will get your levels to an ideal level faster (without the risk of melanoma or wrinkles!).
• Magnesium for production of the body’s own sex hormones (in particular progesterone) and for improving bowel health. Food sources include green leafy vegetables, legumes, nuts and seeds.
• Omega-3 fatty acids for anti-inflammatory properties and pain management. Food sources include oily fish (salmon and mackerel) and flaxseed oil.

If you think you would benefit from meeting with registered Dietitian or Nutritionist for a consultation visit our team page and read about Hannah Eriksen, Juliette Janvresse, Ellie Connor, Pip Meads and Amy Judd who can help.