Diet and endometriosis

Updated: Nov 5, 2020

An estimated 5 million American women of reproductive age suffer from endometriosis, a disease hard to diagnose in some cases due to lack of physical symptoms (Eurice Kennedy Shriver National Institute of Child Health and Human Development, 2017). The pathology of endometriosis is unclear; however it is likely multi-factorial with genetic, inflammatory, hormonal, anatomic, and immune components (Missmer, et al., 2010). Endometriosis is characterized by endometrial tissue growth outside of the uterus. This imbalance leads to inflammation and the formation of lesions or patches on the ovaries, fallopian tubes, and uterus (Eurice Kennedy Shriver National Institute of Child Health and Human Development, 2017).


The two most common symptoms of endometriosis are pelvic pain and infertility, affecting approximately 75% and 50% of women, respectively; although there are many other symptoms (i.e. abdominal pain, pelvic pain, painful sex, debilitating menstrual cramps, heavy periods, and painful bowel movements)(Eurice Kennedy Shriver National Institute of Child Health and Human Development, 2017).


A study by Missmer et al. (2010) found that women with a greater long term intake of omega-3 fatty acids were less likely to develop endometriosis compared to those who consumed trans fatty acids. This is likely due to a concomitant decrease in prostaglandins and inflammatory cytokines (Missmer, et al., 2010).


Red and processed meat consumption may exacerbate pain associated with endometriosis by introducing high levels of readily absorbed heme iron; which if left unbound may result in reactive oxygen species causing additional inflammation and oxidative stress (Yamamoto, et al., 2018). In post-menopausal women, red meat was linked to hormonal imbalance, decreased levels of sex hormone-binding globulin (SHBG) and increased levels of estradiol (E2) which may increase endometriosis risk (Yamamoto, et al., 2018; Brinkman, et al., 2010).  A low-fat vegetarian diet may be beneficial for endometriosis patients, because it increases SHBG, decreases estrogen levels, BMI, and weight (Barnard, et al., 2000).


Curcumin, a naturally occurring phytochemical n turmeric that is popular in Chinese and Ayurvedic medicine, reduces E2 synthesis and proliferation of endometrial cells, consequently reducing inflammation (Zhang, et al., 2013).






References:

Barnard, N. D., Scialli, A. R., Hurlock, D., & Bertron, P. (2000). Original Articles: Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms. Obstetrics & Gynecology95, 245–250.


Brinkman, M. T., Baglietto, L., Krishnan, K., English, D. R., Severi, G., Morris, H. A., … Giles, G. G. (2010). Consumption of animal products, their nutrient components and postmenopausal circulating steroid hormone concentrations. European Journal Of Clinical Nutrition64(2), 176–183.


Eurice Kennedy Shriver National Institute of Child Health and Human Development. (2017). Endometriosis. Retrieved from: https://www.nichd.nih.gov/health/topics/endometriosis

Missmer, S.A., Chavarro, J.E., Malspeis, S., Bertone-Johnson, E.R., Hornstein, M.D., Spiegelman, D., Barbieri, R.L., Willett, W.C., Hankinson, S.E. (2010). A prospective study of dietary fat consumption and endometriosis risk. Human Reproduction¸25(6):1528-1535.


Santanam, N., Kavtaradze, N., Murphy, A., Dominguez, C., & Parthasarathy, S. (2013). Original Article: Antioxidant supplementation reduces endometriosis-related pelvic pain in humans. Translational Research161, 189–195.


Yamamoto, A., Harris, H. R., Vitonis, A. F., Chavarro, J. E., & Missmer, S. A. (2018). Original Research: A prospective cohort study of meat and fish consumption and endometriosis risk. American Journal of Obstetrics and Gynecology219, 178.e1-178.e10.


Zhang, Y., Cao, H., Yu, Z., Peng, H.-Y., & Zhang, C.-J. (2013). Curcumin inhibits endometriosis endometrial cells by reducing estradiol production. Iranian Journal Of Reproductive Medicine11(5), 415–422.

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