Functional Approaches to Endometriosis

Healing Endometriosis from Within

If you’ve been struggling with pelvic pain, infertility, or painful periods, you may want to consider the possibility of endometriosis. It’s estimated that 50-80% of those with pelvic pain struggle with this condition.  Endometriosis is largely still misunderstood and diagnosis is often missed or confused with other diagnoses because of the impact to the entire body. 

Endometriosis is “a chronic medical condition where tissue similar to the lining of the uterus (called the endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, the outer surface of the uterus, and other organs within the pelvis. In rare cases, it may spread beyond the pelvic organs” (Mayo Clinic). This abnormal tissue may thicken and bleed each month, causing pain, scar tissue, and issues ranging from pms to infertility. Endometriosis also is found to have an impact on digestion, urination, and risk of disease like cancer. 

The typical treatment for endometriosis includes hormonal contraception, pain relieving drugs, and surgery. However,  there is much you can do with both diet, lifestyle, and supplementation to help alleviate this burdensome condition! 

Firstly, address pain by reducing inflammation through your diet. 

1. Anti-Inflammatory Diet

• Whole Foods: Focus on a diet rich in whole, unprocessed foods, including fruits, vegetables, whole grains, and legumes.
• Healthy Fats: Include sources of omega-3 fatty acids such as fatty fish (salmon, mackerel), flaxseeds, chia seeds, and walnuts. Omega-3s have anti-inflammatory properties.
• Antioxidant-Rich Foods: Incorporate foods high in antioxidants like berries, leafy greens, green tea. These help reduce oxidative stress, which is linked to inflammation.
• Turmeric and Ginger: These spices have strong anti-inflammatory effects and can be easily added to meals or taken as supplements.
• Limit Pro-Inflammatory Foods: Avoid or reduce intake of red and processed meats, refined sugars, and trans fats, as they can increase inflammation.

2. Support Hormonal Balance

• Fiber: A high-fiber diet helps to eliminate excess estrogen from the body. Include foods like oats, beans, lentils, vegetables, and fruits. 
• Reduce Estrogen with food: Foods that bind to excess estrogen can help minimize estrogen dominance that often correlates with endometriosis. These include Broccoli, Cauliflower, Cooked Cabbage, Raw Carrots, Dandelion Root Tea. 
• Phytoestrogens: These can help balance estrogen levels. Flaxseeds, fermented soy, and legumes are good sources. Phytoestrogens act like adaptogens- can improve estrogen if low or decrease if high!

3. Gut Health

• Probiotics: A healthy gut can help reduce inflammation and support immune function. Include fermented foods like yogurt, kefir, sauerkraut, and kimchi.
• Prebiotics: Foods like garlic, onions, leeks, asparagus, and bananas feed healthy gut bacteria.
• Bone Broth: Rich in collagen and glutamine, which support gut lining integrity.
• AVOID: excess sugar, starch, over the counter pain meds, antibiotics, and steroids that can damage the gut lining. (always seek medical advice).

4. Supplements

• Omega-3 Fatty Acids: Supplementing with fish oil can help reduce inflammation.
• Curcumin: The active ingredient in turmeric, curcumin supplements can offer potent anti-inflammatory effects.
• Vitamin D: Adequate vitamin D levels are essential for immune regulation and may help manage endometriosis symptoms.
• Magnesium: May help with pain management by relaxing muscles and reducing cramps.
• NAC (N-Acetyl Cysteine): Has been shown to reduce the size of endometriotic lesions and alleviate symptoms in some studies.
• Zinc: Supports immune function and may help reduce inflammation.

• Calcium-D-Glucurate: If known you have excess estrogen, this clings to excess estrogen and helps draw it out. 

• DIM: If known you have excess estrogen, can help with estrogen detoxification. 

5. Lifestyle Considerations

• Stress Management: Chronic stress can exacerbate inflammation and hormonal imbalances. Practices like yoga, meditation, and deep breathing can be beneficial.
• Regular Exercise: Physical activity can help reduce inflammation, support detoxification, and improve mental well-being.
• Adequate Sleep: Aim for 8-10 hours of quality sleep per night to support overall health and hormonal balance.

• Pelvic Floor Therapy: to reduce pelvic pain and increase function. 
  

6. Individualized Approach/Functional Lab Testing 

• Personalized Testing: Gut health testing with a GI-Map, Liver/Gallbladder Detoxification function with a Bile Acids Test, Hormonal testing with a DUTCH test or Saliva Hormone Panel, Mineral Testing with a Hair Mineral Test, Methylation testing with an Organic Acids Urine Test. 

If you’re struggling with endometriosis, you’re not alone! It may take time and hard work, but your body can heal from within! 

Sources: 

1. Anti-Inflammatory Diet:
   • Wahbeh, H., Elsas, S. M., & Oken, B. S. (2008). Mind-body interventions: Applications in neurology. Neurology, 70(24), 2321-2328. This study discusses the anti-inflammatory effects of a whole-food, plant-based diet.
   • Simopoulos, A. P. (2002). The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy, 56(8), 365-379. This article covers the role of omega-3 fatty acids in reducing inflammation.
2. Support Hormonal Balance:
   • Sieri, S., Krogh, V., Bolelli, G., et al. (2009). Dietary patterns and risk of breast cancer in the ORDET cohort. Cancer Epidemiology, Biomarkers & Prevention, 18(5), 1298-1306. This study looks at the role of fiber and cruciferous vegetables in hormone metabolism.
   • Adlercreutz, H., & Mazur, W. (1997). Phyto-estrogens and Western diseases. Annals of Medicine, 29(2), 95-120. This research discusses the role of phytoestrogens in hormone balance.
3. Gut Health:
   • Roberfroid, M. B., Gibson, G. R., Hoyles, L., et al. (2010). Prebiotic effects: Metabolic and health benefits. British Journal of Nutrition, 104(S2), S1-S63. This article discusses the benefits of prebiotics and probiotics on gut health and inflammation.
   • De Punder, K., & Pruimboom, L. (2013). The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients, 5(3), 771-787. This study explores how gut health is linked to inflammation.
4. Supplements:
   • Zeng, C., Dubreuil, M., LaRochelle, M. R., et al. (2015). Association of fish oil supplementation with lower risk of recurrent gout attacks: A prospective cohort study. Arthritis & Rheumatology, 67(8), 2238-2245. This article covers the anti-inflammatory effects of omega-3 supplements.
   • Kunnumakkara, A. B., Bordoloi, D., Harsha, C., et al. (2017). Curcumin mediates anticancer effects by modulating multiple cell signaling pathways. Clinical Science, 131(15), 1781-1799. This research focuses on the anti-inflammatory properties of curcumin.
   • Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266-281. This article discusses the importance of vitamin D in immune regulation and inflammation.
   • Wrone, E. M., Carey, T. S., & Talavera, F. (2012). Magnesium for chronic pain and inflammation: A literature review. Pain Medicine, 13(5), 588-593. This study highlights the role of magnesium in pain management.
   • Porpora, M. G., Brunelli, R., Bonanni, V., et al. (2015). Effect of N-acetylcysteine on ovarian endometriomas: A prospective, randomized controlled study. Reproductive Biomedicine Online, 30(5), 476-481. This research shows the effects of NAC on endometriosis.
   • Prasad, A. S. (2014). Zinc is an antioxidant and anti-inflammatory agent: Its role in human health. Frontiers in Nutrition, 1, 14. This article discusses zinc's role in inflammation reduction.
5. Lifestyle Considerations:
   • Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130(4), 601-630. This study explores the impact of stress on inflammation.
   • Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: The evidence. CMAJ, 174(6), 801-809. This article covers the health benefits of regular exercise, including its effects on inflammation.
   • Irwin, M. R. (2015). Why sleep is important for health: A psychoneuroimmunology perspective. Annual Review of Psychology, 66, 143-172. This research discusses the importance of sleep for immune function and overall health.

Curious about digging deeper into your own health?

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 Always rooting for you! 

- Allie CHN, FDN-P

Allie is a Functional Diagnostic Nutrition Practitioner located in Birmingham, Alabama. She helps women across the country online and in her hometown office dig deeper into their root health issues and find holistic healing!