An introduction to Endometriosis

Endometriosis (also known as ‘endo’) is an estrogen-dependent condition whereby functional endometrial tissue is found on sites outside of the uterus, such as the ovaries, ligaments near the cervix (uterosacral ligaments), pelvis, vagina or intestines (Norris, 2019). As tissue is functional, it can lead to scarring, adhesions and ovarian cysts (endometriomas) (Norris, 2019). These sites are referred to as lesions. Due to the challenges in diagnosing endometriosis, the incidence is likely to be higher than reported. Currently, 3.4% of women of reproductive age in Australia are diagnosed with endometriosis (Reid et al., 2019). While the cause of endometriosis is being debated, it’s likely related to inflammation and immune system dysregulation (Norris, 2019).

Risks associated with endometriosis

Endometriosis can cause chronic pain, subfertility, and lead to a reduced quality of life due to reduced participation in school, work and sporting activities (Australian Institute for Health and Wellbeing, 2019). There is currently no cure for endometriosis so treatment focuses on reducing pain and inflammation and reducing the number of new leisions.

Nutrition and endometriosis

If you’re currently consuming the traditional Western diet, it is likely you’re consuming inflammatory foods such as alcohol and trans fats which have been shown to have a negative impact on endometriosis (Helbig et al., 2021).

The Mediterranean diet is recommended for the management of endometriosis to reduce symptoms and improve quality of life (Nirgianakis et al., 2022). If you are experiencing gastrointestinal symptoms such as abdominal pain, bloating, constipation, the Mediterranean diet isn’t for you (Nirgianakis et al., 2022).

Why the Mediterranean diet?

The Mediterranean diet includes a range of anti-inflammatory foods that are rich in antioxidants, alongside compounds that behave in the body the same as ibuprofen and compounds that relax the uterus, reducing pain associated with endometriosis (Nirgianakis et al., 2022). Importantly, the Mediterranean diet is safe for long term use.

Important nutrients in the Mediterranean diet are omega-3 for its anti-inflammatory and antioxidant properties, magnesium for its role in increasing the intracellular calcium levels and relaxation of the uterus and a high level of fibre to support the immune system (Nirgianakis et al., 2022).

Transitioning to the Mediterranean diet

Here are some small changes you can make towards the Mediterranean diet:

• Swap butter for extra virgin olive oil
• Increase consumption of oily fish
• Reduce consumption of processed foods such as fast food and convenience meals
• Swap alcoholic drinks for a non-alcoholic alternative

Lifestyle strategies for managing endometriosis

• Manage stress levels
• Implement a regular yoga or mindfulness practice
• Exercise regularly
• Adequate sunlight exposure for vitamin D production

Other resources

• How to Endo (Bridget Hustwaite)
• Period Repair Manual (Lara Briden)
• Living with Endo – podcast
• Endogram – Instagram
• The Endo Monologues