Endometriosis and nutrition

Diet is one of the pillars at the basis of a global management that combines therapies and natural approaches in case of endometriosis.

In fact, a well managed and adapted diet allows to control and/or to significantly reduce part of the symptoms directly or indirectly related to endometriosis, its treatment (in particular surgery) and its consequences on all organs of the pelvic floor.

Endometriosis patients often highlight the benefits of an “anti-inflammatory” diet; an adjective that has been used and abused in recent years and that ultimately lost its meaning or more exactly, now finds itself having so many meanings that we might wonder about it.

In order to understand and master this diet and then develop and adapt it to each situation, it is necessary to know its origin to understand the subsequent mechanisms of “filtering” (“selection”) that lead to include or limit certain foods in particular.

The logic followed by this diet is therefore the following:

1) endometriosis and the development of endometrial tissue are supported by hormones, mainly estrogens.

Therefore, we will try to avoid foods/supplements rich in phytoestrogens: soy, oats, sage, aloe vera.

2) endometriosis often induces chronic pelvic inflammation.

Therefore, we will drastically exclude the main substances that promote inflammation i.e. the products that introduce a large amount of oxidants into the body: tobacco, alcohol of all kinds, drugs (the discussion for medical cannabis is different and requires a complete article), coffee, tea, chocolate and all highly industrialized products that contain additives (dyes, preservatives, emulsifiers, etc.).

Adopting a slow food diet is therefore a good idea in this case.

We must pay attention to the myths and the various proposals received and (too) frequently spread by health professionals and pseudotherapists (especially naturopaths who are not, it should be remembered, authorised to prescribe a diet if they do not have a state authorization):

Gluten is not pro-inflammatory and neither is lactose! However, as we will see later, gluten and lactose-rich foods should undergo a significant quantitative reduction, but for other reasons.

Inflammation (which is an oxidative process) can be also combated with an increase in the intake of natural antioxidants: parsley, ginger, turmeric, fresh seasonal fruit and vegetables, raw or steamed (to preserve their antioxidant component).

3) chronic pelvic inflammation is a chemical process in which inflammation mediators are released which lead to an increase in the level of histamine, causing an immune response that aggravates inflammation (vicious circle effect).

Therefore, foods rich in histamine or which induce strong releases of histamine after consumption should be reduced or avoided: strawberry, eggplant, kiwi.

In parallel, the integration of quercetin (natural antihistamine and anti-inflammatory) seems to be a very reasonable choice.

4) endometriosis and the resulting inflammation induce a significant pelvic contracture which can lead to neuropathic disorders in the absence of a proper management.

Therefore, we should pay a special attention to the content of magnesium (natural muscle relaxant) in the diet although this could lead to supplementation of this nutrient.

We will also deal with the limitation of the intake of so-called “exciting” substances (which have an effect on muscle arousal) such as spices and peppers.

5) endometriosis promotes the appearance of urinary tract infections and abacterial cystitis.

For these reasons, nutrition should be oriented towards the choice of an alkaline diet in which the sources of animal proteins: meats of all types, cold cuts, fish of all kinds, eggs, cheeses and dairy products (with and without lactose) are moderate to reduce the production of metabolites which, during the elimination of urine, could increase urothelial aggression (urinary acidification). Adopting a semi-vegetarian diet would therefore be a good option in this regard.

The main acidifying agents in food must also be reduced: red fruits in all their forms (cranberry, blueberries, etc.), tomatoes, citrus fruits.

In addition, the daily supplementation of D-Mannose and urinary alkalizing (Ausilium) is an ideal preventive measure.

6) endometriosis promotes the appearance of vaginal infections (both bacterial and fungal) and vaginitis (bacterial).

Once again, it is advisable to be careful with wrong ideas: the consumption of sugars is not to blame as long as these 3 conditions are respected:

– must be reasonable (50 g of pure sugar or equivalent per day)

– correctly distributed throughout the day

– of unprocessed/industrialized sugary products (see point 2)

The best prevention of infections and vulvovaginal disorders continues to be the improvement of sanitation measures and the preservation of the vaginal ecosystem.

7) endometriosis promotes the slowing down of intestinal transit, constipation, microbiota disorders and consequent intestinal porosity.

The consumption of fiber, both from fresh fruit and vegetables and from legumes, is therefore a cardinal point of the diet, but this point is also a logical consequence of all the above mentioned criteria.

Depending on the situation, we can also evaluate the relevance of a supplementation with probiotics to restore the balance of the intestinal flora and combat wall permeability.

The various popular “remedies” against intestinal permeability (clay, glutamine, etc.) are not recommended.

These starting elements, which are already very important, are summarized in the following table, to help you lay the foundations of a 360 ° suitable diet for endometriosis disorders:

And what about fats in this diet?

The previous suggestions reflect more a balanced lifestyle than a “diet” to follow. It is important to add that moderation is the key word in the diet in case of endometriosis and that the total and drastic exclusion of one or more foods is not necessary (except in particular cases of personal aversion or very reduced tolerance).

In fact, excessively rigid exclusions and restrictions often lead to deficiencies that alter the lipid metabolism, cause “oxidative stress” and therefore a worsening of endometriosis.

For the same reasons, the consumption of “good fats” should be maintained: vegetable oils and animal fats in reasonable quantities are therefore perfectly included in the diet for endometriosis.

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