Did you know March is Endometriosis Awareness month? More importantly, do you know what endometriosis actually is? Maybe you read Lena Dunham’s heart-breaking essay in Vogue about her decision to have a hysterectomy after years of endometriosis hell. Maybe you’ve recently been diagnosed. Or maybe you’ve never heard of endometriosis until now.
Hopefully you’ll hear a lot about endometriosis over the next month but nonetheless, I wanted to do my bit to shine a light on this largely overlooked condition and the diet and lifestyle choices which can ease the symptoms of endometriosis, a condition that has very much disrupted my life.
Let’s start with the basics. What is endometriosis and why is it a big deal? Endometriosis affects 1 in 10 women, that’s 176 million women worldwide, although the figures are undoubtedly a lot higher because it can take up to 10 years to be diagnosed and unfortunately medical professionals – never mind women themselves – often dismiss the symptoms as ‘just period pain’. But period pain is barely a tip of the iceberg. Try excruciating pain and impaired quality of life and you’re a bit closer.
Now for the medical bit. Endometriosis occurs when tissue that normally lines the inside of your uterus grows outside your uterus, usually on the ovaries, fallopian tubes and the tissue lining your pelvis. The symptoms of endometriosis include painful periods which are so bad they can even cause you to pass out, pain during or after sex, heavy periods leading to anaemia, chronic pelvic and back pain, severe fatigue, and – for 30-40% of women with endometriosis – infertility. Not to mention the negative impact it can have on your mental health, including bouts of depression and mood swings.
Even though some women don’t have any symptoms at all, for the vast majority of us, endometriosis gradually eats away at your quality of life. Every planning decision in your life – whether it’s a holiday, a work presentation or just a trip to the dentist – you have to factor whether you’ll be in bed, pumped up with ibuprofen and cradling not one but two hot water bottles on that day. This piece from Bust magazine is one of the best I’ve read about the impact of endometriosis on a woman’s life and why it’s so important to talk about periods.
Research into endometriosis is chronically underfunded, especially when compared to the amount of funding that is pumped into researching less common conditions. This has a knock-on effect of a general lack of awareness by both women and health care professionals of endometriosis, which in turn leads to an unnecessary delay in being diagnosed and treated.
At present there’s no cure for endometriosis but it can be treated with drugs, such as religiously taking the pill, hormone treatment or ingesting ibuprofen/codeine/your painkiller of choice. Based on my own experience and from my obsessive reading on the topic, current treatments for endo leave a lot to be desired. This article in medical journal The Lancet goes as far as describing treatment options as “inadequate”, with a particular emphasis on the recurrence of lesions after surgery and the unwelcome side effects of drugs. FWIW, hysterectomies do not ‘cure’ endometriosis either.
If you’ve recently been diagnosed or suspect you have endometriosis, I know this all sounds really depressing but there are some things you can do to make your endometriosis symptoms less overpowering. I’m a big believer in the power of food and nutrition and thankfully diet is one of the major ways – after applying a hot water bottle or taking regular hot baths – you can ease your endo symptoms. Maybe it’s a placebo effect – by changing your diet, you feel like you’re in control and not being held hostage to your condition – but there are quite a few studies which link endo with diet.
Although it hasn’t been established as an autoimmune disease, endometriosis is associated with inflammation so a lot of the dietary advice points towards about an anti-inflammatory diet for endometriosis.
If you’re a newbie to the anti-inflammatory diet, these are the inflammatory foods to avoid:
– Processed and pre-packaged foods
– Dairy (milk, cheese, yogurt)
– Red meat
– Soy (soy milk, soy ‘meat’ substitutes, tofu)
– Refined sugar
– Fried food
– Refined carbohydrates and wheat (pastries, cakes, white rice, white bread)
– Alcohol (sorry)
– Caffeine (sorry, again)
At this stage you might be thinking ‘What CAN I eat?!’ but no need to panic. There’s still plenty out there for you to enjoy, it’s just about swapping things like white rice for quinoa and going for a plant based diet rich in fresh vegetables and fruit as much as possible.
A diet rich in whole foods – that’s non-processed or minimally processed ingredients – is recommended by endo experts like Dian Shepperson Mills, MA, director of the Endometriosis and Fertility Clinic in the UK. So your best bet is to fill your plate with vegetables (go for starchy ones like beets, sweet potatoes and green leafy veg like kale), fresh fruits like antioxidant rich blueberries, nuts (soaked overnight), seeds, grains like amaranth and buckwheat, and legumes like lentils. Add plenty of natural anti-inflammatory food like pineapple, turmeric and garlic, too.
In the last year or so, fats have started to redeem themselves instead of being perceived as a dietary no-no. For the endometriosis diet, quality fats like coconut oil and ripe avocado are recommended. I’ve heard first hand from other women with endo or just bad period pain that eating avocado every day has made a massive difference so, even though I despise the taste, I force myself to eat it as much as possible.
Another side effect of endometriosis is the extreme tiredness of endo fatigue. When you’re in extreme pain for most of your life, it really takes a lot out of your body so self-care is extra important. Make it a priority to sleep properly when you can. I won’t say ‘go to the gym’ because that is the last thing any of us want to do but gentle exercise – even if it’s just a few stretches while you watch Big Little Lies – will help. Look after yourself with small lifestyle changes; it could be something like treating yourself to a massage once a month or arranging with your boss to work remotely when you’re particularly in agony, whatever works for you.
More than anything, don’t be so hard on yourself. When you’re battling endometriosis, you’re going to need all the energy you’ve got so don’t waste time fighting yourself.
Here are some helpful articles and resources about living with endometriosis: