Endometriosis Diet: Key Foods to Include and Exclude To Boost Fertility
What Is Endometriosis?
Endometriosis, a chronic inflammatory condition, impacts about 1 in 10 women and girls in their reproductive years, making it a widespread but incurable disease affecting millions of women globally.
Endometriosis results from the growth of uterine lining tissue outside the uterus, causing scarring and inflammation. Endometriosis frequently presents with symptoms such as pelvic and abdominal discomfort, bloating, painful and heavy periods, fatigue, painful sex, and, in some cases, infertility, which may affect up to 50% of infertility cases, with the severity of the disease stage being a significant contributing factor.
Elevated oestrogen levels are commonly seen in women with endometriosis. Oestrogen is also primarily responsible for the increased inflammation and pain often associated with endometriosis.
Nevertheless, emerging research suggests that increasing antioxidant levels in the body may mitigate the effects of oestrogen in people with endometriosis. Reducing oestrogen levels and following an anti-inflammatory diet offers a promising avenue for managing the symptoms of this debilitating condition, especially for the pain.
How Can Endometriosis Affect Fertility?
Endometriosis can negatively impact egg quality, including hormone imbalance, inflammation, and diminished ovarian reserve. Disrupting the hormonal equilibrium in the body, particularly the balance between oestrogen and progesterone, endometriosis can impede the maturation of eggs and render them more susceptible to genetic anomalies.
Moreover, the inflammatory response elicited by endometriosis can create a hostile environment for egg development and trigger oxidative stress that damages the eggs. Additionally, endometriosis can damage the ovaries and reduce their ability to generate high-quality eggs, resulting in diminished fertility and a heightened risk of miscarriage.
Fortunately, there is growing acknowledgment that diet can play a crucial role in mitigating the severity of endometriosis symptoms and improving fertility, primarily by reducing inflammation levels in the body. One promising approach to mitigate the effects of oxidative stress is to increase the consumption of antioxidant-rich foods in an endometriosis diet. Another approach is to eliminate excess estrogen production by incorporating certain foods.
Foods To Eat & Avoid For Endometriosis Diet
1. The Mediterranean Diet
Eating a healthy, balanced diet with plenty of fresh fruits and vegetables, legumes, nuts and seeds, lean proteins like poultry and fish, whole grains, and healthy fats like olive oil and avocado is key to managing endometriosis symptoms.
Recent research suggests that this eating pattern may be particularly beneficial for individuals with endometriosis, a chronic inflammatory condition that affects many women worldwide. In fact, the Mediterranean diet has been shown to significantly reduce the severity of endometriosis symptoms, including period pain and cramps, as well as pain during sex. This may be due in part to the anti-inflammatory properties of the Mediterranean diet, which can help to reduce inflammation and oxidative stress in the body.
Here are some tips to get started with the Mediterranean diet:
- Focus on plant-based foods: The Mediterranean diet emphasises eating plenty of fruits, vegetables, legumes, nuts, and seeds. Try to include a variety of colours and types of these foods in your meals.
- Use healthy fats: Instead of butter or other saturated fats, choose healthier fats like olive oil, avocado oil, or nut oils. Use these oils for cooking, making salad dressings, or as a dip for bread.
- Choose whole grains: Whole grains like brown rice, quinoa, and whole wheat pasta are staples of the Mediterranean diet. These foods are high in fibre and fertility nutrients, suitable for endometriosis.
2. Omega-3 Fatty Acids
Omega-3 is a polyunsaturated fatty acid and antioxidant commonly found in foods like oily fish (e.g. salmon, trout, tuna and mackerel), nuts, and seeds. In the context of endometriosis, research has shown that consuming omega-3-rich foods can help reduce pain and inflammation associated with the condition and improve fertility.
To reap the benefits of omega-3, current guidelines recommend consuming 2-3 servings of oily, low-mercury fish per week. It may also improve fertility by supporting healthy egg development and promoting a healthy uterine lining.
Here are some examples of fish that are high in omega-3 and low in mercury:
- Wild-caught salmon
- Atlantic mackerel
- Rainbow trout
These fish are also a great source of protein and other essential fertility nutrients, making them a healthy addition to the endometriosis diet.
3. Vitamin D
Vitamin D is an essential nutrient primarily obtained through exposure to sunlight but can also be found in some foods (e.g. egg yolks and fatty fish) and supplements. It plays a crucial role in maintaining overall health and has been found to have several potential benefits for individuals with endometriosis.
Research has suggested that vitamin D may help to reduce inflammation in the body, which is a crucial driver of endometriosis symptoms such as pain and discomfort.
Another research suggests that vitamin D may affect the production of sex hormones like estrogen and progesterone. High vitamin D levels may be linked to a lower risk of endometriosis in women. Before you start any vitamin D supplementation, talk to your doctor about checking your vitamin D levels and whether supplementation may benefit you.
On the other hand, certain foods can exacerbate the symptoms of endometriosis by increasing inflammation in the body.
4. Trans fatty acids
Trans fat, or trans-fatty acid, is unsaturated fat produced when liquid vegetable oils are partially hydrogenated. This process increases the shelf life and stability of oils, making them solid at room temperature and ideal for use in processed foods.
Some common foods that may contain trans fats should be avoided or limited in your diet:
- Fried foods such as french fries, chicken nuggets, and fried chicken
- Baked goods like pastries, cakes, and cookies
- Margarine and vegetable shortening
- Processed snacks like chips, crackers, and popcorn
- Non-dairy creamers and flavoured coffee creamers
- Frozen foods such as pizza, frozen dinners, and breakfast sandwiches
- Fast food items like burgers, hot dogs, and breakfast sandwiches
Trans fats have been found to promote inflammation in the body and interfere with the production of hormones, which may contribute to the development of endometriosis.
In a study published in Human Reproduction, researchers found that women who consumed higher levels of trans fats were more likely to develop endometriosis than women who consumed lower levels of trans fats. Eating just a little bit of trans fats (1% of your food intake) can increase your risk of getting endometriosis.
When grocery shopping, it’s essential to read the labels of packaged foods to check for the presence of trans fats. Look for keywords like “partially hydrogenated oils” or “hydrogenated oils” in the ingredient list, as these are indications of trans fat content.
Gluten is a protein found in wheat, barley, and rye. In some cases, gluten can cause an immune response in the body and damage the small intestine in people with celiac disease or non-celiac gluten sensitivity.
Foods that contain gluten include
- Wheat and wheat products, such as bread, pasta, and crackers.
- Barley and barley products, such as malt and beer.
- Rye and rye products, such as rye bread and rye crackers.
- Some oats are due to cross-contamination with gluten during processing.
- Foods that contain wheat-based ingredients, such as soy sauce, couscous, and bulgur.
- Some processed foods, such as soups, sauces, and gravies, may also contain gluten as a thickening agent.
While there is no direct link between gluten and endometriosis, some studies suggest that a gluten-free diet may help to alleviate symptoms for some women with endometriosis. This may be because gluten can increase inflammation in the body and exacerbate inflammation caused by endometriosis.
If you suspect that gluten may contribute to your endometriosis symptoms, it may be worth speaking with a doctor for appropriate testing or a fertility dietitian to discuss a gluten-free diet and potential alternatives for meeting nutrient needs
- Endometriosis can negatively impact egg quality and fertility by disrupting hormonal equilibrium, creating a hostile environment for egg development, and damaging the ovaries.
- A Mediterranean diet, rich in plant-based foods, healthy fats, and whole grains, can help manage endometriosis symptoms and improve fertility.
- Consuming foods rich in omega-3 fatty acids and maintaining an adequate vitamin D level can also reduce inflammation and improve fertility, while trans fats should be avoided as they increase inflammation and interfere with hormone production.
- While there is no direct link between gluten and endometriosis, some studies suggest that a gluten-free diet may help alleviate symptoms for some women with endometriosis.
Need More Help?
A fertility dietitian can help create a personalised nutrition plan tailored to your fertility and endometriosis needs. Certain foods may worsen symptoms such as bloating, constipation, or diarrhea. A fertility dietitian can help identify triggers and suggest alternatives. Ensure you meet your nutrient requirements through diet or supplementation to boost your fertility.
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