Dietary Factors May Aid in Endometriosis Prevention, Management, Review Study Suggests

Dietary Factors May Aid in Endometriosis Prevention, Management, Review Study Suggests

Eating foods with anti-inflammatory properties, such as certain dietary fats, phytoestrogens, resveratrol and vitamin D, can help fight endometriosis, according to a review study.

The study, “Diet and endometriosis-revisiting the linkages to inflammation,” was published in the Journal of Endometriosis and Pelvic Pain Disorders.

Chronic diseases have emerged as a significant health burden in the past few decades. Risk factors for the majority of these diseases including smoking, alcohol use, diet, and physical inactivity — all of which are considered mostly preventable.

According to a 2016 Global Burden of Disease study, diet is a leading risk factor for early death worldwide.

Endometriosis is a chronic disease that causes pelvic pain, dysmenorrhea (painful menstrual cramps), and infertility in up to 10 percent of women of reproductive age. Many studies have investigated the link between diet and endometriosis.

Studies have found that women who are lean are more likely to develop endometriosis than women with more body fat. This may be due to the fact that obese women are less likely to develop a complication known as menstrual tissue reflux, which is the most commonly accepted cause for endometriosis.

Obesity and metabolic dysfunction often go hand-in-hand. However, metabolic dysfunction also plays a role in endometriosis, since women with endometriosis have different metabolism profiles than those without the condition.

Not surprisingly, animal studies have shown that diets that promote systemic inflammation can actually enhance endometriosis progression. Most of these studies identify chronic inflammation as an underlying driver in the course of endometriosis.

Consequently, dietary factors with known anti-inflammatory effects can delay disease progression, lower the risk for developing advanced endometriosis, and reduce pain.

In particular, polyunsaturated fatty acids, fish oils, vitamins, and flavonoids have been shown to help manage endometriosis. Additionally, gluten-free diets have also shown beneficial effects in reducing pain symptoms in endometriosis patients.

Phytoestrogens — present in vegetables, fruits, and other edible plants — include compounds such as isoflavones, which can alleviate inflammation through multiple mechanisms, including decreasing the production of inflammatory molecules. Studies have shown that women with endometriosis who consume isoflavones have a decreased risk of developing advanced endometriosis. One of these isoflavones, puerarin, has demonstrated anti-inflammatory effects in the cells of women with endometriosis.

Resveratrol — a polyphenol found in grapes, peanuts, pistachios, and berries — was found to reduce lesion size in several mouse models of endometriosis, indicating potential benefits for women with endometriosis.

Vitamin D, which is found in many foods including fatty fish, cheese, eggs, liver, milk, yogurt, and orange juice, has been found to benefit both animal models and women with endometriosis by reducing lesion size and increasing anti-inflammatory responses.

Epigallocatechin gallate — found in green tea — has powerful antioxidant properties and was able to decrease lesion formation in mouse models of the disease.

Importantly, many studies have investigated the significance of consuming a high-fat diet known to promote metabolic dysfunction. However, these studies have not identified a clear association between fat consumption and endometriosis.

Nonetheless, the benefits of certain dietary fats, such as omega-3 polyunsaturated fatty acid, are associated with a reduced endometriosis risk. Eicosapentaenoic acid (EPA), an omega-3-fatty acid, has also been linked to a decreased risk of endometriosis. One study showed that the higher the EPA levels in the blood are, the lower the risk of endometriosis.

“Diet and nutrition have come of age to be at the forefront in the fight against endometriosis, based on recent evidence-supported studies describing the ability of foods with anti-inflammatory actions to mitigate endometriosis progression in animal models and patients alike,” the authors wrote.

“More effective interventions are required to address endometriosis. Understanding the convergence of diet and endometriosis may generate integrated strategies in clinical practices to improve the quality of life for symptomatic women,” they said.

“Nevertheless, due in part to the complex nature of the condition and the lack of reliable markers to detect disease initiation, scientific-based data are currently deficient to support the ability of anti-inflammatory foods and food components to prevent endometriosis. Thus, a longterm goal for endometriosis research is to achieve a clear appreciation of key mechanisms that underlie disease pathology that can be targeted by dietary factors to manage not only disease progression and recurrence but for disease prevention,” they concluded.