Lifestyle and Dietary Changes for Endometriosis

There's no question that endometriosis can play havoc with your quality of life. In this condition, tissue that normally lines the uterus grows outside the uterus. Yet the ebb and flow of estrogen throughout the month works on this external endometrial tissue just as it does on the uterine lining, inciting growth when estrogen levels are high. That's fine for endometrial tissue within the uterus; but when endometrial tissue in the pelvic or abdominal cavity grows, it can cause severe pain, unusual bleeding and damage to other organs, including the bowel and bladder, and even lead to infertility. The pain can be so bad, in fact, that some women spend a day or more a month in bed.

While there are a variety of treatments for endometriosis—ranging from medications to surgery—you shouldn't discount lifestyle changes. We know that lifestyle changes, including what you eat and how much physical activity you get, affect other estrogen-dependent conditions, such as menstruation, fibroids and menopausal symptoms.

Unfortunately, the few studies on endometriosis and lifestyle focus on whether certain diets or levels of activity are connected to endometriosis, not whether those aspects improve endometriosis-related symptoms. However, that doesn't mean they're not worth a try.

Several studies find a strong connection between endometriosis and diets high in red meat and low in green vegetables and fresh fruit. This fits with other studies finding similar connections between these eating patterns and endometrial cancer and fibroids (noncancerous tumors of the uterus). One seminal study in this area compared 504 healthy women and 504 women with endometriosis, finding that women who ate beef every day were nearly twice as likely to have endometriosis, while those who got seven or more fruit and vegetable servings a week were at least 40 percent less likely.

So what's going on? One theory is that dietary fat influences your body's production of prostaglandins, chemicals that stimulate uterine contractions and affect ovarian functioning. It's thought that high levels of prostaglandins could lead to higher production of estrogen, which could influence the growth of endometrial tissue. Other studies find a link between high-fat diets and levels of circulating estrogen; the more fat in your diet, the more estrogen your body produces. This also occurs if you're overweight, and you're more likely to be overweight if you follow a diet high in red meat and low in fruits and vegetables.

Moving on to exercise, we know that women who exercise intensely tend to have lighter periods with reduced ovarian stimulation and estrogen production. In one study, researchers evaluated the effects of high-intensity physical activity on a woman's risk of endometriosis. They found that women who averaged 2.5 hours of high-intensity activity (think jogging, bicycling or aerobics) were 63 percent less likely to have endometriosis. Those who engaged in such activities more often were 76 percent less likely to be diagnosed with endometriosis.

So what does this all mean to you?

Well, whether or not exercise and diet have any effect on endometriosis, we know they have a significant effect on a host of other health-related conditions. Reducing the amount of red meat in your diet, upping intake of fresh fruit and vegetables and getting three or more days of moderate- to high-high intensity exercise will help you in numerous ways—and may make a difference in the severity of your endometriosis. So they're certainly worth a try. Here are some ways to integrate both into your daily life:

• Stock the fridge with washed, precut veggies and fruit bowls. You're more likely to reach for something healthy if it's as easy to eat as that bag of chips.
• Build your meals around a vegetable course, not a meat course. Instead of pork chops with spinach on the side, sauté a huge amount of spinach and dice a bit of pork into it for the protein.
• Bump up the veggies and fruit in unexpected places. How about dicing zucchini and summer squash into your pasta sauce, topping salmon with a fruit salsa and mixing a bag of frozen broccoli into that mac and cheese or lasagna?
• Enlist a partner in your quest for exercise. Together, the two of you sign up for a class at the gym, commit to brisk walking three mornings a week or agree to train for a 5-K run. It's much harder to skip out on a friend than it is to skip out on your own promise to exercise.
• Find something you love to do and do it! Who says exercise has to be a one-hour aerobics class at the gym or a solitary jog? How about signing up for Latina dance classes, creating a new garden, taking up racquetball or tennis, or learning to mountain bike?