I wanted to provide you with some encouraging updates in the world of endometriosis. Over the last year, there are more conversations happening around endometriosis, how to properly diagnose it, and how it can impact fertility and infertility treatment protocols.
It is unfortunately still true that it can take up to 7-10 years for endometriosis to be diagnosed once symptoms are discussed with a health care practitioner.
Typically, endometriosis presents with very painful periods, lower back and or abdominal pain throughout the month, pain with bowel movements, pain with intercourse, and unexplained infertility.
Endometriosis and Fertility
Knowing the impact that endometriosis can have on fertility, it is being investigated on a deeper level to understand how to best approach endo patients and their fertility. It was not always the case that an endometriosis diagnosis was seen as relevant when creating a treatment protocol at a fertility clinic. But we now understand that patients with endometriosis should be individually assessed to understand what course of treatment would provide more successful outcomes while not exacerbating the presentation and symptoms of endometriosis.
This is especially important when doing IVF. Endometriosis lesions can create complexity when deciding on the best approach to take with IVF. We know that surgery to remove endometriosis lesions, while it may be indicated prior to doing an embryo transfer, it may also negatively impact your AMH (anti-Mullerian hormone or ovarian reserve). It may, therefore, be better to opt for doing an egg retrieval first and then plan for surgery after you have completed the retrieval. This avoids impacting your AMH and any other possible complications that may arise from surgery and your reproductive organs. Often, the drugs used to stimulate your follicles when doing a retrieval cycle can worsen endometrial lesions. This is another reason to wait until after a retrieval cycle to consider having surgery, and not before then.
It is important to have these discussions with your fertility doctor. Create a plan that makes sense for you and your fertility preservation.
How diet affects Endometriosis
In those with endometriosis, we understand that there are higher levels of inflammation in the body. My treatment plans will always include a detailed dietary approach to help reduce inflammation. Endometriosis is an inflammatory condition that is worsened by cycling estrogen through the month. There have been several dietary patterns that have linked endometriosis with diet and show that certain dietary patterns appear to increase the risk of endometriosis and may worsen the severity of endometriosis in patients who already have established sites.
Protein, Dairy and Meats
One of the greatest associations between diet and endometriosis is the association between red meat consumption and low fish and omega-3 intake. Based on the literature, the following recommendations are suggested for endometriosis:
Limit your red meat (hot dogs, bacon, sliced processed meat, hamburger, beef/pork/lamb sandwich, pork, beef, liver) consumption to less than once a week. Women who eat more frequent servings (daily or twice a day) have an over 50% greater likelihood of being diagnosed with endometriosis.
Increase your fish intake to 2 x per week and include an omega-3 supplement.
Increase your low-fat dairy and dairy protein in general. Women and adolescents who consume 1-2 dairy products per day such as yogurt have a lower risk of endometriosis.
Butter has been shown to increase the risk of endometriosis. This is the only dairy product that appears to worsen endometriosis.
Fruits and Vegetables
Women with endometriosis have been tracked for years in the research and one of the clearest patterns of nutrition found is that women with endometriosis often eat far fewer vegetables and fruits than women without. Studies have also shown that increasing fruits and vegetables and antioxidants decrease pelvic pain in women with endometriosis by reducing inflammation.
Work towards 8-10 servings of fruits and vegetables per day.
Variety can help support various antioxidants that are only found in certain fruits or vegetables. Variety is important to support antioxidant and nutrient intake.
Fibre is one of the main benefits of eating fruits and vegetables.
Oils and Fats
Generally, the goal with menstrual cramps and endometriosis is to support cellular structure of menstrual tissue to produce less inflammation during menses. We can change the severity of menstrual pain by improving the types of fats and oils in your nutrition.
Include 1 serving of olive oil per day (1-2 tbsp). There are studies that show that olive oil reduces menstrual cramps.
Include 1 serving of nuts per day (a handful of nuts that are raw/unsalted) and a high ratio of healthy oils such as olive oil, omega-3s from flaxseed oil, ground flax and from fish.
Avoid trans fats. Women with endometriosis appear to eat more trans-fats than other women, and by reducing trans-fats, we can reduce the severity of menstrual pain. Trans-fats are labeled on all of your food items you purchase from the store. Ensure you read the labels of baked goods to keep your trans-fats low in your diet.
Alcohol
It is best to try and eliminate alcohol consumption as much as possible, if not altogether, in order to reduce its inflammatory effects. This is best done for a minimum of 4 weeks at which time we can see if a difference is seen.
Looking for fertility support?
If you need guidance or have any inquiries about your fertility journey, please don't hesitate to connect with me. You can schedule a free consultation. I provide in-person consultations in Toronto and Aurora, as well as virtual sessions.
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