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Improvement in lifestyle for improving fertility in endometriosis

In endometriosis, a tissue resembling the uterus lining grows outside of the uterus. 10% of women worldwide are affected by this condition.

The prevalence of infertility is quite significant in endometriosis, with an estimated 50% of women suffering from it being infertile. 

Since endometriosis is an inflammatory condition, factors such as stress, lack of sleep, poor diet, and excess weight can affect the pre-existing symptoms.

Diet and lifestyle changes if incorporated early-on can be a relatively simple and low-cost intervention, which can potentially help with the successful management of the symptoms associated with endometriosis.

Lifestyle changes can help improve the chances of conception:
The lifestyle interventions which could help in improving the endometriosis-associated infertility are diet, exercise, limiting the intake of caffeine and alcohol, smoking cessation among several others.

Diet intervention
Women with endometriosis should eat plenty of fruits, vegetables, whole grains, plant-based proteins, and healthful fats.

1. Cut down on red meat
It increases the risk of endometriosis and can also increase estrogen levels.

Eat Plenty of Fruits, Vegetables and Whole Grains
Fruits, vegetables and whole grains are packed with dietary fiber, which may help decrease estrogen concentration in the body. They also provide vitamins, minerals, and antioxidants, which may help fight pain and oxidative stress.

There are also some special diets such as gluten-free diet and FODMAP diet that may help people with endometriosis.

Limit Caffeine and Alcohol
Caffeine and alcohol may increase the risk of endometriosis. Also, a higher caffeine level can increase estrogen levels.

Exercise
Many women with endometriosis reported that exercise helped them to effectively manage endometriosis. Physically active women have fewer chances of developing endometriosis.

Exercise not only improves fertility, but it also prepares the body for pregnancy. Pilates, a form of exercise can be very helpful for reducing muscle pain and tenseness due to endometriosis. 

Exercise can help improve the energy levels, help manage symptoms, and even decrease the levels of estrogen. 

A few other options…
Apart from diet, exercise and other lifestyle changes, other options that might come in handy and have shown great promise in controlling and improving the symptoms associated with endometriosis include nutritional supplements. A few of them are listed below:

Vitamin D:
Greater plasma level of vitamin D is associated with a lower risk in the development of endometriosis. It is known to control the genes involved in the synthesis of estrogen and embryo implantation. 

Vitamin D supplementation could be a novel, safe and low-cost therapeutic strategy both in the primary prevention and treatment of endometriosis. 

Resveratrol:
Resveratrol is known for its antineoplastic, anti-inflammatory and antioxidant action thus, inhibits the growth and development of endometriosis. Studies have suggested the role of resveratrol in infertile women with endometriosis or impaired ovarian function.
Resveratrol supplements are considered to be safe and are known to improve ovarian function.

N-acetyl cysteine (NAC):
N-acetylcysteine (NAC) is the acetylated form of amino acid, cysteine. NAC mainly works by activating the immune system. It is shown to reduce the size of the endometrioma and decrease its inflammatory and invasive activity.

It is considered to be safe and effective in the treatment of endometriosis. In addition to reducing the menstrual pain, it is also known for improving fertility outcomes. 

Curcumin:
Curcumin found in the Indian spice, turmeric. It is used in the prevention and treatment of endometriosis because of its anti-inflammatory properties.

Its antioxidant property acts as a barrier against oxidative stress. It also regulates the levels of estrogen thus, control or inhibits the growth of endometrial cells.

Curcumin is generally recognized safe to use by the US Food and Drug Administration. 

Some of the pieces of evidence suggest that curcumin can be helpful for infertile women with endometriosis, uterine fibroids, ovarian cysts, etc

References:
1. American Society for Reproductive Medicine, Endometriosis: A Guide for Patients https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/booklet_endometriosis.pdf
2. Troubling Getting Pregnant? You Might Have PCOS or Endometriosis, https://www.endocrineweb.com/conditions/troubling-getting-pregnant-you-might-have-pcos-endometriosis
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