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Lifestyle changes to help combat pain and heavy bleeding due to endometriosis

Endometriosis is an estrogen-dependent gynecological disease. It leads to growth of the endometrial tissue outside the uterine cavity. There is substantial evidence that it results from a local inflammatory peritoneal reaction and oxidative stress.

Endometriosis has a major effect on quality of life – causing severe pain, unusual bleeding and damage to other organs, including the bowel and bladder, and can also cause infertility. There are two basic goals in treating endometriosis: preventing and relieving pain, and treating endometriosis-related infertility for women who wish to become pregnant.

Controlling estrogen and other hormones that stimulate the activity of endometrial tissues helps in management of endometriosis. Lifestyle changes such as regular exercise and limiting certain foods can help reducing the estrogen levels.

Exercises for managing Endometriosis
Some research has shown that regular physical exercise seems to have protective effects against diseases that involve inflammatory processes (e.g. type 2 diabetes, colon and breast cancer, endometriosis, etc.).

Daily aerobic exercise of 30 – 60 minutes such as walking, swimming, dancing, or other activities helps to maintain a healthy weight. Women who averaged 2.5 hours of high-intensity activity (jogging, bicycling or aerobics) per week were found to have 63 percent less chances to have endometriosis. However, very heavy exercise such as running and jumping, for long periods of time, may bring on or increase endometriosis symptoms or other medical conditions.

It is known that exercise releases endorphins – during exercise, the brain releases “feel good” hormones called endorphins. These naturally occurring hormones work like pain relievers to lower pain. Regular exercise lowers the amount of estrogen in the body which is the goal of endometriosis treatment as it improves the endometriosis symptoms.

Food ‘for thought’ in Endometriosis
Several studies have shown a strong connection between endometriosis and diets high in red meat or low in green vegetables and fresh fruit. Eating a nutritious diet can help endometriosis symptoms by reducing inflammation and estrogen levels in the body.

Diets deficient in essential nutrients result in changes in lipid metabolism, oxidative stress and promote epigenetic abnormalities that may be involved in the genesis and progression of the disease. Foods that possess anti-inflammatory effects, supplementation with N-acetylcysteine, vitamins such as vitamin D, curcumin and resveratrol. In addition to the increased consumption of fruits and vegetables (preferably organic), whole grains exert a protective effect, reducing the risk of development and possible regression of disease.

A comparison between 504 healthy women and 504 women with endometriosis, demonstrated that women who ate beef every day were nearly twice as likely to have endometriosis, while those who consumed seven or more fruits and vegetable servings a week were at least 40 percent less likely to suffer from the condition.

Caffeine, alcohol, smoking and very heavy physical activity are known to alter the sex steroid synthesis in women, which may affect hormone‐dependent gynaecologic disease risk, such as endometriosis. Avoiding alcohol and caffeine can also help to modify estrogen levels.

Natural anti-oxidants have shown improvement in endometriosis
Antioxidants alone or in combination, when given with known analgesics or independently have shown to decrease the free radical mediated nociception. Studies have demonstrated an inverse correlation between antioxidant intake and endometriosis pathology and an improvement in antioxidant markers upon supplementation of an antioxidant rich diet.

Resveratrol, a natural drug, induces apoptosis in endometrial stromal cells and has shown promising results. Resveratrol is a phytochemical found in high concentration in grapes, wine, tea, peanuts, and berries. It has demonstrated anti-inflammatory, anti-oxidative, anti-microbial, anti-atherogenic and anti-angiogenic properties.

Curcumin is a naturally occurring phytochemical. Curcumin is the principal polyphenol isolated from turmeric. There is substantial evidence for the anti-inflammatory, antioxidant, anti-tumor, anti-angiogenesis, and anti-metastatic activities of curcumin. Curcumin has the ability of inhibiting endometriosis in vivo and may help in management of endometriosis by reducing estradiol production. It has also been found to inhibit the migration and invasion of endometrial carcinoma cells.

N-acetylcysteine (NAC) is the acetylated form of the amino acid cysteine naturally present in some substances like garlic. It has demonstrated anti-proliferative action on cells of epithelial origin like endometrial cells in addition to anti-inflammatory and anti-oxidant action. It has been found to be effective in treating ovarian endometriosis.

It can be concluded that health education sessions highlighting lifestyle modifications can bring about significant improvement by educating and increasing the awareness of patients and help them to manage their endometriosis related symptoms better.

References
1.”Lifestyle And Dietary Changes For Endometriosis | Healthywomen”. Healthywomen, 2020, https://www.healthywomen.org/content/article/lifestyle-and-dietary-changes-endometriosis.
2.Andersen, Claus Y, and Diego Ezcurra. “Human Steroidogenesis: Implications For Controlled Ovarian Stimulation With Exogenous Gonadotropins”. Reproductive Biology And Endocrinology, vol 12, no. 1, 2014, p. 128. Springer Science And Business Media LLC, doi:10.1186/1477-7827-12-128.
3.Ghonemy, Gehan Ebrahim, and Nadia Bassouni El Sharkawy. “Impact Of Changing Lifestyle On Endometriosis Related Pain”. IOSR Journal Of Nursing And Health Science, vol 06, no. 02, 2017, pp. 120-129. IOSR Journals, doi:10.9790/1959-060205120129.
4.Publishing, Harvard. “Endometriosis – Harvard Health”. Harvard Health, 2020, https://www.health.harvard.edu/diseases-and-conditions/endometriosis2.
5.Santanam, Nalini et al. “Antioxidant Supplementation Reduces Endometriosis-Related Pelvic Pain In Humans”. Translational Research, vol 161, no. 3, 2013, pp. 189-195. Elsevier BV, doi:10.1016/j.trsl.2012.05.001.