Endometriosis - A Common Disorder for Women

This blog was co-written by John Cote, MD and Lauren Williams, RD. 

Happy endometriosis awareness month! -- said no one.

Millions of women have been diagnosed and are being treated for endometriosis.  This month is a reminder to many people that this disease will or can affect you or someone you know.

What is Endometriosis?

Endometriosis is an estrogen-dependent disease in which endometrial-like tissue (tissue normally inside the uterus) is found outside the uterus. The negative effects of this disease can be significant and includes physical issues such as:

• dysmenorrhea (painful periods)
• non-menstrual pelvic pain
• dyspareunia (painful sexual intercourse)
• infertility

Endometriosis Can be Difficult to Diagnose

It often takes years for someone to be diagnosed with endometriosis. This happens for a number of reasons, including poor understanding and communication regarding symptoms and diagnostic testing. At CHI Health, we offer a navigator service specific to pelvic health conditions to help you minimize the time wasted with dead ends and inappropriate referrals.

What Does This Diagnosis Mean for Me?

Patients with endometriosis are often managing one or more additional diseases. This should be looked at as a chronic condition that requires a lifelong management plan. These patients with endometriosis may be at higher risk of:

• gynecologic cancers such as ovarian cancer
• autoimmune diseases such as rheumatoid arthritis and Graves (thyroid) disease
• asthma
• cardiovascular disease
• preterm labor

Endometriosis can be diagnosed in the clinic, but surgical diagnosis has historically been considered more conclusive. This puts pressure on both the patient and the physician to consider surgery. Ideally symptoms are managed conservatively whenever possible, and early diagnosis and treatment is crucial.

How Does Estrogen Affect Endometriosis?

One double-edged sword in the pathway for treatment for endometriosis is the role that estrogen plays in the body. Since estrogen will stimulate the growth of endometrial tissue inside or outside the uterus, if we can lower the amount of estrogen within the body, we can alleviate some of the pain associated with this disease. While decreasing estrogen levels may improve pain, the negative effects may just trade one problem for another.

Progesterone, or how some patients with endometriosis are affected by progesterone, may also be a player. Patients with endometriosis have different gene expression. Specifically, several genes that progesterone normally turns off after ovulation remains turned on, and those that are turned on remain off.

Can Diet Help Endometriosis?

While there is currently no endometriosis-specific diet plan, various studies have revealed that nutrition choices can impact symptoms of this inflammatory disease. A balanced anti-inflammatory dietary approach may assist with symptom management as well as improve overall health.

Include fruits and vegetables daily.

• While it may not be necessary to follow a completely plant-based dietary approach, daily inclusion of an assortment of produce items has proven beneficial for combating inflammation. Whole fruits and vegetables are full of anti-inflammatory antioxidants including vitamin E and C. Good choices include berries, oranges, cherries, tomatoes, and green leafy vegetables. Make sure to thoroughly wash and peel produce items prior to use to eliminate risk of pesticide exposure.

Reduce intake of saturated and trans fats.

• It is recommended to eat less foods containing high amounts of unhealthy fats such as highly processed foods, red meats and ham, deep-fat fried foods, palm and coconut oils. Studies show inflammatory symptoms appear to worsen when paired with higher intakes of these high-fat foods.

Utilize foods containing omega-3 fats more often.

• The major dietary source of these unsaturated fatty acids includes oily fish and fish oils such as mackerel, salmon, trout, sardines, and herring. Additional sources include extra virgin olive oil, flax and chia seeds, avocado, and tree nuts including walnuts. These would be helpful options to utilize in place of food items containing mostly saturated and trans fat.

CHI Health is currently looking at better ways to diagnose endometriosis in a non-invasive manner. We are evaluating the genetic causes of endometriosis and are taking part in multi-center clinical trials looking for newer drugs to treat endometriosis pain. We are creating new animal models to discover alternate pathways to address the root cause and find new treatments for endometriosis. We would like to help you find solutions that keep you feeling healthy and living life to its fullest, without limitations associated with endometriosis symptoms.

If you have questions or feel you may be suffering from endometriosis, call our pelvic health navigator at 402-717-7358 and see how CHI Health can help.

Original post date: March 2021. Updated March 2022.