Reduce endo pain: eat more of these

Today's episode is all about reducing endometriosis pain naturally, a topic that affects 5 to 15% of women globally. I provide a list of over ten different foods that are proven to help. And whether you're planning to have a baby in one year or ten, the tips I share here can boost your chances when the time is right.
We'll explore how diet can be more effective than conventional treatments like surgery and medication (when part of holistic care). So, if you're looking to manage endo pain better join me as I uncover what can *actually* make a difference. You might be in for a surprise or two!

TIMESTAMPS
00:50 Why everyone with endo needs to see a dietitian, if they're planning a pregnancy or not.
02:04 Estrogen dominance and inflammation are...
03:03 What kinds of foods can help?
03:52 Polyphenols and phytoestogens
06:01 How fibre reduces excess estrogen, among other things
12:20 Supplementation
14:21 Secret powerhouses of antioxidants

.... download the herb & spice flavour combinations cheat sheet here.

If you're struggling to beat endo belly, check out this list of the 6 reasons it happens and 12 things you can do about it!

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🤰🏽Preparing for Pregnancy Pack - The 3 Essentials for Pregnancy Success

🥰 10 Ways to Feel Wildly More Supported on Your Fertility Journey

👌🏼25 Simple Things to Curb Your Cravings with PCOS

💃 Beat Your Endo Belly


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Oh Goodness! Nutrition is an evidence-based dietitian practice. However, given the general nature of the content presented on this podcast, it can not replace individualised medical advice. Get yo'self a professional (psst, lik...

Transcript

[00:00:00] Hey friend, you're listening to the I'm Thinking of Having a Baby podcast. I'm your host Hannah Eriksen owner of Oh Goodness! Nutrition. We're fertility dietitians who use food as our superpower to get your hormones on track and help you get your dream family faster. We're in the midst of episodes looking at endometriosis

[00:00:23] Last episode, we covered the dreaded endo belly. And this time we're looking at how to reduce endo pain naturally. As five to 15% globally of women struggle with this chronic pain condition and 50 to 70% of these women have trouble conceiving, whether your plans for having a baby are in the one year or 10 year stage the juicy content we cover here will also increase your chances of getting pregnant when you're ready to.

[00:00:50] There are other benefits to seeing a dietitian if you have endo, and the sooner the better. Because unlike a breakup endometriosis pain does not improve with time. [00:01:00] If left unmanaged, those with endo will continue to experience lesion growth and crippling pain. And while surgery and medication, either hormonal or pain relief are the most routinely provided options, more and more evidence is emerging, that they are not as helpful at dealing with endo as a holistic approach, looking at sleep, stress, diet, and exercise. In addition to your doctor, having a psychologist, a pelvic health physio, and dietitian on your team can actually reduce endo pain. In one systematic review of 58 clinical trials, looking at the effectiveness of surgery and medication on reducing endometriosis pain, 11 to 19% of women got no pain relief from treatment. And 17 to 34% of woman experience recurrent pain after treatment had stopped. 

[00:01:49] That's all to say. There are likely very many women struggling with endo for whom no conventional treatments help. If that's you, or if you want to do [00:02:00] all you can to reduce pelvic pain. Listen in. 

[00:02:04] Let's start by covering the potential ways that nutrition can help. To do that we'll need to understand a couple of the drivers of endo pain: estrogen dominance and inflammation. 

[00:02:16] Estrogen dominance describes a condition where the relative amount of estrogen to progesterone in the body is high. Estrogen and progesterone are two female hormones. And they naturally fluctuate across the course of the menstrual cycle. And if there is too much estrogen in the body and not enough being removed, this can lead to estrogen dominance. Diet can also cause more estrogen to be produced. And it can play a role in reducing it. It all comes down to what kinds of foods you're consuming.

[00:02:46] Inflammation is a condition where the amounts of free radicals are outnumbering the antioxidant levels in your body. I have done an episode on inflammation already. So definitely give it a listen after this. Diet can be tweaked to include more [00:03:00] antioxidants so that the balance is struck. 

[00:03:03] So what kinds of foods can help? Either by targeting estrogen, or inflammation or both at once.

[00:03:10] First up. Green leaves, berries and nuts and seeds. When I say green leaves, I'm thinking spinach, chard, silver beet kale, basically is it green and leafy? And aim for at least a handful a day. In terms of berries, red, blue, black, fresh, frozen, canned, and drained. Aim for half a cup most days. 

[00:03:33] Nuts and seeds all of the regular nuts, including walnuts, Brazil nuts, pistachios include chia, Sesame, flax seeds. But aim for no more than a quarter cup in total per day. These three food groups are all excellent sources of polyphenols and phytoestrogens. 

[00:03:52] Polyphenols are plant compounds that are potent antioxidants. Perfect for dealing with those inflammation causing free [00:04:00] radicals. Phyto estrogens are plant forms of estrogen that bind weakly to estrogen receptors in our bodies. The good thing about this is that they can beat out our own estrogen at the binding sites and only weakly trigger an estrogen response, meaning that there can be a reduction in the effects of estrogen through our bodies. 

[00:04:18] Examples of phytoestrogens are resveratrol from berries and lignans from flaxseed. The cool thing is that it's not uncommon for a polyphenol to also be a phyto estrogen, two for the price of one. And of course you're eating food for food's sake, not just for the nutrients they contain. So find green leaves, berries and nuts and seeds that you actually enjoy and are able to have on a regular basis. No one is forcing you to eat Brazil nuts if you're not a fan. 

[00:04:49] Whole grains, like quinoa brown rice oats millet, barley buckwheat. If you think about whole grains, is it whole, and is it brown? Include potatoes and [00:05:00] kumara or sweet potato and corn in this list. You're aiming for four to six half cup cooked servings per day. Now this might sound like a lot, but it's easy if you're having a small amount of whole grains at each meal. 

[00:05:15] It might also be a challenge if you're used to eating carbs, but they're not so whole. Start by incorporating some into your meals. For example, mix some brown rice or quinoa in when you cook white rice, try soba noodles instead of regular pasta. Switch from your keto cereal to having a granola where the first ingredient is whole grain. 

[00:05:37] In the context of endometriosis, you'll discover that keto is not endo friendly. But whole grains are. Why? Mainly because they're an excellent source of fiber. So are the foods we've just listed, but we're aiming for more than 30 grams of fiber a day. And it's very hard to do that if you're skimping on the quality or quantity of the grain foods [00:06:00] you're having. 

[00:06:01] Fiber reduces endo pain by removing estrogen from the body. Pretty amazing, right. So let me explain with a quick biology lesson. Our liver breaks down hormones like estrogen and changes them into water soluble substances called bile acids. These bile acids go into our bile, which is the fluid stored in our gallbladder. 

[00:06:22] When we eat, these bile acids help digest fat. And they go into our small intestine. After doing their job, most of the bile acids are absorbed back into the bloodstream. They go back to the liver to be used again. Some pretty neat recycling. 

[00:06:38] Here's where fiber comes in. Some types of fiber, like soluble fiber can stick to the bile acids in our intestines. Instead of going back into the bloodstream, the fiber bound, bile acids stay in our intestines and come out when we have a bowel movement.

[00:06:55] When fiber sticks to bile acids and they get removed from our body, the liver [00:07:00] needs to use cholesterol from our bloodstream to make new bile acids. When the liver uses up more cholesterol, it can indirectly lower the levels of estrogen in our body. So by eating fiber, we can help our body get rid of some estrogen and keep our hormones in balance. I hope you noticed that there's a particular type of fiber called soluble fiber, which is often found in our friendly whole grains. And this is the thing that binds your bile acids and indirectly lowers our estrogen levels. Perfect. If you have endometriosis, this is what we want. 

[00:07:31] After whole grains, we've got legumes and I'm thinking black beans, kidney beans, Pinto, chickpeas, dal, lentils. They're rich in soluble fiber, which we've just talked about and in phyto estrogens, helping reduce your estrogen levels overall. Aiming for about half a cup cooked most days of the week is fabulous. 

[00:07:53] That might be a challenge though. So can you add some lentils into a mince gravy dish, like bolonaise or can you throw some chickpeas [00:08:00] on a baking tray, partway through roasting veg for a nutritious crunch? Or, how about having a meatless Curry night with dal instead? 

[00:08:08] Next up, we've got milk yogurt and cheese. Specifically lower fat milk. Yoghurt, including Greek and lower fat cheeses, like edam, ricotta, feta, paneer. They are all excellent sources of calcium and vitamin D. And you're aiming for three servings per day. One serving of milk is a cup, greek yogurt is three quarters of a cup or 200 grams. If you're doing flavored yogurt, halve that. Cheese is 40 grams or two small slices. This might come as a surprise to some, because those with endometriosis are usually encouraged to cut out certain food groups, dairy often being one of them. However, there is little research to suggest cutting out helps. Instead, there is the suggestion that dairy, which is also rich in anti-inflammatory components can help reduce endo pain. [00:09:00] A research study investigated the impact of dairy product consumption on endometriosis. They found that consuming at least three servings of dairy products daily had significant positive effects in reducing endometriosis risk. However, a high consumption of butter was associated with an increased risk of endometriosis. Of course, if you are lactose-intolerant or if you suspect that you are get it checked out. A dietician can help you with this and determine what the intolerance to dairy might be caused by and figure out how much you can enjoy without nasty side effects. 

[00:09:39] As always starting with small volumes of dairy and increasing gradually is a good idea if you're not used to having dairy regularly. 

[00:09:48] Oily fish is another food group that is known to help reduce endo pain. Things like sardines, mackerel, anchovies, tuna, salmon, trout. These [00:10:00] contain essential, omega three fatty acids. By essential, I mean that our bodies cannot make them. And so are dependent on our diet to cover it off. The omega-3 oils in particular in fish that have been shown to have the greatest anti-inflammatory effect are ecosapentaoic acid and dicosahexanoic acid. Commonly referred to as EPA and DHA for obvious reasons. 

[00:10:25] On top of dampening the inflammatory responses, EPA and DHA suppress prostaglandins in the body. These compounds are interpreted by our brains as pain. By reducing the amount of prostaglandins there is a reduction in pain. 

[00:10:43] So there is a connection between eating oily fish regularly and experiencing less pain. That's pretty cool. If you aim for two servings per week of oily fish, that'd be awesome, but if that's never going to happen, research has shown that having a daily dose of omega-3 with more than 200 [00:11:00] milligrams of that being DHA can result in less endo pain. 

[00:11:06] Extra Virgin olive oil is another food to have more of for less endo pain because it's a fat that's high in monounsaturated fatty acids, particularly oleic acid. And this acid has been shown to have an anti-inflammatory effect. And it's known that women with endometriosis consume less mono unsaturated fat than those without endo. 

[00:11:28] And the Mediterranean diet which is shown by a high intake of olive oil has been linked to lower levels of inflammation. However, the jury is still out as with our current knowledge and research, no clear link is found yet between consuming olive oil and reducing endo symptoms. We'll need to watch the space to know for certain. 

[00:11:48] However in saying that it's not a bad idea to include olive oil when cooking. I often get asked, what is the best oil to cook with? And given EVOOs low smoke point it is [00:12:00] actually remarkably stable when cooked to high temperatures, more so than other cooking oils. Because of its anti-inflammatory properties and the fact that it's the safest to cook with I recommend having about two tablespoons per day on average. Of course, this varies for every individual depending on their goals as well. 

[00:12:20] The foods I've listed already contain vitamin C like berries, potatoes, leafy greens; vitamin E, in your EVOO in your nuts and seeds. And vitamin D and your dairy and oily fish. But it's worth mentioning these three nutrients because they are each powerful antioxidants that can be challenging to get enough of consistently. 

[00:12:41] And they're also linked with reducing pelvic pain. In a study of 59 women, participants were randomly assigned a combination of vitamin E and C or a placebo. After two months, 43% of the woman with the antioxidants reported a decrease in everyday pain. [00:13:00] 37% said they felt a decrease in painful periods. And 24% said they had less painful sex. However, in the placebo group only 7% felt less pain during their periods and none saw improvements in their daily, chronic pain or pain with intercourse. Okay. Granted, this is a small study, but it illustrates what we've known about antioxidants and endo. In terms of the quantities of these nutrients food is the best source. However, sometimes supplementation is also an option. Of course on a podcast, I cannot recommend exactly how much you in particular should supplement with, because I don't know your diet. The work I do with clients involves analyzing it and making supplement recommendations based on their needs among other things. So if this is something you would fancy, go ahead, drop me a line. You can visit me on my website ognutrition.co.nz on Instagram ohgoodness_nutrition and drop me a DM. 

[00:13:56] Finally let's cover an underutilized antioxidant [00:14:00] powerhouse, spices and herbs. Not only do they make food tasty, they contain a plethora of biochemicals that put these free radicals in their place. 

[00:14:11] One of the biggest limiting beliefs I see in my clinic is that vegetables have to be plain. Eating healthy should be delicious and all it takes is some spice additions. And if eating healthy is going to be something you want to do and can keep on doing all the days of your life, it needs to be tasty and it needs to be easy. 

[00:14:29] Check out my spice combination list in the show notes if you want some added inspo for how to make vegetables, legumes and tofu more yum. 

[00:14:38] It goes without saying that the information I've covered here is not personalized advice. Some of us like to DIY things. And I hope you've found some pointers and support in listening. If at any point you've tried things and have a hard time being consistent, or if you feel like your diet is too restricted, I invite you to talk to a dietitian to rediscover what deliciousness you can safely resume. [00:15:00] 

[00:15:00] The way I work is by asking you a million questions, developing a plan for less pain. And providing you with all the tools to make it a reality in your life. This begins with a meal plan, but it finishes with you learning what your body needs, how to do it, and you actually wanting to do it. I set you up so that even when I'm not around, you're able to continue. 

[00:15:20] Thank you so much for listening to today's episode. Stay tuned for the next one: in two weeks time, we'll drop how to reduce endo pain, naturally, but this time what to avoid. See you then.