Endometriosis pain

Endometriosis: Management and dietary tips

What will be included in this article?

  • What is endometriosis and its symptoms?
  • How does Chinese medicine address endometriosis?
  • What dietary and lifestyle considerations can be used to manage this condition?

What is endometriosis and its causes?

Endometriosis is a disorder which affects women from adolescence to reproductive age and is characterised by endometrial tissue growing outside of the uterus and commonly associated with extreme pelvic pain and infertility. Based on a study performed in 2021, it is estimated that at least 11% of women in Australia are diagnosed with endometriosis or have clinically suspected endometriosis, peaking at around the ages 30-34 years old [1]. Other sources believe the real percentage is as high as 15%. At the time of this article there is no known direct cause for endometriosis, however several risk factors have been associated with a high incidence. These include chronic caffeine and alcohol use, early age of menarche (first period in adolescence), high stress levels, a shorter menstrual cycle length, and genetic factors. On the other hand, frequent exercise and low inflammatory foods which are high in Omega 3 essential fatty acids have been associated with a lower risk for endometriosis [2].

What are the symptoms?

The clinical symptoms of endometriosis varies, however the most prevalent symptom includes extreme pelvic pain which is especially prevalent during menstruation. Other symptoms include spotting between periods, pain and discomfort during sexual intercourse, painful urination or opening of the bowels, abdominal bloating, nausea, fatigue, and mental-emotional symptoms due to the chronic and severe nature of endometriosis.

Infertility:

Clinical research has demonstrated that endometriosis can cause problems with fertility due to multiple underlying mechanisms. A research paper Obstetrics and Gynecology Clinics of North America proposed the following mechanisms between endometriosis and infertility [3].

  • Altered pelvic anatomy due to pelvic adhesions
  • Disruption to progesterone in the luteal phase (the time between ovulation time and onset of period).
  • An increase in numbers of inflammatory cells in the peritoneal fluid which damages the oocytes (immature egg) production and ovulation. These inflammatory markers has been shown to also damage sperm cells, impairing the ability to successfully form an embryo.
  • Damage and impairment to the follopian tubes normal function as a result of chronic inflammation

How does Chinese medicine view endometriosis?

Endometriosis and Chinese Medicine pulse taking

Chinese medicine considers endometriosis to be an impairment of normal menstrual flow and is commonly diagnosed as Qi stagnation, Blood stasis, Blood Cold, Damp-Water accumulation or a combination of these Chinese medicine patterns. The primary focus of Chinese herbal formulas in the treatment of endometriosis includes moving Qi, transforming Damp-Water, and warming and invigorating blood circulation.

Qi stagnation & Blood stasis:

Qi stagnation and Blood stasis will be discussed together as these patterns are frequently seen together and have a lot of overlap in symptoms.

The most common symptoms include the following:

  • Fixed, sharp stabbing pelvic pain during menstruation
  • Emotional and physical pre-menstrual tension (PMS)
  • Breast tenderness
  • Discomfort along the rib-side or chest stuffiness
  • A dull and dry complexion
  • Chronic low grade thirst
  • Dryness or scaly skin in the lower body and legs
  • Dark fingernails and large dark sublingual veins (the veins underneath the tongue)

Blood Cold:

In Chinese medicine Blood Cold often refers to a lack of warmth in the uterus and concurrent lack of warm blood circulation into the limbs.

Some of the most common symptoms include:

  • Cold hands and feet
  • Aversion to cold weather and a love for hot weather
  • Lack of heat symptoms like hot flushes, thirst and aversion to warmth
  • A difficulty to sweat, even after prolonged exercise
  • Dull-stabbing abdominal pain during menstruation

Damp-Water accumulation:

Damp-Water accumulation is often seen with Blood Cold and/or Blood stasis patterns in the clinic. According to Chinese medicine, Damp-Water accumulation involves a lack of normal water metabolism and subsequent accumulation of pathological fluids, which impair the movement of Blood or Qi.

The most common symptoms are:

  • Abdominal fullness and bloating during menstruation
  • Fluid retention in the lower body
  • Loose stools at the onset of menstruation
  • Lack of thirst with frequent urination
  • Postural light-headedness or heart palpitations
  • Fatigue and lack of appetite

Dietary suggestions for endometriosis:

In regards to endometriosis and dietary recommendations, there is no single-one dietary approach that fits all women who suffer from this disease or experience significant menstrual related pain. Instead, focus on adopting dietary suggestions which resonate and are easy to assimilate into your daily eating plan.

Salmon diet and endometriosis

Foods to focus on:

Based on Chinese medicine philosophy, it is essential to eat meals at regular times a day and in a calm and relaxed state. Focus on eating foods which support the Spleen and Stomach and are easy to absorb.

Several examples include:

  • Baked and steamed vegetables
  • Soup, stews and broths
  • Plenty of cooked asian greens such as napa cabbage, bok choy and broccoli
  • Warming spices like turmeric, garlic, ginger, cinnamon, fennel, cloves and parlsey
  • White rice and congees which ginger and shallots
  • Cooked daikon radish
  • Rich sources of Omega 3 fatty acids like salmon, sardines and flaxseeds
  • Good quality protein such as beef, lamb and fish

Foods to minimise:

The following foods tend to affect the Spleen and Stomach’s ability to transform foods if consumed too frequently, which can lead to the accumulation of internal Dampness. Prolonged Dampness will slow the normal movement of Qi, Blood and Yang, allowing Dampness to accumulate in the lower body, and prevent warm circulation to the uterus. Therefore, Chinese medicine advises minimising or only consuming these foods in moderation for most cases.

  • Processed sugar
  • Caffiene and alcohol
  • Raw foods
  • Smoothies
  • Cold foods and beverages
  • Dairy such as milk and cheese
  • Excessive intake of fruit
  • Most processed grains with the exception of cooked white or brown rice

Summary

Endometriosis is a complex and multi-faceted disease which affects many women in Australia. Although the understanding of its causes and treatment options are still evolving, Chinese medicine and its rich history offers insight into potential dietary considerations for the management of this disease. If you are interested in Chinese medicine and its role in the management of endometriosis or severe period pains, reach out and see if this medicine is right for you.

[1] Rowlands, I. J., Abbott, J. A., Montgomery, G. W., Hockey, R., Rogers, P., & Mishra, G. D. (2021). Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study. BJOG : an international journal of obstetrics and gynaecology128(4), 657–665.

[2] Parasar, P., Ozcan, P., & Terry, K. L. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical Management. Current obstetrics and gynecology reports6(1), 34–41.

[3] Macer, M. L., & Taylor, H. S. (2012). Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstetrics and gynecology clinics of North America39(4), 535–549.

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