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May 28th is the International Day of Action for Women’s Health; a day to highlight aspects of women’s health that are frequently ignored, stigmatised, criminalised, or where there is a lack of understanding and education.
Unfortunately there are so many areas of women’s health that don’t receive the attention they need, from heart health (heart attacks present very differently in women than in men), to hormone imbalance (often women are told "it’s all in your head" and prescribed anti-depressants for things like PMS) and women’s sexual and reproductive health (such as safe and free access to abortion facilities, for example).
But one area that I’d like to discuss in this article, because I see more and more women suffering with it and often not given any support or information from their healthcare provider, is endometriosis.
1 in 10 women will be affected by endometriosis in their lifetimes, and it takes, on average, 7 years to get a diagnosis.
This painful condition is characterised by the growth of endometrial tissue (which is normally found inside the uterus) in other parts of the body (where it shouldn’t be), where it can then attach to other organs. Every month (assuming we’re not pregnant) our period comes, where the uterine lining (the endometrial tissue) is shed from the body (since it doesn’t have to hold a fertilised egg in place). But now this tissue is not only in the uterus, it’s also in other parts of the body (like the abdomen, for example). Since it still acts like endometrial tissue (responding to hormonal cues), it tries to shed, but has nowhere to go. This can cause excruciating pain for women with the condition.
While there can be a genetic component to endometriosis, we also know that our environment and lifestyle have a huge role to play in the severity of symptoms.
For example, the rise of endometriosis in the past few decades coincides with the proliferation of toxic chemicals – particularly xenoestrogens – in our environment. Since studies have shown that dioxins (a type of xenoestrogen) can spontaneously cause endometriosis in female monkeys, there is reason to believe that this excess of estrogen we are now exposed to – and, especially, harmful xenoestrogens – may play a role in conditions of estrogen dominance such as endometriosis.
We also know that endometriosis is associated with inflammation (this makes sense, since pain is a common sign of inflammation in the body), and inflammation is driven by many lifestyle factors, including the food we eat, smoking, stress, and environmental toxins. The good news is that this means we can reduce inflammation by addressing these areas.
It pains me so much to hear from women who were (eventually) given a diagnosis of 'endo' from their GP, only to be told... well, nothing. No solutions, no support, and no information on how to manage or address their symptoms, other than going on the pill, or, in the most severe cases, surgery. It makes me so angry on behalf of these women, because there are lots of things we can do naturally to alleviate the symptoms and help this condition.
Take diet, for example.
We know that excess estrogen has a role to play in endo, so we need to focus on supporting the liver (since the liver’s job is to detox old hormones, like estrogen). We can do that by reducing (or eliminating) our consumption of things that overburden the liver, such as caffeine, alcohol, refined sugar, trans fat (which primarily comes from processed foods, but also from meat and dairy), and artificial substances and chemicals (such as those found in processed foods), whilst, at the same time, increasing our consumption of foods that help support the liver, such as cruciferous vegetables, artichoke, leafy greens, and fibre-containing foods (note that fibre is only found in plant foods, there is no fibre in animal products), as fibre helps the body excrete harmful substances.
We also want to avoid consuming excess estrogen which means reducing (or eliminating) our consumption of animal products, since animals produce their own hormones, which we are ingesting in their meat and other products. This is especially problematic with dairy, as it is often routine practice now to milk cows while they are pregnant, which means they have even more hormones circulating in their bodies - and in their milk - which we then drink. There’s also the issue that many animals are injected with hormones to increase their growth (and therefore provide more meat), not to mention the fact that, if the animal is eating food that has been sprayed with pesticides (etc.), they are ingesting xenoestrogens, which is passed on to us through their meat and other products.
Since we know that inflammation plays a role in endometriosis, we also want to avoid the most inflammatory foods (namely refined sugar, dairy, gluten, eggs, refined carbs, vegetable oils, and any other foods that commonly cause an allergic response), and increase our consumption of anti-inflammatory foods such as fruits, veggies, nuts and seeds. Omega-3 is also anti-inflammatory, as it contributes to the production of ‘good’ prostaglandins (while too much omega-6 can create more ‘bad’ prostaglandins, which cause pain in the body - this is important since pain is one of the main symptoms of endo). Flaxseeds, walnuts and chia seeds all contain one type of omega-3 known as ALA, but we also need the other types of omega-3: EPA and DHA. These are found naturally in algae (many people mistakenly believe they derive from fish, but in fact they derive from algae – the fish just eat the algae! Since most fish are now contaminated with heavy metals and other pollutants, which is accumulated the higher we go up the food chain, it’s better to avoid the middleman (middlefish?!) and go straight to the source). You can incorporate seaweed into your diet - being mindful of your iodine intake – but I would also recommend taking an algae-based omega-3 supplement since this nutrient is so important for our health (not just for endo). The cleanest omega-3 supplement I’ve found (and I’ve done a lot of research!) is by Feel. You can get 20% off your first order with this link.
Studies have also shown that 5g of seaweed a day (about 1/2 tsp) may help with symptoms of endo; it lengthened one endo-sufferer's cycle from 16 days to 31 days, whilst decreasing the duration of the bleed (from 9 days to 4 days in another woman). While this was a small study, it’s worth trying, since it’s not that difficult and seaweed is good for us anyway! Personally, I use nori flakes in my chickpea ‘tuna’ salad recipe (which you can find on my Instagram page) but you can also add them to any meal as a salt replacement.
Other supplements that you may want to consider for endometriosis are:
DIM (derived from cruciferous vegetables, helps to lower excess estrogen)
Chaga (a medicinal, or functional, mushroom, which is mineral-rich, so helps to replenish the body if you suffer from very heavy bleeding each month)
Cramp bark (does what it says on the tin! Traditional remedy used for cramps, can be taken in tea, tincture, or supplement form)
Milk thistle (traditionally used to support the liver)
Dandelion (supports the liver)
Burdock (supports the liver)
Please always check with your healthcare provider before starting any new supplements. Supplements can interact with any medication you are currently taking, or other supplements, and I cannot attest to your unique circumstances. Many supplements also interfere with hormonal contraception, so always check with your healthcare provider if you’re on hormonal contraception and don’t want to get pregnant.
Other lifestyle tools...
It’s not just diet, however. There are lots of other ways in which we can help to alleviate endometriosis symptoms.
Given the role inflammation has to play in the condition, for example, we can look at where the inflammation might be coming from in our lives. Besides the food we eat, the other most common sources of inflammation in our lives are: exposure to toxins in our environment, and stress.
In terms of stress, this may mean examining where the stress is coming from and either removing the source or finding ways of coping as best we can, using tools such as breath-work, self-care practices, therapy, and so on.
With regards to environmental toxins, the main sources are plastics (especially plastic food containers and water bottles), exposure to pesticides (through non-organic produce or products we use in the garden/on our crops), animal products (as already mentioned), toiletries and beauty products, and household cleaning products.
Please note, this doesn’t have to be a daunting, all-or-nothing approach. I encourage you to, first of all, just look at your products to see whether they contain ingredients you can’t pronounce or that you know to be harmful.
Awareness is always the first step.
From there, you could choose one area to overhaul each month, or simply wait until you’ve run out of a certain product, and, instead of buying the usual, replace it with a more natural alternative.
Finally, there may also be an emotional component to endometriosis. A detailed explanation is outside the scope of this post; suffice to say, in relation to endo specifically, the condition has been described as the woman's body trying to 'mother' her. Since the endometrial lining supports the fetus, it is seen as having a 'mothering' role, so the fact that it migrates to other parts of the body suggests that the woman is not taking care of herself, perhaps putting others' needs before her own. Thus, the body steps in and tries to 'mother the mother'. The emotional aspect is not a root cause, by any means, but, if the idea of constantly putting others before yourself rings true for you, it might be something else to think about as part of your healing journey.
If you’d like to know more about how to deal with hormone conditions such as endometriosis, check out my workshop all about hormone imbalance, where I go into more detail on the liver, toxins, nutrition for hormone health, supplements, and more.
If you’d like more personalised advice and support on dealing with endometriosis, book in for a free consultation with me to see how health coaching could support you on this journey.
I will soon be offering specialised courses on specific hormone conditions, such as endo, on my website. Sign up to my newsletter to be the first to hear when these are launched (I also offer special discount codes to my subscribers!).
You do not have to deal with this alone, nor is this just ‘something you have to live with’. Sadly, Western society (and the NHS) still does not seem to understand or acknowledge women’s health issues (at least not to the extent they should). That’s why I do the work I do, because women have a right to this information, and to know that there are options out there. If you need support with any of the issues raised, please reach out to me.