Endometriosis: Can diet help and if so, what kind?

Peer reviewed / Manuscript (Overview) received: 04 January 2021 / Revision accepted: 08 April 2021

Introduction

The etiology and pathogenesis of endometriosis are still largely unknown [1]. Estimates of the prevalence of endometriosis among women of reproductive age vary from 1% [2, 3] to 10% [4]. Endometriosis has a significant societal impact because it decreases the work productivity and social functioning of a relatively young cohort of individuals. Impairment of various areas of life (school, education, work, partnership, sexuality, friends and family) and poor quality of life are common complaints [5]. As the available treatment options are limited and have numerous side-effects, the question of whether there is an endometriosis- specific diet is gaining increasing attention.

Chronic pelvic pain, the cardinal symptom
Endometriosis is, by definition, characterized by the presence of endometrial tissue outside the uterine cavity. The etiology and pathogenesis of the disease have not yet been conclusively established. Various explanatory models have been proposed in the literature, including the Coelomic metaplasia theory [6], the transplantation or implantation theory [7], and the archimetra concept [8]. However, none of the known theories alone can explain how and why endometriosis develops, so a multifactorial explanatory model seems to be required [1, 9].

Abstract

Although approximately 10% of all women of reproductive age suffer from endometriosis and the pain and potential infertility associated with it, the etiology and pathogenesis of the disease are still largely unknown. It is believed that endometriosis symptoms, like those of other inflammatory diseases, can be positively influenced by dietary interventions. The present systematic literature review identified 20 publications confirming that diet has a fundamental influence on symptoms associated with endometriosis. However, no diet explicitly designed for endometriosis can be recommended based on this evidence. The only recommendation that can be derived from the findings is to maintain a balanced diet that is low in irritants, high in polyunsaturated fatty acids and includes sufficient amounts of fruits and vegetables, which should preferably be untreated and organically grown.

Keywords: dietary recommendations, inflammation, endometriosis, diet, women’s health, gynecology



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