Can an Endometriosis Diet Help You Conceive?

Salmon and green salad
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Currently, there is little research directly connecting diet and fertility for women with endometriosis. There are no scientifically proven foods that will help you get pregnant. However, there has been research on the role of diet and pelvic pain in women with endometriosis. There are also studies looking at diet and the overall risk of endometriosis.

Is it possible that the diet changes that lessen pelvic pain—or reduce the risk of the disease—might help you get pregnant?

At this point, we don’t know.

If endometrial lesions or adhesions have blocked the fallopian tubes, or are interfering with ovulation or healthy fallopian tube movement, no diet can improve the situation. Surgery or IVF treatment is likely required.

That said, diet may improve the odds of conception alongside fertility treatment or surgery. Here’s what the research does have to say on endometriosis and diet.

More Omega-3s, Fewer Trans Fats

Of all the studies on diet and endometriosis, research looking at “good” and “bad” fats in relation to endometriosis risk has been the largest and most convincing.

Women who consume high levels of trans fats are more likely to have endometriosis. On the other hand, women who have more omega-3 fatty acids in their diet are less likely to be diagnosed with the disease.

Generally speaking, nutrition experts recommend all people reduce or eliminate trans fats from their diets and increase omega-3 intake.

This is for overall good health.

Foods you should avoid or be cautious of:

  • Fried foods
  • Pastries, especially those with a flaky texture
  • Margarine (more are being made trans-fat free)
  • Crackers
  • Food products with the ingredient “partially hydrogenated oils”

Foods you should add to your diet to increase healthy omega-3 fats:

  • Flaxseed oil
  • Fish oil
  • Chia seeds
  • Walnuts
  • Salmon
  • Mackerel
  • Oysters
  • Spinach

Adding Antioxidants to Your Diet

Oxidative stress may play a role in endometriosis. You may have heard of free radicals. Free radicals are created inside our cells when weak molecular bonds break apart. These unstable molecular bonds search for other molecules and attempt to steal or break their bonds apart. This can lead to cell damage and death. This process is called “oxidative stress.”

Some free radical activity in the body is normal. For example, creating free radicals is part of how the body’s immune system fights off infection. You want your body to break apart “bad cells” like bacteria or viruses. Oxidative stress is also responsible for the natural process of aging.

However, when free radicals become overly abundant, they can attack too many healthy cells. Excessive free radicals lead to chain reactions, with free radicals breaking apart more and more molecular bonds. This can result in disease and advanced aging.

Biological markers of oxidative stress are higher in women with endometriosis. It’s thought that these markers may encourage endometrial-like tissue to grow and stick to organs and surfaces outside of the uterus.

One possible way to lower the oxidative stress in the body is to increase the number of antioxidants in your diet.

Antioxidants stop the chain reaction of cell damage caused by free radicals. Instead of a free radical breaking apart another healthy cell (which in turn increase more free radicals), it attaches itself to the antioxidant. The antioxidant neutralizes the free radical, stopping the chain reaction of cellular damage.

Researchers have found that women with endometriosis tend to have lower intakes of antioxidants in their diet. One study put women on a diet high in antioxidants for four months.

After the four months, blood markers for oxidative stress in these women were lower. Foods included in a high-antioxidant diet are those high in vitamins A, C, and E.

In this particular study, participants were aiming to intake 1050 μg of vitamin A (150 percent of the recommended daily value), 500 mg of vitamin C (660 percent of the recommended daily value), and 20 mg of vitamin E (133 percent of the RDA).

The best way to increase the antioxidants in your diet is to eat more veggies and healthy fruits. Foods high in antioxidants (specifically high in vitamins A, C, and E):

  • Sweet potato
  • Beef Liver
  • Spinach
  • Carrots
  • Cantaloupe
  • Peppers
  • Mangoes
  • Black-eye peas
  • Oranges
  • Almonds
  • Sunflower seeds
  • Wheat germ oil

Yogurt and Cheese: Dairy Foods for Endometriosis

In a study that included just over 70,000 women—and 1,385 diagnosed cases of endometriosis—it was found that women who consumed three or more servings of dairy foods were 18 percent less likely to be diagnosed with endometriosis when compared to women who reported only two dairy servings per day.

Why are dairy foods associated with a decreased risk of endometriosis? Is it the milk protein? The milk fats? Could it be the nutrients commonly found in dairy products, like calcium and vitamin D? This is unknown.

Calcium Foods for Endometriosis

If it’s the calcium found in dairy products that reduces endometriosis risk, milk products aren’t your only option. This is good news for those with a dairy allergy or intolerance.

Calcium intake has been found to reduce oxidative and inflammatory stress in the body. Given that both oxidative and inflammatory stress are associated with endometriosis, adding more calcium to your diet may help decrease inflammation.

Foods that are high in calcium include:

  • Dairy products (especially mozzarella, cheddar cheese, and yogurt)
  • Sardines
  • Fortified alternative milk (like soy, almond, or coconut milk)
  • Fortified orange juice
  • Salmon, with the bones
  • Cooked kale

Vitamin D for Endometriosis

Studies have found that women with lower levels of vitamin D are more likely to have endometriosis. Research has also found that low vitamin D levels are associated with infertility in men and women.

One study evaluated women’s vitamin D levels in relation to their relative risk of endometriosis, sorting the women into five groups. They found that women who placed in the highest quintile (with the highest levels of vitamin D) were 24 percent less likely to have endometriosis compared to those in the lowest quintile.

However, it has not yet been shown that taking vitamin D supplements or eating vitamin D-rich foods can reduce the risk of endometriosis. (Diet is not an efficient way to raise vitamin D levels in any case.)

In fact, a small double-blind clinical trial prescribed women 50,000 IU of vitamin D weekly after being surgically treated for endometriosis. Pain levels for the women taking vitamin D were not significantly reduced when compared to women not taking any supplement.

Talk to your doctor about getting your vitamin D levels tested, to find out if supplementation is right for you.

Magnesium-Rich Foods

Research has found that women who are deficient in magnesium are more likely to experience premenstrual syndrome (PMS) and have a history of pregnancy loss.

What about the connection between magnesium and endometriosis? One study found that women with higher intakes of magnesium-rich foods were less likely to be diagnosed later with endometriosis.

Foods rich in magnesium include:

  • Almonds
  • Boiled spinach
  • Cashews
  • Peanuts
  • Black beans
  • Some fortified cereals

Gluten-Free Diet and Endometriosis

What you eat may be as important as what you don’t eat, especially if you have celiac disease or non-celiac gluten sensitivity. Gluten gets blamed for a number of disease and health conditions, including infertility, though it’s debatable in the scientific community how much blame it deserves.

Could gluten cause problems for those with endometriosis? According to a study of 11,000 women, a prior celiac diagnosis increased the risk of a future endometriosis diagnosis.

Another study looked at whether a gluten-free diet may reduce pain symptoms in women with endometriosis. (These women were not diagnosed or suspected of having celiac disease.) Women who described their endometriosis-related pain as severe were placed on a gluten-free diet for 12 months.

At a 12-month follow-up, 75 percent reported significantly reduced pain scores. None of the women on the gluten-free diet experienced increased pain.

As with all the studies mentioned in this article, a reduction in pain doesn’t mean their pregnancy rates would be higher. (That wasn’t being studied.) But it’s interesting to consider.

If you want to try a gluten-free diet, be sure that you get the nutrients you need. Gluten-free doesn’t automatically mean healthy. In fact, many gluten-free products are decidedly unhealthy.

Avoiding Endocrine Disruptors and Environmental Estrogens

Some pesticides, pollutants, and chemicals that get into our foods are known endocrine disruptors. Endocrine disruptors are chemicals (both natural and synthetic) that influence the hormone systems in both animals and humans. These hormonal disruptions may increase the risk of birth defects and cancer, and can negatively impact the body’s reproduction, immunological, and neurological systems.

Sperm quality has been decreasing in the general population, and male infertility has been increasing. Environmental factors are suspected as being a possible cause of these worrisome trends. Currently, the National Institute of Environmental Health Sciences is supporting studies looking into the possible connection between endocrine disruptors and infertility, endometriosis, and some cancers.

Environmental estrogens are especially relevant when it comes to endometriosis. Environmental estrogens include xenoestrogens, which are chemicals that mimic estrogen in the body, and phytoestrogens, which are estrogen-like compounds found in food.

Endometrial-lesions feed on estrogen. Exposure to estrogen-mimickers is suspected of increasing the risk of developing endometriosis or worsening the condition.

How can you reduce your exposure to environmental estrogens?

  • Avoid BPA lined cans and plastics. Buy fresh whenever possible, or choose foods stored in glass or BPA-free containers.
  • Reduce consumption of soy proteins. Soy contains phytoestrogens. (There’s some debate on whether soy is good or bad for reproductive health.)
  • Avoid produce known to be high in pesticide exposure and choose organic whenever possible. Consult the Environmental Working Group’s Dirty Dozen list for the latest information.
  • Consider your choice of deodorants and cosmetics carefully. Check the products you use on the Environmental Working Group’s Skin Deep website.

A Word From Verywell

The research on diet and endometriosis is far from conclusive, with currently no evidence that changing your diet will increase your odds of getting pregnant. However, many of the recommendations above have been found to be good for your health in general.

Making changes to improve your wellness can give you a sense of control and empowerment. At the same time, going into these lifestyle changes with unreasonable expectations can create a situation where you drop all the great improvements you made if you don’t get that positive pregnancy test result as quickly as you hoped.

If you decide to follow any of the above recommendations, focus on doing this for your overall health—not exclusively to conceive.

Sources:

Hansen SO, Knudsen UB. “Endometriosis, dysmenorrhoea and diet.Eur J Obstet Gynecol Reprod Biol. 2013 Jul;169(2):162-71. doi: 10.1016/j.ejogrb.2013.03.028. Epub 2013 May 2.

Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. “Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study.Am J Epidemiol. 2013 Mar 1;177(5):420-30. doi: 10.1093/aje/kws247. Epub 2013 Feb 3.

Marziali M, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. “Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?Minerva Chir. 2012 Dec;67(6):499-504.

Mier-Cabrera J, Aburto-Soto T, Burrola-Méndez S, Jiménez-Zamudio L, Tolentino MC, Casanueva E, Hernández-Guerrero C. “Women with endometriosis improved their peripheral antioxidant markers after the application of a high antioxidant diet.Reprod Biol Endocrinol. 2009 May 28;7:54. doi: 10.1186/1477-7827-7-54.

Stephansson O, Falconer H, Ludvigsson JF. “Risk of endometriosis in 11,000 women with celiac disease.Hum Reprod. 2011 Oct;26(10):2896-901. doi: 10.1093/humrep/der263. Epub 2011 Aug 12.

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