Endometriosis and the effects of dietary interventions: what are we looking for?

Abstract

Endometriosis is the most prevalent benign gynaecologic disease with invalidating effects on quality of life and decreased economic productivity. As pharmacologic and surgical treatment are only partially effective, women look for self-management strategies in order to control their symptoms. Many dietary interventions have been claimed successful. But it is unclear whether these effects are caused by the idea of taking control about symptoms by adhering to a diet, or by the dietary intervention itself. In order to gain more evidence with regard to the mechanisms behind the effect of dietary intervention in the management of endometriosis, a number of issues need to be addressed for future studies. First, we need clearly defined endpoints in our studies. Second, we have to be aware of the difference between the effects of diet on the risk of developing endometriosis, and the effects of diet on symptoms in women with already established endometriosis. Third, it may be difficult to strictly define the intervention diet and the control or placebo diet. Fourth, we have to define endometriosis-related as well as patient-related factors that may influence the success of a dietary intervention. Fifth, we have to understand the biological mechanisms behind the perceived effects of dietary interventions. These issues will be addressed in this opinion paper.

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

“…Given the complexity of the disease, this is not surprising [ 34 ]. The general recommendation is to consume a diet high in fiber, with an emphasis on fruits and vegetables, while minimizing the intake of sugar and animal products [ 35 ].…”

Nutritional practices and dietetic provision in the endometriosis population, with a focus on functional gut symptoms

“…35 Although IWE found dietary changes had a beneficial effect on their wellbeing, symptoms and energy levels, there was a distinct lack of HCP interest and support, which made implementing dietary changes challenging. 35 Given that it is not yet known which dietary intervention has which effect on women with specific types of endometriosis or specific characteristics, 19 individualised, patient-centred care is required.…”

“…[13][14][15] Specifically, the low fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) diet, proven to provide symptomatic relief in IBS patients, 16,17 was effective in reducing recurrence of gut-related endometriosis symptoms. 18 However, overall, the evidence was determined to be of low quality, [13][14][15] with many unanswered questions remaining, 19 including the role of dietetic care. In the UK, diet and nutrition are not currently listed as treatment options for endometriosis.…”

Gluten and Wheat in Women’s Health: Beyond the Gut

“…For these reasons, many women seek non-medical intervention to relieve pain and improve their QoL such as exercise, meditation, and dietary changes [ 80 , 81 ]. A cross-sectional study by Mazza et al [ 82 ] developed an online questionnaire monitoring self-reported changes in eating habits after an endometriosis diagnosis.…”