The Link between Endometriosis and the Gut
Endometriosis is a chronic inflammatory condition that impacts 1 in 10 women. It is where the tissue that normally lines the inside of the uterus grows outside of it like on the ovaries or the bowel. This can lead to a cascade of symptoms including, but not limited to:
Severe bloating
Menorrhagia (heavy menstrual bleeding)
Dysmenorrhea (cramping pain before or during a period)
Headaches/migraines
Pain during sex
Low back pain and lower abdominal pain
Irregular menstruation and spotting
Constipation and nausea
Abdominal fullness
Fatigue
Nutritional deficiencies (including B12 and iron deficiency)
The exact cause of endometriosis is unknown but there are some factors that are thought to increase the risk of developing endometriosis including your immune system, genetics, backflow during your cycle, and high estrogen production.
The Gut-Endometriosis Connection
Studies have also shown that there is an association between gut microbiota and endometriosis. One theory is that endometrial tissue can travel to other parts of the body, including the gut. Once there, it can implant and grow, leading to inflammation and digestive symptoms.
A study from 2022, indicated that patients with endometriosis have an approximately threefold increased risk of developing irritable bowel syndrome and that women with endometriosis are more likely to experience digestive symptoms such as bloating, constipation, and diarrhoea, suggesting a link between the gut and endometriosis.
Women with endometriosis have a different gut microbiome composition than those without the condition. Recent studies have demonstrated the ability of endometriosis to induce microbiota changes. Those with endometriosis may have diminished Lactobacillus dominance, as well as an elevated abundance of bacterial vaginosis-related bacteria and other opportunistic pathogens that nourish the gut and benefit our health.
This altered microbiome may contribute to the development of endometriosis and its ongoing symptoms by affecting the immune system and promoting inflammation.
Women with endometriosis have also been seen to have increased intestinal permeability or what is more commonly referred to as ‘leaky gut’. This can allow toxins and other harmful substances to pass through the gut lining and into the bloodstream, leading to inflammation.
How to Manage Endometriosis Through the Gut
Given the strong link between the gut and endometriosis, focusing on healing and nourishing the gut may be essential to the management of endometriosis. To start:
Focus on gut health through diet
Maintaining a balanced diet focusing on anti-inflammatory food and gut health support. This involves incorporating foods that are rich in fibre, such as fruits, vegetables, and whole grains, which help the production of short-chain fatty acids which help the maintenance of intestinal barrier integrity, mucus production, and protection against inflammation.
Probiotic-rich foods such as yogurt, kefir, and kimchi also help to promote a healthy gut microbiome.
Fibrous foods such as fruits, vegetables, legumes, and whole grains are recommended.
For women suffering from endometriosis and IBS (or other gut-related issues like SIBO), working to manage these gut conditions by using a combination of lifestyle changes, dietary modifications, and tailored supplements may be beneficial. This may involve working with a nutritionist on the low-FODMAP diet process. For a gut health kickstart click here to get your free E-book.
Reducing inflammation in your diet
Following an anti-inflammatory diet or Mediterranean Diet may reduce inflammation and support a healthy immune system. The Mediterranean Diet is rich in antioxidants, such as polyphenols, carotenoids, and vitamins C and E, found in plants which reduce oxidative stress in the body. It is also loaded with omega-3 fatty acids, found in fish, and walnuts, which have been shown to reduce endometriosis symptoms.
The Mediterranean Diet is also rich in fibre, whole grains, olive oil, legumes, fruits, vegetables, nuts, and seeds, which support a healthy gut microbiome and reduce inflammation.
Choose the right vitamins and minerals to relieve your symptoms and initiate gut repair
Specific vitamins and minerals like (but not limited to) glutamine, zinc, prebiotics and probiotics play a vital role in the repair of the gut and relieving symptoms associated with the gut and reducing inflammation. If you suspect you have gut issues, struggling with bloating, discomfort, irregular bowel movements and more, it is best to consult with a nutritionist before starting supplementation.
Glutamine - is an amino acid produced by the body and is also found in food. It helps protect the lining of the gastrointestinal tract known as the mucosa and it provides energy for immune cells in the gut.
Zinc - is an essential nutrient for mucosa production and has been shown to tighten gut junctions (reduce “leaky gut”).
Omega-3 fatty acids - may help to reduce inflammation throughout the body.
Probiotics and prebiotics - Probiotics help your body maintain a healthy community of microorganisms or help it return to a healthy condition. Specific strains of probiotics like bifidobacteria found naturally in kefir, help modulate the gut microbiota, prevent inflammation and protect from many diseases. Prebiotics, like inulin, found in asparagus, promote the growth of beneficial microorganisms in the gut and help with the maintenance of a healthy gut environment.
Move your body
There is an interplay between exercise and gut microbial composition. Regular exercise can help to improve digestion and reduce inflammation in the body. Exercise can also relieve symptoms of IBS and endometriosis.
Stress Management
Stress can have a negative impact on gut health and worsen digestive symptoms. Therefore, stress management techniques such as yoga, meditation, and deep breathing exercises can help to improve gut health and reduce inflammation. Stress can trigger symptoms of IBS and endometriosis.
The link between the gut and endometriosis is a complex and emerging field. While more research is needed to fully understand the mechanisms behind this connection, there is growing evidence that a healthy gut can be crucial in managing this condition.
By adopting a nutritious diet, taking supplements for support, exercising regularly, and practising stress management techniques, women with endometriosis can help to support gut health and reduce inflammation. This, in turn, can help manage endometriosis symptoms and improve overall quality of life.
If you are interested in learning more about the interplay between your gut and your hormones and improving your gut and hormone health, book a consultation with Christiana and get personalised nutrition, lifestyle and supplement advice.
References
Nabi MY, Nauhria S, Reel M, Londono S, Vasireddi A, Elmiry M, Ramdass PVAK. Endometriosis and irritable bowel syndrome: A systematic review and meta-analyses. Front Med (Lausanne). 2022 Jul 25;9:914356. doi: 10.3389/fmed.2022.914356. PMID: 35957857; PMCID: PMC9357916.
Jiang I, Yong PJ, Allaire C, Bedaiwy MA. Intricate Connections between the Microbiota and Endometriosis. Int J Mol Sci. 2021 May 26;22(11):5644. doi: 10.3390/ijms22115644. PMID: 34073257; PMCID: PMC8198999.
https://doi.org/10.1016/j.rbmo.2021.07.011
Mahmood A, FitzGerald AJ, Marchbank T, Ntatsaki E, Murray D, Ghosh S, Playford RJ. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007 Feb;56(2):168-75. doi: 10.1136/gut.2006.099929. Epub 2006 Jun 15. PMID: 16777920; PMCID: PMC1856764.
Mailing, Lucy J.1; Allen, Jacob M.2; Buford, Thomas W.3; Fields, Christopher J.4; Woods, Jeffrey A.1,5. Exercise and the Gut Microbiome: A Review of the Evidence, Potential Mechanisms, and Implications for Human Health. Exercise and Sport Sciences Reviews 47(2):p 75-85, April 2019. | DOI: 10.1249/JES.0000000000000183
Svensson A, Brunkwall L, Roth B, Orho-Melander M, Ohlsson B. Associations Between Endometriosis and Gut Microbiota. Reprod Sci. 2021 Aug;28(8):2367-2377. doi: 10.1007/s43032-021-00506-5. Epub 2021 Mar 3. PMID: 33660232; PMCID: PMC8289757.