Nutrition for Adenomyosis – Dietary Tips and Advice

The nutrients in food and a woman’s immune system can play a large role in helping with reproductive issues. There has been research for the effect of diet on fertility, PCOS and endometriosis, but the information on diet for adenomyosis is not well-researched or documented. Therefore, similar diet principles are applied for treating endometriosis as adenomyosis, specifically focusing on anti-inflammatory foods. As with anything, it is not a perfect formula and something that works for one client may not work for the next.

The great thing about the diet pattern that assists with symptoms for endometriosis and adenomyosis, is that it strips everything back and focuses on those general healthy eating principles, which means that even if changing your diet does not aid with symptoms, you are still developing high quality eating habits.

Adenomyosis and common misconceptions

A bit of a recap for you: Adenomyosis is characterised by endometrial like tissue found in the muscle wall of the uterus (uterine wall). Common adenomyosis symptoms include heavy and, painful periods, pain with sexual intercourse, and a feeling of an enlarged and ‘bulky’ uterus. People with adenomyosis often experience prolonged chronic pelvic pain which continues through all stages of the cycle. Adenomyosis is an estrogen dependant condition, so many treatments focus on reducing excess levels of estrogen.

Diagnosis of Adenomyosis and Treatment

The ‘gold standard’ of diagnosis for adenomyosis is through transvaginal ultrasound sonography (TVUS) and magnetic resonance imaging (MRI). Both of these should be conducted by a specialist who is familiar with the appearance of adenomyosis on scans, and what to look for when conducting the imaging.

Management of Adenomyosis

Treatment for adenomyosis unfortunately only focuses predominantly on management of symptoms rather than getting to the source and managing the disease itself. The most common medical treatments include either hormonal or surgical options.

Hormonal treatment includes:

• The Contraceptive Pill
• Progesterone releasing IUD (Mirena)
• Gonadotropin releasing hormone (GnRH) agonists

These aim to control estrogen levels, and therefore manage uterine bleeding, uterine size, and pain.

Surgical options include:

• Uterine artery embolisation
• Endometrial ablation
• The only known cure, hysterectomy

You can read more about diagnosis, treatment and management of adenomyosis.

If you do a google search on anti-inflammatory diets, they tend to be quite strict and restrictive, and they demonize carbohydrates and caffeine. Any “diet” that restricts certain food groups are going to be difficult to follow, and can often leave you feeling overwhelmed, upset and like you failed. There is also a lot of noise out there around guaranteed fixes, cures, and overall empty promises.

While there is no promise of a cure or quick fix, you can reduce your pain and symptoms by following plan guided with help from nutrition. This does not mean that people should stop taking their medications but rather find different ways in which they may need less pharmaceutical assistance through dietary changes. It is for this reason, that I will share with you, my nutrition tips for adenomyosis. Again, I reiterate that each person is totally different, and what works for one, may not work for the other, but it is always good to have a few tools in your toolbox!

NUTRITION TIPS FOR ADENOMYOSIS:

TL;DR – Here’s a list of foods you should incorporate into your diet for adenomyosis:

• Fruits and vegetables (especially berries, citrus fruits, tomatoes, and dark leafy greens)
• Avocados
• Nuts (especially those high in selenium, like Brazil nuts)
• Fatty fish (such as salmon, mackerel, ocean trout, sardines, and anchovies)
• Garlic (provided you can tolerate it)
• Green tea (Rich in catechins)
• Herbs and spices (dried and fresh)

1. Fill your day with fresh vegetables.

Vegetables are packed full of antioxidants. Antioxidants are anti-inflammatory and can counteract inflammatory effects of adenomyosis. A special mention to vegetables of the cruciferous family (broccoli, kale, brussel sprouts, cauliflower, bok choy), capsicums, and spinach. These vegetables aid in balancing your estrogen, by aiding in estrogen removal. The best part is you can have these vegies any way you want! Roasted, steamed, boiled, or with herbs and extra virgin olive oil (EVOO) for a little extra flavour and antioxidant power.

2. Don’t ditch the fruit

A lot of information may tell you to avoid fruit because of the sugar or carbohydrate content. Fruit is filled with essential vitamins, minerals, fibre and antioxidants. Make sure you include your two serves of fruit a day. A go-to fruit for peak antioxidant power are berries! So load up on your berries at breakfast, and during snacks.

3. Include grains and carbohydrates

Following on from the fruit advice, there is a lot of information that tells you to cut out all grain foods, carbohydrates or gluten. The problem with this is grain foods are essential for our energy stores, and to meet our fibre needs. Fibre is especially important for those with endometriosis and adenomyosis as bowel changes are often experienced with these conditions. In practice, distinguishing between IBS and endometriosis or adenomyosis can be difficult, and this is where there can be a possibility of misdiagnosis and/or delayed diagnosis.

You may have thought about going gluten free, or maybe you have already cut out wheat products. Often, as is the case for IBS, Often, as is the case for IBS, fructans cause the issue and not gluten. Fructan is a polymer/large molecule of fructose molecules, and one of those fermentable carbohydrates that are generally troublesome for those with IBS. These are known as fructoligosaccharides (FOS) and inulin.

Fructans are found in many fruits, vegetables, and legumes. One of the major sources of fructans in the diet is wheat, which is why those who go gluten or wheat free may experience a large improvement in symptoms of gas, bloating, pain, reflux, and altered bowel movements. Overall, a gluten free diet, or low FODMAP diet may help people with endometriosis or adenomyosis, but really this should be explored with an experienced dietitian to make sure you are not unnecessarily restricting.

When choosing grain foods, choose brown or less refined, such as:

• Brown rice
• Wholemeal pasta
• Quinoa
• Multigrain bread
• Popcorn
• Oats

4. Include sources of healthy fats

Including sources of high quality fats in your diet can improve overall pain, pain experienced with periods, and pain during sexual intercourse. Some key nutrients that fall under this category are omega 3 fatty acids, and vitamin E.

Vitamin E may also help to reduce overall pelvic pain during menstruation and intercourse for endometriosis sufferers. Oleocanthal, found in extra virgin olive oil has been studied for it’s similar properties to ibuprofen in providing an anti-inflammatory and pain relieving effect.

Foods to include in this group are:

• Avocado
• Nuts and Seeds
• Oily fish (sardines, trout, mackerel, salmon, anchovies)
• Extra virgin olive oil

5. Reduce your alcohol and caffeine intake

A glass of wine at the end of the week is nothing to be worried or ashamed of, but if you are a glass a day type person, try to slowly cut down to twice a week. In terms of caffeine, caffeine is found in more than just coffee. Generally, it would be best to stay away from energy drinks, coca cola (and soft drinks) and to reduce your current coffee intake.

If you are a “4 cups a day” type person, you might work on halving this to twice a day, if you are a one a day maybe try for one every second day. Caffeine doesn’t necessarily affect every person the same, and it is all about navigating what works best for you and your lifestyle.

6. Reduce your intake of saturated fats and excess sugar

There is quite a bit of research around foods high in saturated fat contributing to a pro-inflammatory response in the body. Given that adenomyosis is an inflammatory condition, it makes sense to minimise (where you can) foods that will trigger this type of response. Foods to minimise include:

• Butter
• Coconut Oil products
• Ghee/Lard
• Processed or Fried food items
• Cakes and pastries

7. Move your body in a fun and enjoyable way

Find fun and enjoyable ways to move your body. Exercise is just as important for your mental health as it is for your physical health. Being in chronic pain or feeling constantly unwell takes a large toll on your mental health. It takes you away from loved ones and social events, but it also makes you feel pretty yucky and drained to deal with all of that consistently. Many people find that some movement can improve symptoms of pain, such as stretching, yoga, swimming, or a light walk. A 15-minute walk is better than no activity at all, so you find what works for you!

I hear all of you #endo and #adeno warriors rolling your eyes because Julie in accounting has told you “have you tried yoga or meditation?” but again – what works for one may not work for another. It is important to reach out to other health professionals such as pelvic floor physiotherapists, women’s health exercise physiologists, and they can assist you with specific exercises to reduce, manage and improve pain.

8. Take care of your mental health

Coping with chronic pelvic pain can weigh very heavily on those with adenomyosis, and/or chronic pelvic pain. Working with a pain specialist, and/or psychologist can help you to manage your pain, and decrease levels of stress and anxiety. Chronic levels of stress and anxiety can impact levels of pain and inflammation. Having chronic pain can take you away from work, social events and relationships.

It can be difficult to navigate this without professional support. The pain is ABSOLUTELY NOT in your head, and you deserve to be validated and listened to.

A few things to note about supplementation

Certain vitamins, minerals and supplements can assist with adenomyosis management. Seeing a dietitian experienced in this area can recommend specific supplements that are right for you. Magnesium can be helpful as it acts on relaxation of smooth muscle such as the muscles in the uterus, and gastrointestinal tract. A tailored probiotic can be useful in improving gut health and gut symptoms.

The reason why this matters so much to me:

I became passionate about helping women with endometriosis and adenomyosis after I watched my sister struggle through chronic abdominal pain for years, with no relief and no diagnosis. It was only recently (5 years ago) that she was finally given a diagnosis – which was adenomyosis. As my sister and I are close, I have lived through her ups and downs each day. I know what chronic pain, and a chronic illness looks like and how it can impact the smallest of everyday tasks. My sister may have a diagnosis, but at this current moment there is little management from her healthcare team which means she still battles chronic pain and illness daily.

She is the reason for my business name ‘Big Sis’ and fuels my passion for helping women by listening and acknowledging their struggles. I want to assist you in working to reduce that pain. I want to work with you, because I honestly think that you already have all the tools you need, and I am just here to guide you.

Book a consultation today

When following an eating pattern for a specific condition it is best to have your health team behind you. By consuming a large variety of anti-inflammatory foods and following this dietary pattern you can naturally reduce your symptoms. Adenomyosis management focuses on improving quality of life, and symptom reduction. Unfortunately, there are limited treatments for the actual condition itself, rather most treatments are symptom focused.

Get personalised support and advice, without being over restricted at Big Sis Nutrition today. If you want to live a life with reduced pain, and a less restrictive diet book a consultation today or contact me if you have any further questions or concerns.