Endometriosis occurs when the lining tissue from the uterus grows outside of the uterus, throughout the pelvis, and sometimes into the abdomen. Just like the lining of the uterus, endometriosis lesions are sensitive to menstrual hormones and bleed causing:

• painful periods
• pain with sex
• pelvic pain
• heavy menstrual bleeding
• reduced infertility

Sometimes there are no symptoms, and the condition is discovered during fertility assessments.  According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), one in seven Australians who were born as female will be diagnosed with endometriosis by the time they’re 49 – so it’s common, but the cause is unknown.

RANZCOG has developed what they call a Living Evidence Guideline which aims to be practical, up to date and give women the knowledge and choices they need to minimise the impact of what can be a seriously debilitating condition.

Hormone therapy and pain relief are the bases for treatment, with surgery as a secondary option, but there’s increasing evidence that non-drug treatments can help. However, there hasn’t been many credible studies for a firm recommendation.

Pelvic physiotherapy has been reported to have some benefits, as well as mindfulness classes to help manage the pain. Dietary changes can help manage symptoms; fish oil has been suggested to help reduce the inflammation and vitamin D supplements have potential benefits.

The other recommendation has been the FODMAP diet which was developed in Australia, and was originally designed for people with Irritable Bowel Syndrome (IBS). The diet is not a permanent change since it is not nutritionally complete, and a FODMAP diet is low in poorly absorbed fermentable carbohydrates.

A small, randomised trial conducted by Monash University in Melbourne found that a low FODMAP diet improved gastrointestinal symptoms in women with endometriosis. Symptoms like bloating, abdominal pain, and poorly formed (or loose) stools. The diet was also associated with an improvement in quality of life.  This trial doesn’t prove that there is a reliable benefit, but for women desperate for some relief, the diet could be worth trying after discussion with your GP.  The Monash FODMAP group has various resources available including recipes. Low FODMAP Diet | IBS Research at Monash University – Monash Fodmap