Ernährungshilfe für Frauen mit Endometriose

The endometrium, derived from the Latin term for the uterine lining, refers to the tissue that lines the cavity of this organ. Physiologically, its thickness after the end of menstruation ranges from 1 to 3 mm. In subsequent days, under the influence of hormones (estrogen and progesterone), it grows to approximately 1 cm and remains until the end of the cycle. During menstruation, it sheds and is expelled along with the blood. In some cases, small fragments of this tissue can migrate to other organs. This is one of several theories explaining the development of endometriosis, a condition in which tissue similar to the uterine lining grows outside the uterus (e.g., in the ovaries, fallopian tubes, peritoneum, or intestines). In these locations, it behaves similarly to the natural endometrium—growing during the cycle and bleeding during menstruation, leading to the formation of cysts, inflammation, and various symptoms. Organs where endometrium settles lose the ability to fully perform their physiological functions, and the resulting scars can develop into tumors, polyps, or other changes with hormonal activity that affect the endocrine system. Risk factors for endometriosis include early onset of menstruation, short cycles, prolonged bleeding, and genetic predisposition. The condition is more common in women before their first pregnancy and in those with low body weight. It often coexists with PCOS (polycystic ovary syndrome) and infertility issues. Despite several theories about the etiology of endometriosis, its exact cause remains unknown. The unclear pathogenesis complicates the development of optimal diagnostic methods. Ultrasound is most commonly used, sometimes magnetic resonance imaging and laparoscopy. Despite its invasiveness, laparoscopy is considered the most reliable diagnostic method for endometriosis to date.

Endometriosis is characterized by heavy menstrual bleeding, often accompanied by blood clots, as well as pain in the lower back and abdomen, which intensifies before and during menstruation. Affected individuals may experience nausea, vomiting, painful intercourse, general weakness, and anemia due to excessive blood loss. Additionally, the condition can lead to constipation and painful bowel movements, sometimes with blood present in the stool.

Endometriosis treatment primarily aims to alleviate symptoms, as its exact causes remain unclear. The primary approach involves pharmacological therapy to reduce bleeding and pain. Hormonal replacement therapy, including oral contraceptives, is often utilized to inhibit the proliferation of the cervical epithelium. If pharmacological treatment proves ineffective, surgical intervention becomes necessary to excise the affected areas or, in extreme cases, remove the reproductive organs.

Despite the lack of complete understanding regarding the causes of endometriosis, developing a targeted nutritional strategy remains challenging. However, the primary focus should be on reducing inflammation in tissues outside the uterus where the endometrium develops and alleviating pain. It is also crucial to regulate estrogen metabolism and restore hormonal balance between estrogen and progesterone. The diet should include omega-3-rich foods such as tuna, salmon, mackerel, walnut oil, and flaxseed oil, due to their anti-inflammatory properties and potential role in reducing endometriosis risk. Key dietary components should also include curcumin, selenium, and vitamin E. Vegetables, rich in antioxidants and fiber, help manage estrogen excess. In cases of anemia, adequate iron intake should be ensured through diet or, if necessary, supplemented with ferritin or lactoferrin under medical supervision. Highly processed foods, sugar, trans fats, caffeine, and alcohol should be avoided as they may exacerbate symptoms. It is also advisable to test for food intolerances, as their elimination can help reduce chronic inflammation.