Hansen, S. O., & Knudsen, U. B. (2013). Endometriosis, dysmenorrhoea and diet. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 169(2), 162-171. https://doi.org/10.1016/j.ejogrb.2013.03.028
Hansen SO, Knudsen UB. Endometriosis, dysmenorrhoea and diet. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):162-171. doi:10.1016/j.ejogrb.2013.03.028
Hansen, S. O., and U. B. Knudsen. "Endometriosis, dysmenorrhoea and diet." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 169, no. 2, 2013, pp. 162-171.
Omega-3 intake linked to lower endometriosis risk in diet review
A 2013 systematic review of 23 studies suggested that certain dietary fats are associated with endometriosis, painful periods or both. The largest study, a cohort, linked long-chain omega-3 intake to lower endometriosis risk and trans fat intake to higher risk. Fish oil seemed to ease period pain.
Key Findings
In the largest cohort, 70,709 women, high trans-unsaturated fat intake was associated with higher endometriosis risk (relative risk 1.48; 95% confidence interval 1.17–1.88), and long-chain omega-3 intake with lower risk.
In that cohort, each 1% of energy from omega-3 fatty acids in place of trans fat was associated with a nearly 50% lower endometriosis risk.
In a randomized trial of 259 women after laparoscopic cystectomy, 6 months of dietary therapy including fish oil had no significant effect on endometrioma recurrence at 18 months compared with placebo.
Studies disagreed on fruit and vegetables. Two case-control studies associated fruit, beta-carotene and fiber with higher endometriosis risk. Another case-control study associated high fruit and green vegetable intake with lower risk.
For dysmenorrhea, the review examined 11 trials of different designs covering 1433 women in total and concluded that fish oil seemed to reduce it.
Interpretation
This systematic review combined cohort studies, randomized trials and animal studies to assess diet's role in endometriosis and painful periods. The omega-3 finding is backed by the largest cohort studied and echoed in smaller studies, and fish oil was linked to less pain across multiple trials. The authors note that the literature on specific foods remains sparse and its results equivocal. The findings support larger studies of diet as a modifiable factor in endometriosis and pain.
RRM Context
Restorative reproductive medicine looks for modifiable contributors to disease. The authors propose diet as one candidate that may act through inflammation. They note that existing hormonal and surgical treatment has shown unimpressive results. Excision remains the surgical standard RRM endorses. The review addresses diet, risk and pain.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To review the literature on the effects of diet on endometriosis and dysmenorrhoea.
Study Design
A systematic search for trials investigating a relationship between diet and endometriosis/dysmenorrhoea was undertaken, and 23 studies were included in this review.
Results
Data on the relationship between diet and endometriosis were limited to 12 trials, three of which were animal studies, resulting in a total of 74,708 women. One large study (n=70,709) found a relatively strong association between endometriosis and trans-fatty acid consumption, and a lower risk of endometriosis with increased consumption of long-chain omega-3 fatty acids. The latter finding was also supported by smaller studies. No further dietary recommendations for reducing the risk of endometriosis were possible, and results for intake of vegetable, fibre and fruit were equivocal. The relationship between diet and dysmenorrhoea was investigated in 11 trials with different designs, including a total of 1433 women. Intake of fish oil seemed to reduce dysmenorrhoea.
Conclusion
The literature on endometriosis and dysmenorrhoea in relation to diet is sparse, yielding equivocal results on specific elements. Overall, however, the literature suggests that specific types of dietary fats are associated with endometriosis and/or dysmenorrhoea, thereby indicating that there may be modifiable risk factors. Further research is recommended on both subjects.
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