Female Fertility + Health

What Do You Eat if You Have PCOS or Endo?

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Finding the right diet can be difficult but when you have a hormonal disorder or a disease, it can be even more complicated. Then add trying to conceive on top of it. So how do you make sure you’re living a healthy lifestyle? We’ve broken down what foods to avoid and what to eat if you have endometriosis and PCOS.

What is Endometriosis?

Endometriosis is a condition where the tissue that’s typically found inside the uterus grows on the outside of it.  The tissue that lines the uterus is called the endometrium, which is where the condition’s name comes from.  Symptoms include extreme pelvic pain, cramping, bloating, pain in other parts of your body that can include back pain, leg pain and pain during intercourse.  While pain during menstruation is normal, endometriosis pain is chronic, severe and consistent. Endometriosis is foundationally an inflammatory disease with symptoms that are triggered by hormonal imbalance and excess estrogen. For more information about endometriosis, check out this infographic.

What is PCOS? 

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges.   Women with PCOS are usually found to have excess androgen hormones and too much insulin. PCOS is also known to be a metabolic disorder.  In fact, there have been some doctors, researchers and women’s health care advocates who have proposed that PCOS be renamed to “Metabolic Reproductive Syndrome” to give a more complete picture of what this syndrome involves. Because PCOS involves insulin and metabolism, it is one reason why something like the keto diet can be helpful in treating PCOS since it can help lower insulin levels and regulate blood sugar (more on this later). For more information about PCOS, check out this infographic.

Although PCOS and endometriosis are very different, they are similar in that they both involve hormone imbalance and inflammation. They are also both known to contribute to infertility.

Foods to avoid for both:

  • Sugar – Since sugar disrupts both hormone balance and triggers an inflammatory response in the body.
  • Highly processed carbs – Things like white bread, pastries and other baked goods (in wrappers) should be avoided. Since these are processed much the same as sugar in the body the same applies as above.

Foods to avoid if you have endometriosis:

  • Gluten – Gluten is an inflammatory agent that causes an overall inflammatory response in the body. Gluten is also often laden with pesticides and research shows that 75% of endometriosis sufferers will see improvement after 12 months on a gluten-free diet.
  • Dairy – Research shows dairy is known to trigger the symptoms of endometriosis via an inflammatory response.  One thing to note is that dairy containing A1 Casein has been found to cause higher levels of inflammation than dairy that contains A2 Casein.  A2 Casein is found in the milk of goats and sheep so some women may be able to tolerate these products.
  • Alcohol – Alcohol can raise your estrogen levels which can worsen symptoms of PCOS and endometriosis (as well as any estrogen-dominant hormonal health issue).

Foods to avoid if you have PCOS:

  • Soy – Soy milk is often substituted for dairy milk when looking for an alternative.  Soy isn’t your friend if you have PCOS because it contains “phyto” or plant estrogen that acts like estrogen in the body, and eating too much of it confuses your body into thinking it has enough of the real deal in supply. This sends a signal to your endocrine system to slow down estrogen production, subsequently slowing the production of luteinizing hormone (LH), and possibly shutting down ovulation.
  • Seed oils – Seed oils are used in processed foods and by restaurants because they are cheap and don’t have a unique flavor, which makes them easy to use in any food product. Seed oils include vegetable oil, soybean oil, canola oil, rapeseed oil, sunflower oil, safflower oil amongst others. They are unhealthy because they are composed primarily of omega 6 fats, which cause inflammation. Inflammation is one of the primary causes of insulin problems, hormone imbalance, and PCOS. Avoid them by avoiding processed foods, and by cooking with coconut oil, olive oil, or ghee (clarified butter) at home.
  • Coffee – The caffeine in coffee increases your stress hormones which in turn increases your insulin levels. Becoming accustomed to coffee decreases your insulin sensitivity, making it more difficult to regulate your blood sugar levels. The acidity of coffee causes digestive discomfort, indigestion, heartburn, and imbalances in the gut microbiome. Caffeine can also disrupt sleep and promotes anxiety.

So, what should I eat?

  • Leafy greens – Greens such as kale and spinach are rich in Vitamin B and minerals like Calcium. They can play a key role in regulating sugar, hormones, thyroid function, and fat metabolism.
  • Healthy fats – Fatty acids can help balance hormones and can encourage fertility. These include avocado, nut butters, chia seeds, extra virgin olive oil, and fatty fish like salmon (wild when possible).
  • Immune system boosters —Ginger and garlic are known to promote good immunity.
  • Foods that support liver health – Examples include beets, lemon, lime, cabbage, and carrots.
  • Organic whenever possible – Eating organic is healthy all around and can alleviate symptoms of both endometriosis and PCOS

Bonus – While not food related, it’s good to eliminate all toxic household and personal care products form your life when dealing with any sort of hormone imbalance. There are so many “non-toxic/green” brands to choose from now – check out EWG.org for recommendations.

All of this said it’s important to note “bio-individuality” or the idea that each person is unique in how they can or cannot tolerate certain foods. The best suggestions for your specific case can be obtained from your reproductive endocrinologist or physician. Also, be sure to celebrate the “little victories” instead of being too hard on yourself if you aren’t 100% on any diet advice. Almost no one can be, so give yourself credit when you have one less sugary treat one day and cut yourself some slack when you don’t.

If you’d like more information or have a question, speak to your healthcare provider or contact your dedicated Progyny Patient Care Advocate.

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