This month’s case study is 35 year old ‘Abigail’ who came to the Clinic with a diagnosis of endometriosis.

I had been suffering with painful periods from the age of 30 and they had become increasingly debilitating. Having relied on painkillers, which I think I was becoming resistant to, I thought it was time to seek help. I suppose I was putting off going to my GP because I was scared of what the outcome would be. He talked me through the options and recommended that I get referred to a gynaecologist for further investigation.

My appointment came through fairly quickly and when I saw the gynaecologist he recommended I have a procedure called a laparoscopy – an exploratory procedure to look at my ovaries and womb to see what, if anything, was causing my painful periods. I was very nervous because I hated going to hospital, but I had got to the point where I needed to find out why I was in so much pain. After the procedure the gynaecologist diagnosed endometriosis, (a condition where the womb lining migrates and grows outside of the womb). He said it was quite advanced and I had patches of endometriosis growing over my ovaries and around my bowel, which is why I would also experience pain with a bowel movement. During the laparoscopy, the gynaecologist removed the patches of endometriosis with a laser which would stop the pain, but he explained that this was not a guarantee that it would not grow back.

 

The first three periods after my operation were relatively pain free, which was amazing. But after that the pain returned, albeit less intense. I decided to research into endometriosis to see if there was anything I could do to support myself. I had heard that complementary therapies could be useful. I looked on the internet and came across the Dr Marilyn Glenville Clinic, which specialises in women’s conditions and endometriosis was one of them. I decided to download an ‘e-book’ on endometriosis. It was very useful as it explained what the condition is, how it can develop and both the medical and natural treatments available. Although the e-book was helpful, I knew I needed some more help so I called the number at the back to find out more about having a consultation.

 

I spoke to a very helpful receptionist at the Dr Marilyn Glenville Clinic who explained how the clinic worked and what I could expect from my first session with one of the nutritionists. It sounded exactly what I was looking for, so I went ahead and booked a consultation. I was sent a comprehensive questionnaire to complete and return before my consultation, which allowed me to write down what my main health concerns were, symptoms I was experiencing and my diet! After I had completed this I was appalled at how much alcohol I was consuming over the two days. (I thought it was better to be honest than to write down what the nutritionist wanted to hear!)

 

I met with the nutritionist 2 weeks later and we went through the questionnaire in detail together. I felt very encouraged by this because no one had ever taken so much interest in me and ‘my condition’. The nutritionist explained that endometriosis is a condition in which the lining of the womb (the endometrium) implants and grows outside the womb itself. These endometrial implants can grow in the pelvis, fallopian tubes, ovaries, bowel and bladder. More uncommonly, they can also crop up in the lung, heart, eye, armpit or knee. Wherever it grows, the womb lining responds to the natural hormone cycle and bleeds every time a period occurs. When women bleed normally throughout menstruation, blood leaves the body through the vagina. However, in the case of endometriosis the blood has no outlet and becomes trapped in the tissue, causing pain, inflammation, cysts and scar tissue.

 

Endometriosis is stimulated by excess oestrogen, so one of the main dietary principles is to keep this hormone under control. Oestrogen is found in meat, dairy products and the water supply and even in preservatives that are routinely put into our everyday skin creams and shampoos. Our liver is the organ that helps controls levels of oestrogen by detoxifying the hormone and ensuring elimination, so it’s important that it is functioning well. Liver function can be compromised by alcohol and caffeine, preservatives in our diet and taking drugs (painkillers etc). The nutritionist explained that we are more exposed to these ‘xenoestrogens’ (foreign oestrogens) than ever before because of the way our food is processed, pollution and increased use of chemicals.

 

The pain associated with the endometriosis is due to inflammation, so cutting out foods that are pro-inflammatory (causing inflammation) and eating plenty of foods that are anti-inflammatory was recommended. Pro-inflammatory foods include red meat and dairy products and anti-inflammatory include oily fish, nuts and seeds and avocados. I had been drinking a lot of milk and I loved cheese, but the nutritionist gave me plenty of alternative options. It was recommended that I eat a daily serving of dark leafy green vegetables because of the mineral magnesium, which is a natural muscle relaxant and has been shown to reduce cramps and spasms associated with endometriosis.    

 

To support the liver I was advised to cut back on my caffeine (I was drinking 3-4 cups of strong coffee daily), alcohol and processed foods – which can be a strain for the liver to process, which in turn reduces its ability to process the extra oestrogen that my body has to deal with. She explained that some food/drinks can naturally have a supportive effect on the liver. Broccoli and brussel sprouts are particularly useful because of a compound within them that promotes oestrogen detoxification. She also recommended I drink nettle and dandelion tea, which are good for the liver.

 

The nutritionist also explained to me the importance of using natural skin and hair products because they can contain ‘parabens’, which are synthetic preservatives that have been linked to oestrogen related breast cancer and may also be linked to endometriosis. She recommended specific brands, which made it easier than trawling through the shops!

 

I was also advised to take some specific nutritional supplements to address the high oestrogen, using a combination of herbs and liver support. I also took natural anti-inflammatory supplements like fish oil, ginger and magnesium, which was just amazing for the cramps! It is often known as ‘nature’s tranquilliser’ and this certainly was the case!

 

I booked a follow up consultation for 8 weeks time so the nutritionist could see how I was getting on. She decided on 8 weeks because I would have had 2 periods in that time and we could get a better idea of how I was getting on with the programme. I kept a food and symptom diary and even with my first period, I definitely had less pain. I only had to take 1 painkiller where I would usually take at least 6 over the duration of my period. By my second period I had virtually no symptoms! It was amazing. Not only had my menstrual symptoms disappeared I generally felt I had more energy, clearer skin and had lost weight, which wasn’t intentional but was certainly appreciated! The nutritionist did say it was a good thing that I had lost the weight because fat cells produce oestrogen.

 

Six months on and my diet consists mainly of fresh fruit and vegetables, some organic poultry, fish, beans, nuts and seeds, brown rice and oats. I also largely avoid dairy and wheat, which I really feel has helped enormously. I am disciplined with my diet but do have occasional lapses, which the nutritionist said was ‘ok’ every so often! But the truth of it is I actually don’t enjoy eating or drinking those foods when I do have them.  

 

I am so pleased that I decided to book the consultation and I feel so much more in control of my endometriosis, because I understand the condition. This is what I found frustrating about my gynaecologist – there was no explanation and I found it quite depressing to think my only option was surgery. The nutritionist did recommend that I go back to my gynaecologist in another 6 months to review, because endometriosis can ‘grow’ back, but with the change of diet she hoped this would not be the case or at least it would slow it down. All I can say is thank you so much to my nutritionist and all the team at The Dr Marilyn Glenville Clinic for their help and support.  

 

 

  

Marilyn’s Comment

 

This is a wonderful case of how powerful nutrition can be in dealing with hormone imbalance. It is not just endometriosis that can be supported with nutrition, but fibroids and PCOS too, which are also hormonally driven. Unfortunately we’re seeing so many more cases, especially in young women. It is important to always have painful periods checked by a medical practitioner for a diagnosis. With the case of Abigail her endometriosis was at a severe stage and required surgery, but if it is less aggressive, it may be that you have a 6 month ‘window’ to really focus on the nutritional approach rather than going down the medical route straight away. 

 

If you would like to find out more about our clinics and the products mentioned, then please see the Resources Page.

Q: I’m 47 and for the last year, about ten or so days before my period, my breasts are so painful I can’t stand anyone near me. Taking evening primrose hasn’t helped much. Are there any other natural remedies I can try?

A: Breast swelling and pain, especially in the week or so before your period are normal reactions to fluctuating hormone levels. As women reach their 40s, however, this discomfort can develop into severe pain called mastalgia, where the breasts become hard and extremely painful. A mastalgia attack can last for up to ten days, and it sounds very much like you could be suffering from this. The causes are not completely understood, but mastalgia may be caused by unusual sensitivity of breast tissue due to fluctuating hormones as menopause approaches.

 

If you do experience breast pain your immediate fear would be that the pain was due to breast cancer, but in most cases mastalgia is a benign condition. You should, however, still see your doctor to rule out any potential problems. 

 

Evening primrose contains an omega 6 fatty acid with anti inflammatory properties and it can be effective for some women. If it isn’t helping, you may need a higher dose. Try to get a supplement with at least 100mg of GLA, which is also found in borage oil (see the Resources Page for a high strength GLA supplement). It’s also possible that the treatment isn’t right for you because, although older studies showed that supplementing your diet with evening primrose oil that contains GLA (gamma linoleic acid) could reduce breast discomfort, more recent studies have not backed this up. Do bear in mind though that evening primrose oil needs to be taken for about three months to be effective, so you may just need to be patient.

 

You may also be eating too many trans and saturated fats, which can block the absorption of essential fats. Trans fats from hydrogenated oils are found in processed products and saturated fat is found in red meat and dairy, so reduce your intake.

 

Then try the recommendations below:

• If you suffer from breast tenderness make sure you wear a comfortable supportive bra – one that does not irritate the nipple area as you move.
• To treat the pain put a towel soaked in hot water on the area for 15 minutes, then a cold one for 15 minutes. Do this in the morning and evening to ease discomfort.
• Make sure you get your phytoestrogens, found in foods such as soya, chickpeas and lentils.
• Cut down on foods and drinks containing caffeine. They have been shown to increase problems with tender breasts because they contain substances called methylxanthines. Methylxanthines are a family of substances found in coffee, black tea, green tea, chocolate, cocoa, cola and decaffeinated coffee, as well as in medications that contain caffeine, such as headache remedies. These methylxanthines have been linked to painful and uncomfortable breast. 
• Up your fibre intake. Research has shown that there may be a link between constipation and a painful breast condition called fibrocystic breast disease. So make sure you drink enough water and have a good intake of fibre to ensure regularity. You may also like to sprinkle some flaxseeds (linseeds) on your cereal in the morning. There is an excellent flaxseed (linseed) product that The Natural Health Practice stock, which is made from crushed organic cold milled flaxseeds – it’s all ready to eat just by sprinkling on your food.  It is called Fortiflax.
• Don’t, however, include bran in your diet. Bran can actually make things worse because it contains substances called phytates, which can interfere with the absorption of important nutrients, like magnesium and calcium.
• Vitamin E has been shown to reduce breast pain and tenderness in some studies. So eat foods rich in vitamin E, such as oats, sunflower oil, whole grains, soya oil and leafy green vegetables. You may also like to take a supplement for a couple of months to give you a kick start.
• Eat some live yogurt every day. Breast tenderness may be related to an excess of oestrogen; the beneficial bacteria in live yogurt can help to reabsorb old hormones and also to increase the efficiency of your bowel movements. Or else take a probiotic supplement like BioKult.
• Increase your intake of omega 3 fatty acids. Omega 3 fatty acids, found in fish oil and flaxseeds, have been found to relieve breast tenderness and fluid retention. Take fish oil capsules (like the Omega 3 Plus) or eat more fish or sprinkle linseeds (flaxseeds) on to your salads and soups.
• The B vitamins are of particular value if you suffer from breast tenderness because they help your liver break down excess oestrogen. Improve your intake of B vitamin foods and think about taking a B complex supplement for a couple of months.
• A number of essential aromatherapy oils, such as lavender, fennel and juniper, can encourage lymphatic drainage and help relieve breast pain by helping to regulate hormones. Massage them on your breasts putting one drop of your chosen oil on a teaspoon of carrier oil, such as sweet almond or sunflower, or use a few drops in your bath.
• The herb Ginkgo Biloba has proved to be effective. A French study showed women with PMS breast tenderness taking Gingko Biloba reported less pain that those taking a placebo. Other helpful herbs include agnus castus – to balance hormones, and milk thistle – to help your liver process oestrogen efficiently, allowing excess to be excreted (a good combination of these herbs which I use in the clinic is called Agnus Castus Plus, see the Resources Page).

This month’s case study is 32 year old ‘Katy’ who came to the Clinic with painful periods

I started having my periods at the age of 12 and I have suffered with severe pain ever since. My mum took me to the doctor when I was about 15 and he put me on the Pill. At the time it was great because I went from being totally incapacitated for 2 days every month to being ‘normal’. I came off the Pill in my late twenties because I knew it was not good to be on long term. The pain seemed to be even worse having come off it. Each month I would be in so much pain that I would often be sick and faint. Although my work colleagues were very supportive, it was difficult if I was in an unfamiliar situation.

I went back to my doctor and he suggested I try a different type of Pill, so I said I wanted to explore other options. He sent me away with a prescription for mefenamic acid – a very strong painkiller. I was reluctant to take it but went off to get a supply as an emergency. I searched for ‘painful periods’ on the internet and came across a really interesting site by Dr Marilyn Glenville. The site explained how nutrition can be helpful for the treatment of painful periods. I downloaded an ‘e-book’ on ‘Understanding Painful Periods’, which I read and found very useful.

 

I phoned the Dr Marilyn Glenville Clinic because I decided that I needed more support from an expert rather than trying to help myself and struggle on my own. I spoke to a very helpful receptionist who talked me through the consultation process and what I would get out of my initial appointment. She sent me a questionnaire to complete and return for the nutritionist to review before meeting me. I had to fill in a two day diet diary, which was interesting because it made me write down everything I was eating and drinking – it was quite an eye opener. I thought it best to be honest rather than write down what the nutritionist wanted to hear!

 

Before my first consultation it was recommended that I perform a Hair Mineral Analysis to identify any mineral deficiencies. This was really straightforward because all it involved was taking a sample of my hair and sending it off to the laboratory for analysis and the results would be back in time for my consultation.

 

The nutritionist went through my questionnaire with me and asked about my painful periods – how long they had been painful, what medical investigations had I had and any drugs I was taking. It felt very thorough and she was really taking time to understand my symptoms (rather than having a rushed 5 minutes with my GP).

 

She explained that pain is usually a warning signal from your body, so it is important that the pain is investigated. She asked whether my doctor had referred me to a gynaecologist. I explained that he had never mentioned this, even when I had shown concern that I may have a condition like endometriosis. The nutritionist suggested that I follow this programme for 3-6 months and if there was no improvement I should ask my doctor to refer me for further investigation.

 

The nutritionist did say, however, that period pains can be unusual in that there may actually be nothing medically wrong – they can simply be an abnormal functioning of your body around the time of your period. This is pretty good news because it means that if you can get things back into balance, you’ll not only get rid of the pain but you’ll prevent it from returning. The natural approach aims to treat the condition, not simply mask the pain or ‘turn off’ your cycle. Furthermore, if you work to put your body back into balance all aspects of health and well-being will be improved.

 

The results of my Hair Mineral Analysis identified low levels of zinc and magnesium. The nutritionist explained that magnesium acts as a muscle relaxant and it has been shown to have a beneficial effect on painful periods and lower back pain. Magnesium also has the ability to lower the ‘bad’ prostaglandins (hormone-type substances that can cause inflammation) that may be causing the womb to over-contract. Zinc is important for eliminating pain because it is needed for the proper conversion of essential fatty acids into ‘good’ (anti-inflammatory) prostaglandins.

 

The nutritionist went through my diet in depth with me. She was concerned that I didn’t eat enough fresh vegetables and fish and relied too heavily on processed meals and sugar! I had never really enjoyed cooking and I suppose I used this as an excuse. She said that I didn’t need to always cook from scratch and spend time in the kitchen – there are always short cuts! She explained that some foods like red meat, dairy and sugar can actually be pro-inflammatory (cause inflammation) which triggers the painful periods, and some foods can be anti-inflammatory (calm inflammation) like oily fish, nuts, seeds and dark green leafy vegetables. Luckily, I do enjoy these foods – I just never really ate them! She said that I could eat tinned fish to make my life easier, and sardines and mackerel in particular are rich in the anti-inflammatory omega 3 oils. Dark green vegetables, including salad leaves (watercress and rocket) are rich in magnesium, which is a natural muscle relaxant so helps with the cramps I was experiencing.

 

The nutritionist explained that when the body is out of balance, and has been for some time, diet alone is not always sufficient. She recommended that I give my body extra support with nutritional supplements. She put together a tailor-made plan that incorporated a good multi vitamin and mineral as a ‘foundation’, then added to this extra vitamin B complex, magnesium, high strength fish oil and zinc. She explained that the B Vitamins are needed to help produce ‘good’ prostaglandins, which help to relax and widen blood vessels (as opposed to ‘bad’ prostaglandins, which increase the womb contractions and increase the pain). The B vitamins have been shown to significantly reduce the intensity and duration of period pains.

 

The nutritionist told me that taking EFAs (essential fatty acids) in supplement form is extremely important in the treatment of painful periods. Research has shown that women with low intakes of omega 3 fatty acids have more painful periods than women who have a good intake.

 

I booked a follow up consultation for 8 weeks later so the nutritionist could assess me after two menstrual cycles. The first period my pain was definitely less intense and on my second cycle there was a remarkable difference. The intensity and frequency of pain was much less. I didn’t need to take any time off work – which was amazing – and I felt normal the whole cycle! I didn’t have to take any painkillers at all, which was brilliant.

 

I am now 6 months on from seeing the nutritionist and I have kept up with eating well and taking the supplements. I can’t thank the Dr Marilyn Glenville Clinic enough for their support and encouragement in getting me to better health. My life is transformed and I am now in control of my period rather than the other way around! The best thing about it is that I no longer have to plan my life around my period!

 

Marilyn’s Comment

 

Katy’s story is a great example of how powerful nutrition can be in actually addressing the underlying cause, rather than just treating the symptoms. With a change of diet and taking specific, good quality, nutritional supplements Katy has not needed to take strong painkillers and she can lead a normal life – whereas before she was losing at least 2 days each month to her painful periods.

 

As the nutritionist stressed in the consultation, sometimes pain can be due to an underlying medical condition, so it is always important to be vigilant and further medical investigation is sometimes needed. Although Katy noticed improvement within one menstrual cycle, it can take up to 6 months to correct the balance. Nutrition can take longer to take effect and change hormone balance compared to conventional drugs but the benefit is longer lasting.

 

If you would like to find out more about our clinics and the products mentioned, then please see the resources page.