Case Study: endometriosis

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. 


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