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Barry Sears said it best in his book, The Omega Rx Zone:
“Fat has become a foul three-letter word in our society. We’ve become a nation of fat phobics, and some of us try to avoid this nutrient at all costs in an effort to lose weight and improve our health. Yet this war on fat has been completely misguided.”¹
During the time that I dealt with adenomyosis, the non-fat diet fad was quite popular. In my attempt to eat healthy, my ex-husband and I tried to buy as much non-fat food as we could, thinking at the time that this was the right thing to do. Boy, were we ever wrong!! My struggle with adenomyosis was at its worst during the time that I was on this non-fat diet – excruciating abdominal pain, very heavy menstrual bleeding with clots, severe bloating – it was just horrible.
After putting up with these monthly symptoms for several years, I read an article about the health benefits of flaxseed. I learned that this food contained high levels of omega-3 fatty acids and was found to be helpful in a slew of medical issues. I was intrigued. After years of different birth control pills, antispasmodics, and pain killers, I was ready to try just about anything.
I began to sprinkle ground flaxseed on just about anything I ate – yogurt, spaghetti sauce, salad…even a peanut butter and jelly sandwich. The taste was rather earthy if eaten on its own, but when added to these dishes, I couldn’t really taste it at all.
Several months went by, and I began to notice a significant decrease in my pain level and heavy bleeding. I still had problems, but it was definitely better than where I had been before I added flaxseed to my diet. This led to more research on omega-3s, and I quickly realized that a non-fat diet was, in fact, not healthy. I learned that some fat is necessary for optimum health. At the same time, I learned how the Western diet is overloaded with omega-6 fatty acids while deficient in omega-3s. Let me explain further.
Fat is needed for both immediate and reserve energy as it supplies two times as many calories per molecule as compared to carbohydrates or protein. It is needed for the formation of hormones, cell walls, enzymes and brain tissue. Fats are also needed for the proper absorption of many vitamins and minerals and for the proper functioning of nerve synapses.
Fats can be divided into two groups: saturated and unsaturated. Saturated fats are solid at room temperature and are known to increase cholesterol. Examples are lard and butter. Unsaturated fats can be further subdivided into monounsaturated and polyunsaturated fats. Monounsaturated fats are liquid at room temperature but cloudy when refrigerated. Examples include olive, peanut and canola oil. Polyunsaturated fats are liquid at both room temperature and in the refrigerator. Examples are fish, corn, soybean and sunflower oils.
Fats can also be found in their natural and unnatural forms. In their natural forms, the hydrogens of the fatty acid are on the same side of the carbon chain. Since these hydrogens naturally repel each other, the carbon chain will bend away from the hydrogen side. These kinks help the cell to be more fluid and flexible which allows a healthy exchange of nutrients in and out of the cell. Trans fats, widely regarded as very unhealthy today, are the unnatural forms of fats. These fats are made through a process called hydrogenation, and this process is known to destroy omega-3 fatty acids. The hydrogen atoms in trans fats are on opposite sides of the carbon chain, so no bending of the chain takes place, and they jam the “plug” for the natural fats. Examples of trans fats include partially hydrogenated vegetable oil, solid shortenings, hydrogenated lard, and solid margarine.
A specific group of unsaturated fats, called the essential fatty acids, are particularly important in overall health. These fats are called “essential” because they must be included in the diet as they cannot be made by the human body. Three classes of essential fatty acids exist: omega-3, omega-6 and omega-9. The omega-3s include alpha linolenic acid (LNA), eicosapentenoic acid (EPA), and docosahexanoic acid (DHA). The omega-6s include linoleic acid (LA), arachidonic acid (AA), and gamma linoleic acid (GLA). An example of an omega-9 fatty acid is oleic acid. It is a monounsaturated fat and can be found in olive oil, avocados, and nuts.
The omega-3 fatty acids help to keep cell membranes fluid and flexible which allows for effective exchange of nutrients in and out of the cell. These fatty acids in general produce good eicosanoids, a type of hormone. Good eicosanoids prevent blood clots, dilate blood vessels, reduce pain, enhance the immune system, and improve brain function. Since these fats are polyunsaturated, they tend to oxidize and turn rancid easily. To overcome this problem, the food industry came up with the process of hydrogenation as discussed earlier. Hydrogenation makes the fats more stable, but it also destroys the effectiveness of omega-3s. As a result, the Western diet is now dangerously deficient in these important fatty acids.
The omega-6 fatty acids are the most common polyunsaturated fat found in food. In general, they lead to the production of bad eicosanoids. These eicosanoids promote blood clots, constrict blood vessels, promote pain, and decrease immune and brain functions. Although this seems like a bad thing, it is necessary to have these fatty acids present for optimum health.
Both omega-3s and omega-6s need to be present in the human body in the right ratio. The National Institute of Health recommends the following daily intake of essential fatty acids:
EPA/DHA – 650 mg.
LNA – 2.22 g
LA – 4.44 g
With today’s Western diet that is predominant in processed food, our intake of omega-6 fatty acids is too high whereas our intake of omega-3 fatty acids is lacking. I found that when I added flaxseed (high in omega-3s) to my diet, my symptoms of adenomyosis reduced significantly. This makes sense as these fatty acids make the good eicosanoids which reduce inflammation. To reduce adenomyosis symptoms, I recommend getting the balance of omega-3 to omega-6 fatty acids back into a healthy range. Reduce your intake of processed foods and eat more natural and organic fruits and vegetables. In addition, get a good omega-3 supplement such as flaxseed or fish oil. You might be surprised at the results!
For more information, please check out my book, Adenomyosis: A Significantly Neglected and Misunderstood Uterine Disorder.
¹Barry Sears, The Omega Rx Zone: The Miracle of the New High-Dose Fish Oil (New York: Harper Collins Publishers, Inc, 2002) 20.
During my struggle with adenomyosis and through my research, I have found that the following foods and supplements may improve symptoms of adenomyosis and estrogen dominance. This information may be particularly useful to those who do not want to undergo a hysterectomy.
Would you like to comment on your own experiences regarding diet and adenomyosis? See “My Blog” and tell your story!
1. Fiber – helps to rid the body of excess estrogen. Good sources include beans, nuts, seeds, oatmeal, and fresh vegetables.
2. Omega-3 fatty acids – an anti-inflammatory nutrient that has also been shown to balance hormone levels. Sources include anchovies, mackerel, wild salmon, herring, sardines, tuna, walnuts, chia seeds, and flaxseed.
3. Organic foods – because of the way they are grown, these foods contain less xenoestrogens.
4. Cruciferous vegetables – contain a substance called diindolylmethane that has been shown to help the body rid itself of excess estrogen. Sources include broccoli and cauliflower.
5. Phytoestrogens – weaker estrogens than that found in the human body and they compete for estrogen receptor sites. Good sources include flaxseed, sesame seeds, pistachios, sunflower seeds, almonds, beans, soy, multi grain bread, rye, and barley. Sunflower seeds also have a high vitamin E content which has aromatase inhibiting action. See “Treatments” for more information on aromatase inhibitors.
6. B vitamins – help to balance hormone levels. Sources include tuna, salmon, turkey, chicken, beans, potatoes, milk, bananas, and eggs.
7. Foods high in magnesium and zinc – these nutrients help to increase progesterone production. Sources include bran, dark chocolate, pumpkin, squash, edamame, molasses, roast beef, oysters,crab, and lamb.
8. Foods high in sulfur – help to detoxify the liver by binding to estrogen and eliminating it through the GI system. Good sources include onions, garlic, lemons, and leafy green vegetables such as kale, spinach, and swiss chard. Kale chips can be made at home by adding some olive oil and salt and baking it in the oven. Alternatively, I found some wonderful kale chips at Trader Joes. They are a nice alternative to regular potato chips.
9. Vitamin E – low levels of this vitamin are associated with high estrogen in the body.
10. White mushrooms – these have been shown to have some natural aromatase inhibiting action. Since aromatase synthesizes estrogen, eating food with aromatase inhibiting action helps to lower estrogen levels and may possibly help to reduce adenomyosis symptoms. See “Hormonal Imbalance?” and “Treatments” for more information.
11. Citrus fruits – contain d-limonene which helps in the detoxification of estrogen in the liver. Examples include oranges, tangerines, lemons and grapefruit.
12. Seaweed – an effective xenoestrogen detoxifier. Examples include dulce, kelp and nori.
13. Brazil nuts – contain high levels of selenium which is known to have aromatase inhibiting action. See “Hormonal Imbalance?” and “Treatments” for more information.
Herbs high in phytoestrogens and other useful supplements
Phytoestrogens are weaker estrogens and therefore may have a beneficial effect for those suffering from estrogen dominance. Please refer to “Different Types of Estrogen” for a full explanation. This subject is often misunderstood by the general public. Although research is pointing to the overall benefits of phytoestrogens in women’s health, there are conflicting studies. It is strongly recommended to talk to your physician before using the following herbs, especially if you have a family history of estrogen sensitive tumors (breast, uterine, ovarian).
This section has been updated as of May 5, 2016. I have done extensive research on phytoestrogens in preparation for writing my second book, and some of the previously advised herbs have been taken off this list. This list may be updated again as I learn more about phytoestrogens. I recently talked to another adeno sister who brought up an excellent point. Phytoestrogens are weaker estrogens, and in theory, if you increase your phytoestrogen intake, they will occupy the estrogen receptor sites in the body and will prevent the dangerous xenoestrogens from doing so. That sounds great, but it is also necessary to have a liver that is functioning optimally so that it can break down these dangerous xenoestrogens and get rid of them. Just as an example, let’s say a woman with adeno increases her phytoestrogen intake but still eats a lot of processed or junk food. Her liver may be sluggish, so the potent xenoestrogens are still in her body – the liver is not able to break them down efficiently, and they are not eliminated from the body. Eventually the phytoestrogens will disconnect from the estrogen receptor sites, and since the xenoestrogens are still in her body, these dangerous chemicals will then attach to the receptor cells. This, in theory, could lead to a very dangerous estrogen dominant condition. Again, this is just a theory. This topic is very complicated, and we are learning new things every day. I urge you to do your own research and talk to an expert before using phytoestrogens. I do believe they COULD help if, and only if, you change your diet and lifestyle as well.
For a more detailed discussion of phytoestrogens and herbs, please read my book, Adenomyosis: A Significantly Neglected and Misunderstood Uterine Disorder.
1. Milk Thistle – This amazing herb has been known for thousands of years to protect and nourish the liver. Silymarin is the active constituent of the plant, and this substance protects the liver from damage by toxins several ways. First of all, it is a strong antioxidant, and it has been shown to be more effective than both vitamin C and vitamin E. It also helps to prevent the depletion of glutathione which is needed for the proper functioning of the liver. Silymarin has been repeatedly shown to be beneficial in treating cirrhosis and hepatitis. Since estrogen is processed in the liver, it is vital to keep the liver healthy, so the addition of this herb to the diet of adenomyosis sufferers is an excellent idea!
2. Damiana – Known for its aphrodisiac properties, this herb may help with anxiety, depression, hot flashes, and night sweats. It may inhibit aromatase which is needed to convert androgens to estrogen. A 1998 study found that this herb had anti-estrogenic activity, and, according to Zava et al. (1998), this herb is one of the six highest progesterone-binding herbs. It has also been noted that this herb may contain compounds similar to progesterone. Damiana may interact with other herbs and supplements that alter progesterone levels.
3. Dandelion – Believe it or not, this little yellow weed is an invaluable herb. Dandelion, also known as “pee in the bed”, is a powerful diuretic which could be invaluable if you suffer from severe bloating due to adenomyosis. An additional benefit is this herb will reduce bloating without causing the body to lose large quantities of potassium, an unwanted side effect of diuretic drugs such as Lasix. According to Zhi et al. (2007), this herb may be useful “for the clinical treatment of reproductive hormone-related disturbances” (Abstract).
4. Royal Jelly – This nutritious supplement is made from bees. The major constituent is water (67%), but it also contains many nutrients such as protein, sugars, fatty acids, minerals, enzymes, vitamin B5, vitamin B6, and a little bit of vitamin C. It has been used for PMS, insomnia, menopause, and liver disease, and it has been reported to decrease inflammation and nourish the endocrine system. According to Hiroyuki et al (2012), this supplement appears to increase testosterone levels in men and also appears to have no effect on the conversion of aromatase in humans. Caffeic acid phenethyl ester (CAPE) is a substance that is found in bee propolis. Jung et al. studied CAPE in 2010 and found that it had binding affinity to ERβ. Also, CAPE did not increase the growth of MCF-7 estrogen receptor-positive breast cancer cells, and it did not increase the uterine weight.
5. Dong Quai – Zava et al. (1998) report that this herb did not inhibit the production of alkaline phosphatase, which means it does not block the activity of progesterone. In addition, this group notes that this herb has very little estrogenic activity. This herb may actually suppress estradiol synthesis since saliva levels in women who take this herb are very low.
6. Grape Seed Extract – Discovered in 1951 by the French scientist Dr. Jacques Masquelier, this amazing supplement has been shown to be a potent aromatase inhibitor. The ability of this supplement to inhibit aromatase may be very beneficial to women who suffer from estrogen dominance. In a study by Kijma, Phung, Hur, Kwok, and Chen (2006), grape seed extract was shown to possibly be a useful treatment in cases of hormone-dependent breast cancer. Grape leaves, especially the leaves of the red grape, have been shown to have astringent qualities, and this might be beneficial in treating heavy menstrual bleeding. In addition, the proanthocyanidins in grape seed extract are powerful antioxidants which can help keep the liver healthy. Although the data is insufficient, grape seed extract may also help in cases of premenstrual syndrome.
7. Melatonin – This hormone is produced in the pineal gland and is important in modulating our circadian rhythms. It is also a free radical scavenger, helps with the proper functioning of the immune system, and plays an important role in the regulation of sex hormones. Recent studies have shown this hormone may reduce binding to estrogen receptors while it increases binding to progesterone receptors. A study by Rato et al. (1999) showed melatonin interfered with the activation of an estrogen receptor by estradiol. Abd-Allah, El-Sayed, Abdel-Wahab, and Hamada (2003) showed a 59 percent reduction of estrogen receptors in rats that were treated with melatonin. In addition, this same group showed an increase in progesterone receptors of 53 percent in these same rats.
8. N-acetyl cysteine (NAC) – NAC is an excellent antioxidant and chelator of heavy metals. It is an excellent supplement as it aids in optimum liver function. It is derived from the amino acid cysteine and contains a good amount of sulfur.
9. Oregano – According to Zava et al. (1998), oregano is one of the six highest progesterone binding herbs. In addition, the volatile oils in oregano help to detoxify the liver.
10. Quercetin – Quercetin is a plant flavonoid and a strong aromatase inhibitor. A study done by van der Woude et al. (2005) showed that quercetin exerts phytoestrogen-like activity. The group states “the results point at the relatively high capacity of quercetin to stimulate supposed ‘beneficial’ [estrogen receptor] beta responses as compared to the stimulation of [estrogen receptor] alpha, the receptor possibly involved in adverse cell proliferative effects” (Abstract). Quercetin is found in red wine, green tea, onions, berries, and apples. It works best when taken with Vitamin C.
11. Rosemary – According to the Cleveland Clinic (2016), rosemary may lower estrogen levels. This herb is also anti-inflammatory, and its volatile oils aid in liver detoxification.
12. SAMe – Also known as s-adenosyl methionine, this substance is made in the body as a result of a reaction between methionine and ATP. Methionine must be supplied through the diet as it cannot be made by the body. SAMe is an excellent source of sulfur and helps to convert estradiol (E2) into the less harmful estriol (E3). SAMe has been used for PMS and premenstrual dysphoric disorder (PMDD), a more severe form of PMS. It has also been used to help with depression and may even be useful in liver disease. SAMe is an anti-inflammatory and used to relieve pain. An interesting study by Frezza, Tritapepe, Pozzato, and Di Padova (1988) looked at the use of SAMe in women who had a past history of liver disease called intrahepatic cholestasis of pregnancy (ICP). These women have an increased sensitivity to estrogen. They concluded “The data support the belief that SAMe acts as a physiological antidote against estrogen hepatobiliary toxicity in susceptible women” (Abstract).
14. Black cohosh – A member of the buttercup family, this wonderful herb has been used extensively by the North American Indians. It has a long history of use for premenstrual syndrome and menstrual cramping, and it may also be helpful with menopause symptoms such as irritability, hot flashes, and vaginal dryness.
15. Chasteberry – also known as Vitex, this herb is frequently advised for women who suffer from PMS. Chasteberry influences the pituitary to produce more lutenizing hormone (LH) which in turn signals the ovaries to produce more progesterone. So, this herb is especially valuable in women who are suffering from estrogen dominance.
9. Resveratrol – this wonderful supplement has numerous health benefits, one being an aromatase inhibitor. Since aromatase synthesizes estrogen, eating food with aromatase inhibiting action helps to lower estrogen levels and may possibly help to reduce adenomyosis symptoms. See “Hormonal Imbalance?” and “Treatments” for more information. Resveratrol can be taken as a supplement (usually extracted from the Japanese knotwood plant) or can be consumed by eating the following foods: red grapes, red wine, peanuts, or cocoa.
10. Good Quality Probiotic – this will support the gastrointestinal tract which will ensure proper elimination of estrogen from the body.
Try to avoid the following foods:
Excess saturated fats
When I was going through my struggle with adenomyosis, I could not get any relief from any medication that the doctors had given me. Believe me, I was put on a bunch of them. At the time, I had been diagnosed with irritable bowel syndrome (which was incorrect as I found out many years later). I finally got to the point of looking into holistic treatments since these medicines weren’t helping me.
About 8 years into my ordeal with adenomyosis, I came across an article about the health benefits of flaxseed, an excellent source of omega-3 fatty acids. I was so impressed that I immediately ordered some and added it to all kinds of foods, from spaghetti to yogurt. To my shock and amazement, my symptoms began to improve!
This led to my thesis work for my Master’s degree in Holistic Nutrition. I ended up publishing my thesis titled “The Health Benefits of Omega-3 Fatty Acids in Irritable Bowel Syndrome and Inflammatory Bowel Disease”. Remember, at the time I thought I was suffering from irritable bowel syndrome.
Although my symptoms had improved, they hadn’t gone away completely. Seventeen years into my struggle, I had a hysterectomy. The pathology report showed that I had deep, diffuse adenomyosis with possible fibroids. My symptoms stopped completely after this surgery. I was shocked to find out that I had actually had adenomyosis and NOT irritable bowel syndrome!
Recent research is now showing that there is a link between endometriosis symptoms and low intake of omega-3 fatty acids. Although as of yet I have not found studies on adenomyosis and diet, endometriosis is a similar disorder, and in fact the two disorders are often times seen together.
In 2010, an article was published by Stacey Missmer from Harvard University entitled “A prospective study of dietary fat consumption and endometriosis risk”. They analyzed 12 years of data from the Nurses’ Health Study II. They found that increased intake of omega-3 fats were associated with an decreased occurrence of endometriosis. In addition, those who had the highest intake of trans-fats were 48% more likely to be diagnosed with endometriosis. Their conclusion states that this “provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.”¹
There are many other studies that have been done recently that have come up with similar conclusions. Therefore, if you have either of these disorders, it might behoove you to remove trans fats completely from your diet and increase your consumption of omega-3 fatty acids.
¹Source: Pub Med: Missmer, Stacey A. et al. “A prospective study of dietary fat consumption and endometriosis risk.” Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, published in Human Reproduction (Impact Factor):4.67), 03/2010; 25(6):1528-35.