Dietary modification to alleviate endometriosis symptoms

interview between nutritionist Dian Shepperson Mills and Dr Mark Perloe

Dr Mark Perloe

Mark Perloe: “I’m Mark Perloe and I’m here with the American Society of Reproductive Medicine meeting in Seattle, Washington [October, 2002] and I’m with Dian Mills who recently updated her book on nutrition. We talked earlier about how nutrition plays a role in fertility but I understand that the book is a bit more comprehensive. Can you first of all tell us the title of the book and when the new edition will be out?”

Nutritionist, Dian Shepperson-Mills


Dian Mills: “Yes, the new edition was out in America on the 1st of August 2002. Mike and I have rewritten three new chapters in the book, one on the ovary, one on the nervous system because when I was in Helsinki the Danish and Swedish groups were saying, ‘Why are we so depressed all the time?” so I’ve explained a little bit about that. Then I put another in on food and what to eat and how to prepare shopping lists, more about these and everything else like that.”

Mark Perloe: “One of the theories about endometriosis that I was so interested in is, women who had endometriosis. It may actually not be the endometrial implant that is to blame. There are women who have bladder systems, interstitial cystitis and have bowel related symptoms and fibromyalgia. There is a lot of thinking that perhaps this is a disorder of para-sympathetic nerve connection or pelvic neuropathy. What role would nutrition play in dealing with pelvic pain aside from the actual presence of a lesion?”

Dian Mills: “Well, this is a good question because I always suspect that a lot of the pain which we get with endometriosis, I don’t know that it’s necessarily caused by the endometriosis itself. I think there are a lot of immune products in the peritoneal fluid, which are increasing inflammation, which are causing the bowel and bladder to go into spasms. Also you can look at digestion because if a person is not absorbing the nutrients correctly, due to whatever reason, that could also lead to more higher levels of pain perception in the body because they are not taking in the nutrients that would help dampen down the pain pathways.”

Mark Perloe: “What nutrients specifically might be involved?”

Dian Mills: “Ah, now this is interesting because there are lots of research papers on pain and nutrients. Vitamin C is an antihistamine so it can dampen histamine release. Vitamin E can help with pain because that will also help with histamine release and it also works as an antioxidant that can stop cell damage at the membrane if you’ve got free radical damage damaging the cell membrane, which could be weakening the cell membrane so that the endometriosis can attach. And the B vitamins, especially B1, B6 and B12 when taken in combination, work as well as any analgesic when they are in the right level in the body.

Essential fatty acids, like omega-6 fatty acids from linseed oil and fish omega 3, evening primrose oil, borage oil, star flower oil front the six. What I find very interesting is that when people are eating a lot of processed foods they are taking in trans-fatty acids. That’s fats that have been hydrogenated and they’ve been changed in their shapes so they don’t lock into cells in the same way. Fats that are natural, the cis fatty acids have a horseshoe shape and lock into cell membranes and give them integrity.

Whereas the trans fatty acids form just a kink shape and the cell membrane loses its integrity, oils and magnesium are important at the cell membrane as they are seen from research to stop cancers attaching. So if you can change the balance to improve good cis oils and remove the bad trans oils from the diet it may be giving the cells more integrity. Also, if we think about this logically, all the hormones, so if you are using the correct oils and they’re being metabolized into prostaglandins series one and three, which are anti-inflammatory and you reduce the oils in dairy and meat which are pro-inflammatory, series two prostaglandins, you can possibly, or we see this happening, reduce pain levels.

The other interesting thing that I found is that there has to be some mechanism with wheat with endometriosis. Wheat has been genetically modified and there are two hormones out of two, the genome. There is also problems with gluten sensitivity, and more people are becoming gluten sensitive and I find that when I’ve taken wheat out of the diet, in 80% of the women with endometriosis, their pain subsides.”

Mark Perloe: “Fascinating.”

Dian Mills: “And when they reintroduce the wheat the pain comes back.”

Mark Perloe: “Is this all wheat flours? I mean are they, buckwheat, which is a protein, or whole wheat do you have it as much as the processed wheat?”

Dian Mills: “Whole wheat, all wheat is a problem. Anything with wheat flour, like pastry cakes, pizza, pasta. Buckwheat isn’t wheat; that’s rhubarb family. That’s the same plant as rhubarb, so buckwheat isn’t wheat. That works in a different way. But there’s something different. I think there may be the hormones in the wheat or the phytic acid is locking up some of the minerals but certainly there seems to be some modality with wheat and endometriosis. It’s almost as though something within wheat is exacerbating the implant.”

Mark Perloe: “Some of us are going to get on a wheat-free diet. Would you just say try this for a period of time and see if it works?”

Dian Mills: “Yes, I would say try it for two months. Don’t have anything with wheat in, modified starch, malto-dextrins, dextrins, rusk, you know anything like that, avoid. Rye, Ryvita, rye breads, rice cakes, rice, rice noodles, corn pasta and corn and rice pasta. Anything made with lentils, like popadoms; what else is there, minute buckwheat would be all right. You replace the wheat with other foods so that you are not lacking in any in any nutrients. Do that for 28-30 days alongside taking multi-vitamins and evening primrose and fish oil. Magnesium is helpful because that relaxes muscles in the uterus and the bowel. And also you may need to take a digestive enzyme and an acidophilus if you have digestion problems. And if you do that for a month and then challenge yourself with one slice of bread and see what symptoms recur over the next 24 hours. That’s quite a good way of looking at if you’ve got a food intolerance. You can do it with dairy foods as well. You will then know whether it is creating more pain and bloating, certainly abdominal boating can be reduced.”

Mark Perloe: “Well, I think that’s wonderful. How would people learn more about the book if they wanted to order it online do you have a website where they can get more information?”

Dian Mills: “Endometriosis: A Key to Healing and Fertility Through Nutrition, by Dian Shepperson Mills and Mike Vernon and the publisher is Thorsens Harper Collins.”

Mark Perloe: “Thank you so much, Dian.”

Dian Mills: “Thank you very much.”

Contact details for Dian Shepperson Mills
  • The Hale Clinic, London (to book an appointment please call +44 (0)20 7631 0156)
  • The Putney Clinic, London (to book an appointment please call +44 (0)20 8789 3881)
  • The Endometriosis and Fertility Clinic, Hailsham (to book an appointment or to arrange for a telephone consultation please call +44 (0)1323 846888).

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