Diet and Endometriosis

Fiona McMahon, DPT

Yellow ribbon

Yellow ribbon, Bone cancer / Osteosarcoma. Endometriosis awareness.

March is Endometriosis Awareness Month. Endometriosis is a condition that is near and dear to our hearts at Beyond Basics Physical therapy. Endometriosis is a gynecological disease that occurs when a tissue similar to the lining of the uterus implants itself outside of the uterus in the abdominal and pelvic cavity. It is an inflammatory condition, whose symptoms can vary from mild to severe. Most commonly endo is seen as causing painful periods, but it can also cause bowel and bladder symptoms, issues with fertility, pain with sexual activities and general pain. For the past two years we have done a post about endometriosis during endometriosis awareness month on how musculoskeletal pain can be a contributor or the primary cause of abdomino-pelvic pain condition. To learn more about how the disease affects the body and its symptoms as well as how we treat the condition at BBPT click here:

For this year’s Endometriosis Awareness Day I decided to review an article on how diet may or may not affect endometriosis. The full version is here for free:

http://www.rbmojournal.com/article/S1472-6483(13)00007-2/abstract

About this Article

The article by Fabio Parazzini and his colleagues is a literature review. The point of a literature review is to aggregate many studies on one topic and determine a general trend in the data in one place. A literature review is not as powerful as its cousin a meta-analysis, in which more powerful statistical tools can be applied to interpret the data. Nonetheless, literature reviews can provide us with a general sense of what is going on in a certain field of research.

First things first, let’s talk about the limitations of this review. Designing a single study on endo and diet can be rather difficult. First of all, not all endo is the same. Women with endo can experience vastly different symptoms that don’t always correspond to the amount of endometrial deposits seen on laparoscopy. It can be really difficult for researchers to ensure they have a homogeneous (or similar) study population. Secondly, studying something like diet it usually correlational and not causal. Diet can reflect a lot of other components besides the nutrients going into one’s body. Diet may reflect factors such as culture, wealth, education, geographic region, which all may play independent roles in the diagnosis and progression of endo. Most of the studies examined were based on self-report, which also may not be entirely accurate.

Now that we have the caveats out in the open, let’s talk about why a study like this is useful. Like I said before, this article is an aggregation of multiple other publications. When we see similar results produced by different authors in different groups of people, it lends a little more weight to the individual study’s findings. Most importantly Parazzini is also careful to include information on why a particular food group may be more beneficial or even harmful in the progression of endometriosis.

What the Article Found

Green Vegetables and Fruit

The authors found two studies that show that a higher intake of green fruits and vegetables reduce the risk of endometriosis. They found that the higher the intake of green fruits, specifically (think okra, etc) caused the decreased risk of endometriosis and did not find the same relationship with green vegetables (think kale, spinach, and lettuce). Parazzini notes that green vegetables and particularly fruit are high in a compound called organochlorine, which has been shown in other studies to reduce the risk of endometriosis. Organochlorines are a particularly broad class of molecules and can be found in healthy things but also make up compounds used in industrial purposes. This study is referring to those occurring naturally in vegetables and fruits.

Vitamin A

Vitamin A is found in animal products like fatty fish, dairy, and animal kidneys and livers. Its building blocks are found in green and orange vegetables and fruits and can be manufactured into vitamin A in the body. Parazzini and colleagues found mixed results some with no benefit for development of endo and some that did show benefit. No studies showed harm.

Vitamin C and E

These vitamins were not consistently found to be helpful in reducing endometriosis risk. Some studies reported that increased amounts of vitamin C and E intake reduced risk of endometriosis, while other studies failed to yield significant findings. Parazzinni did provide evidence from other studies which demonstrates the antioxidant properties of vitamins C and E. Parazinni purposes that because there may be a link between oxidative stress and disease, vitamin C and E may be helpful in reducing the inflammation associated with endometriosis.

Red Meat and Saturated Fat

Again, results were mixed. Saturated fat mainly occurs in animal products. Some studies found a correlation between red meat and endo risk, but no association with butter. In other the results were flipped.

Other items investigated

  • Soy
  • Olive Oil
  • Fish and Omega 3
  • Minimal to no evidence supporting associations between endo and dietary intake for any of these products were found.

 

What’s it All Mean?

One of my patients once told me she was instructed to finish every study, with the phrase, “more research is needed.” This is certainly the case in the field of endometriosis treatment. There’s a lot about endometriosis that we don’t understand We need well constructed studies that will allow researchers to do more powerful meta-analysis to help guide our treatment. This review was only able to include 11 studies for review out of the 256 initially found.

With all that said, I do think there are some key takeaways from this study. There was a general trend in healthier foods and more promising results. Parazinni was also diligent to include mechanisms by which these healthy foods could be helpful. Secondly, there was no harm found by eating what is considered a healthy diet, (high in greens and vitamins). These findings, although small, in combination with the general benefits of a healthy diet, should encourage patients with endo to explore in more depth how eating certain foods affects their symptoms.

At Beyond Basics we take pride in treating our patients from a holistic perspective and we appreciate that we can collaborate with other healthcare providers in our community, including expert nutritionists, naturopaths, functional medicine doctors and mental health therapists. We find that the combination of diet, specific physical therapy techniques, mental health and self-care, can significantly reduce pain and other symptoms and improve function in many patients. Our clinicians specifically are experts in manual therapy techniques such as visceral and connective tissue mobilization techniques, myofascial release and other soft tissue mobilization techniques discussed in the previously mentioned endometriosis blogs. If you are suffering from endometriosis, come visit us today.

Learn more about what we do at BBPT with our upcoming PH101 classes, which are free to the public. Here are some you may find interesting:

April 6th: Does my diet really matter?

April 13th: Pain & Sexuality: Is it all in my head? No, it is not!

April 20th: Ladies Only Session

April 27th: Optimize reproductive health

May 4th: Improve your birthing experience.

All events are at 7pm with light snacks.

Register at: pelvichealth-101.eventbrite.com because space is limited!!

See full list of classes below

pelvic-health-101-spring-2017

PH101: Something’s Wrong with my What?

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Image via PlayBuzz

On March 16, 2017 at 7pm we will be kicking off our spring semester of pelvic health education class, we call Pelvic Health 101 (PH101). In our first class we will be introducing you to the pelvic floor muscles, where they are, what they do, and how they relate to the health and function of your bowel, bladder, and sexual functioning. We will also be covering how things such as alignment, posture, muscle tone and nerves can affect your symptoms. This course is a great starting point to help you understand your pelvic floor and pelvic floor symptoms.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth-101.eventbrite.com

Here is our line up of this and future classes:

pelvic-health-101-spring-2017

PH101: Reproductive Health and Nutrition with Melissa Stendahl, DPT & Nutritionist Jessica Drummond, MPT, CCN, CHC.

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Fiona McMahon, DPT

Being able to get pregnant is sometimes a little harder than society will have us believe. The female reproductive system is a complex and intricate part of our bodies and there are many factors that go into fertility. If having children is a goal of yours, do not miss our free reproductive health seminar on November 10th at 7pm with nutritionist, Kamila Veljkovic and physical therapist, Melissa Stendahl. They will be discussing how both nutrition and pelvic and abdominal tissue health can optimize your reproductive function and help with painful reproductive conditions like endometriosis and pain with intercourse.

 

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

 

Check out our upcoming courses!

Pelvic Health 101 Fall- (003)

Ryanne Glasper and Melissa Stendahl Expand Their Expertise with Additional Hands on Training!

Melissa Stendahl, PT, DPT

In June, my colleague Ryanne and I had the opportunity to attend the American Physical Therapy Association’s  Gynecological Visceral Manipulation Course, taught by Gail Wetzler, PT, DPT, EDO, BI-D.

Gail is well known for her visceral (organ) mobilization skills and teaching worldwide with Jeanne-Pierre Barral of the Barral Institute. She is a leader in the physical therapy field and in education for women’s health, manual diagnostics, visceral structures and disorders, and integrative therapies for animal health. She is dedicated to techniques to help balance the body’s systems for optimal function. Gail is considered an excellent and sought-after instructor in advanced manual therapy techniques for PTs.

In class, we learned how to assess the  biomechanics and mobility of the pelvic organs (including reproductive organs, the urinary system, and the rectum). We learned  treatment techniques for these structures, and how to integrate these findings and techniques into PT treatment for injuries and disorders affecting posture, core stability, spinal mechanics, and overall movement. Having these skills helps the PT to more successfully and specifically treat pelvic conditions that affect bowel, bladder, reproductive and sexual function. It takes hard work and practice to develop the sensitivity to feel the organs and their potential restrictions, and the PTs at Beyond Basics have all taken advanced training to enhance this skill  because of its importance for our specialty in returning patients to good bowel, bladder, and sexual health and reducing pelvic pain.

We did a detailed anatomy review and excellent hands-on time with lab partners to refine these techniques for our own individual practice! Did you know: neighboring structures “talk” to each other within the body? For example: the liver  is a large organ located within the parietal peritoneum. This peritoneum is a membrane (a thin covering) that wraps around the liver and many other organs in the abdomen. It travels just next to, but does not enclose, the pelvic organs. This membrane becomes neighbors with the bladder, uterus, and rectum. If the liver  is damaged, injured or restricted, the peritoneum membrane enclosing it can tighten in response, kind of like how your arm muscles might tighten up or spasm to help protect you after a shoulder dislocation.  But since the peritoneum is also neighbors with the pelvic organs, this tight restriction at the liver can also result in tension all the way down to the bladder, uterus, or rectum, contributing to urinary or bowel dysfunction or pain! So it may be possible that assessing and treating these lines of tension can help get rid of lingering pain or incontinence, and is a great example of how structures near or even far from the original site of dysfunction can be involved.

So what is a PT really treating when they do “visceral manipulation”? Good question. PTs do not take the place of physicians who specialize in organ function and hormones, like urologists, colorectal, GI or Endocrinologists. But PTs can influence the mobility and positioning of the organs in the abdominal and pelvic cavities, so that they can move and glide as you bend over, run, poop, pee and ovulate, and to reduce inflammation from injuries, or adhesions like scar tissue from surgery. This can be a very valuable treatment option to promote better organ function for digestion, bowel, bladder, sexual and reproductive health.

Link to Gail’s site (https://wetzlerptcenter.wordpress.com/meditate-zen1.jpg

PH101: Pain and Sexuality: Is it all in my head?

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By Fiona McMahon, DPT

Sex should feel good… really, really good. But when it doesn’t, you may start to wonder, what’s wrong with me? Am I broken? Am I a prude? Am I frigid? Painful sex isn’t something we talk about. No one would look at you twice if you walked into work complaining of pain in your elbow, but if you walk into work complaining about pain in you vagina or penis, you may end up having a meeting with HR.

On October 6th at 7pm, we at Beyond Basics are breaking down those taboos and having an educational seminar, followed by an optional question and answer session at the end. We will discuss the many causes of sexual pain and how physical therapy can help.  The event will be hosted by one of our therapists, Stephanie Stamas, DPT, ATC. Stephanie will give a detailed seminar about pelvic health and take time to clear up some common misconceptions many people have concerning their bodies and sexual function.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth-101.eventbrite.com

Here is our line up of this and future classes

Pelvic Health 101 Fall- (003)

Beyond Basics’s Pro-Bono Clinic for PT Day of Service!

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Victoria LaManna, DPT

October is around the corner! And a busy month for many. Whether you are getting back into the swing of school or work after summer vacation, preparing your Halloween costume or getting ready for all the upcoming holidays right around the corner – there is a lot going on!
This time of year is also an opportunity to do good and give back. October is National Physical Therapy Month, where physical therapists celebrate their amazing field of healing and getting people back to optimal function. In addition, many of the PT’s throughout the U.S. give back to their communities during this month. This year we are taking it up a notch. Physical therapists WORLDWIDE are getting involved for the second annual Global PT Day of Service Saturday, October 15th. Whether it is by hosting a pro-bono clinic, serving in a soup kitchen, participating in a 5k for a cause, or cleaning up a community garden – physical therapists globally as a profession are coming together to make a positive impact on the world around them.
At Beyond Basics, we have decided to host a pro-bono clinic Saturday, October 1st to give back to those in the New York City area who may not have insurance or access to physical therapy. We are providing 30 minute one-on-one evaluations and recommendations for home programs to up to 30 participants. For more information and to sign up please visit: http://signup.com/go/Nu1T4Q
You can also check out PT Day of Service here and follow on twitter (#PTDOS) to see how the day unfolds! http://ptdayofservice.com/
The American Physical Therapy Association (APTA) is also involved in hosting National Physical Therapy Month. This year the APTA’s focus is on it’s national public awareness campaign, #ChoosePT. This campaign lets consumers know about the risks of opioid use and that physical therapy is a safe, non-opioid alternative for managing pain.
I encourage you to check out educational resources provided by the APTA (www.apta.org) and Move Forward PT (http://www.moveforwardpt.com/Default.aspx). Learn all about how physical therapy can help you overcome pain without the use of opiods, improve mobility and maintain independence throughout your lifetime.

day-of-service

Pelvic Health 101 is Back and With ALL NEW Courses Added

Fiona McMahon, DPT, PT

Pelvic Health 101 is back with some old favorites like, “Something’s wrong with my what?” and “Why is pooping so difficult?” as well as some new additions to our curriculum such as “Does my diet really matter?”, a look into how diet can affect pelvic floor conditions, and “ How does pregnancy & birth affect my body?”.

If you have questions, we have answers. Join us for lectures and question and answer opportunities with expert pelvic health physical therapists, childbirth educators, nutritionists, and yoga instructors. Please reserve your spot early at pelvichealth-101.eventbrite.com. Remember spots fill up quickly. As always, light refreshments will be served.

Pelvic Health 101 Fall- (003)