Research Abstract published in Fertility and Sterility

Volume 86, Issue 3, Supplement, Pages S270-S271, September 2006 P-365:

http://www.fertstert.org/article/S0015-0282%2806%2902300-4/fulltext - article-footnote-1 for a copy of this text.

Nutritional therapy provides an effective method of improving fertility rates and reducing abdominal pain in women with endometriosis. "What is one man's meat is another man's poison, may presumably have a chemical basis." Integrated medicine at the point of diagnosis may enhance treatment of women with compromised fertility and abdominal pain

Author: D. Shepperson Mills
The Endometriosis and Fertility Clinic, London, United Kingdom.

Objective

To demonstrate that nutritional therapy provides a method of relieving abdominal pain and improving the fertility rates in women with endometriosis in a cost effective manner.

Design

We review the health of women with endometriosis over six months using the Medical Research Council (UK) MYMOP questionnaire (Measure Yourself Medical Outcome Profile), designed by Dr. Charlotte Paterson MB ChB PhD, MRC research fellow, to measure outcomes from the patient's perspective.

Materials and methods

One hundred and eighty women with endometriosis treated over six months with nutritional therapy completed MYMOP questionnaires each month. They select 2 symptoms, 1 activity, and monitor their well being at the first consultation. This is scored on a scale of 0 to 6; 0 being as good as it could be, 6 being as bad as it could be; noting duration of symptoms, pharmaceutical medication taken, daily doses, and side effects, nutritional supplements and excluded foods. Adverse health effects exhibited when foods such as bovine dairy and wheat are reintroduced are recorded. Gluten and lactose tolerance tests are done. The patient re-score's the MYMOP monthly, adding a further symptom if necessary, indicating events impinging on their health, i.e. operations or changes in medication and how closely they follow dietary and nutritional supplement programme's. A one-hour nutritional consultation examines health history, nutritional deficiency signs, and dietary habits. An individualised programme of dietary changes and nutritional supplementation is prescribed and revised each month.

Results

MYMOP results allow observation of reductions in the normalised score over the months and measure the patients' improvement in symptoms. Patients with adverse reactions to wheat and dairy note an increase in abdominal pain and adverse bleeding patterns following reintroduction. The patient sample includes those on and off medication. We can track a reduction in the use of painkillers. The analysis looks at the symptoms chosen and where there is a pattern of symptoms we look for consistently high or low improvement scores. 86 per cent of patients showed an improvement in normalised MYMOP scores; 82 per cent avoid wheat due to adverse reactions, 60 per cent avoided bovine dairy. Fertility rates of 29.5 per cent were observed from 68 women presenting with infertility. The study gives an insight into the benefits of sound nutrition to patients with endometriosis.

Conclusion

An integrated medical approach to improving health looks for underlying factors in the diet that may cause or perpetuate a condition. Nutritional therapy highlights possible triggers in pain mechanisms that affect endometriosis. Immune reactions to certain foods may affect the way in which the body's immune system is able to deal with endometriosis. Foods affect the digestive system, the right type of fibre enables the body to excrete excess oestrogens by forming anti-oestrogen compounds, enterolactone and enterodiol, which are protective. We observe a cohort that displays adverse reactions to seemingly normal foods. Alongside orthodox medicine, nutritional therapy provides cost effective treatment and improves pain reduction and enhances reproduction. The Endometriosis and Fertility Clinic is committed to working towards the provision of integrated medicine. More collaborative projects, including patients, practitioners and researchers, should be carried out in the field of nutrition.