http://www.fertstert.org/article/S0015-0282%2805%2901944-8/fulltext - article-footnote-1 for a copy of this text.
Nutritional Counseling and Therapy Provides a Cost Effective Method of Improvement in the Pain Scores and the Sense of Well Being in Women With Endometriosis
Author: D. Shepperson Mills
The Endometriosis and Fertility Clinic, London, United Kingdom.
To demonstrate that nutritional counselling and therapy provides a cost effective method of improving the pain scores and the sense of well being in women with endometriosis.
To review the health progress of women with endometriosis using a medical audit, with MYMOP (Measure Yourself Medical Outcome Profile) scores. This questionnaire has been adapted from the MYMOP2 form of Dr. Charlotte Paterson MB ChB PhD, a research fellow at the Medical Research Council. This questionnaire is designed to explore and measure outcomes from the patient's perspective.
Materials and methods
A hundred women with endometriosis treated over six months with nutritional counselling and therapy, completed their MYMOP questionnaires at each monthly consultation. The women select up to 2 symptoms and 1 activity, and monitor their sense of well being at the first consultation. This is scored on a scale of 0 to 6; with 0 being as good as it could be, and 6 being as bad as it could be. The women state how long they have had these symptoms and write down any pharmaceutical medication taken, with their daily doses, noting any side effects. Nutritional supplement use is charted and foods that have been excluded from their diet are named. The adverse health effects exhibited when these foods are eaten are noted. Over each subsequent month, the patient is required to re-score the same symptoms, activity and sense of well being, adding a further symptom if necessary. They also give indications of external events, which have impinged on their general health, i.e. food poisoning, stress, operations or changes in their medication. They also score how closely they have followed their dietary and nutritional supplement programme. They note foods excluded from their diet and any adverse effects triggered when these foods are reintroduced. The one-hour nutritional consultation examines the individual patients' history, indications of nutritional deficiencies and dietary habits, using a comprehensive nutrition questionnaire. An individualised programme of dietary changes and nutritional supplementation is prescribed for the following month and revised at subsequent thirty-minute consultations.
From the MYMOP results we are able to see reductions in the normalised score over the months of treatment, which measure the patients' improvement in symptoms. 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. Over three months, 93 per cent of patients showed an improvement in normalised MYMOP scores. The study has allowed us to follow-up a cohort of patients who have undergone nutritional counselling and therapy. The paper presents the results of these patients over three months and six months of treatment, giving an insight into the benefits of sound nutrition to patients with endometriosis.
Nutritional counseling and therapy alongside orthodox medical treatments provides a cost effective method in the reduction of pain and improvements in the quality of life of women with endometriosis. The Endometriosis and Fertility Clinic is committed to working towards the provision of complementary medicine at the point of need. We conclude that further collaborative projects, which include patients, practitioners and researchers, should be carried out in the field of nutrition.