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 An Excerpt from Foods That Fight Pain, Using Foods against Menstrual Pain
A few years ago, a young woman called me to ask for pain-killers. She was having menstrual cramps that were so excruciating she was unable to work. She was actually unable to do much of anything except lie in bed and wait for the pain to go away. Her mother had had the same problem and needed Demerol, a narcotic pain-killer, for a few days every month in order to function. I told her that I would be glad to prescribe pain-killers for a few days, but also suggested that she try a diet change, just as an experiment, for the next four weeks. She agreed, and a month later she called again. She felt wonderful. The disabling pain that had arrived month after month had simply not come back. She had virtually no discomfort at all. At the time, I was not entirely sure that what I had suggested would work, because we did not know then what we know now about how foods affect hormones. But I had made an educated guess and it worked wonderfully. I described this episode in a previous book, Food for Life, and some months later I received a letter from Ellen Moore of Houston, Texas. She had tried the nutrition approach I recommended. In the process, she wrote, she lost four dress sizes and her energy level increased. "The greatest benefit of all, however, is that since January I have not had to take even one extra-strength Tylenol for menstrual cramps," she wrote. "This is a miracle of the first order. As a teenager, I can recall having cramps so severe that not even Percodan or Demerol provided complete relief. Now I finally am able to live a normal life." What Causes the Pain? Menstrual pain is significant in about half of women, and in up to 10 percent it is severe enough to interfere with work and other activities for one to two days every month. Sometimes it diminishes after childbirth, but for many it continues. (Mersky 1994) In the 1960s, it became clear that chemicals called prostaglandins are a central part of the problem. In a previous chapter [of Foods That Fight Pain], we saw how these chemicals are made from the traces of fat stored in cell membranes and that they promote inflammation. They are also involved in muscle contractions, blood vessel constriction, blood clotting, and pain. Shortly before your period begins, the endometrial cells that form the lining of the uterus make large amounts of prostaglandins. When these cells break down during menstruation, the prostaglandins are released. They constrict the blood vessels in the uterus and make its muscle layer contract, causing painful cramps. Some of the prostaglandins also enter the bloodstream, causing headache, nausea, vomiting, and diarrhea. (Chan 1983) Researchers have measured the amount of prostaglandins produced by the endometrial cells in women with menstrual pain and found that it is higher than for other women. (Ylikorkala 1978) The concentration of prostaglandins circulating in the blood is higher, as well. (Chan 1983) This helps explain why nonsteroidal anti-inflammatory drugs work for menstrual pain. Ibuprofen (Motrin), naproxen (Anaprox), and other NSAIDs reduce the production of prostaglandins. For most women and their doctors, that is the end of the story. For a few days each month, pain-killers battle with prostaglandins. The problem, however, is that for many women the relief is far from complete. They find themselves taking more than the recommended doses, but not getting the relief they need. Using Foods against Pain There may be a more fundamental approach. Rather than focus on the prostaglandins themselves, it may help to focus on the cellular "factories" that make them. After all, we know that birth control pills reduce menstrual pain, and they apparently do this by reducing the growth of the endometrial cell layer. The smaller this layer of cells is, the less tissue there is to make prostaglandins. In my conversation with the young woman mentioned at the beginning of this chapter, I hypothesized that foods might be able to do the same thing, because foods have a profound effect on your hormones. In every monthly menstrual cycle, the amount of estrogens in a woman's body rises and falls.* Estrogens are female sex hormones. You can think of them as a sort of hormonal fertilizer, making the cells of your body grow. Estrogens are responsible for breast development at puberty, and each month, they cause the lining of the uterus to thicken in anticipation of pregnancy. If you were to measure the amount of estrogens in a woman's bloodstream as her period ends and a new cycle begins, you would find that it is gradually rising. For about two weeks, it rises toward a peak and then falls quickly around the time of ovulation. It rises again in the second half of the month and then falls just before her next period. The uterus sheds its lining in a menstrual flow, accompanied by crampy pain. When the young woman called to ask for help with menstrual cramps, I simply helped her choose foods that would keep her estrogen level from rising so high. The goal was simply to smooth out the hormone roller coaster, so that the changes in her uterus would not be quite so dramatic. How Foods Change Hormones The amount of estrogen in your blood is constantly being readjusted. Some foods push hormone levels up. Others bring them down. Here's how it works: Fat drives estrogen levels up. Any kind of fat will do it: chicken fat, fish fat, beef fat, olive oil, canola oil—you name it. It does not matter if it is animal fat or vegetable oil; the more of it there is in your diet, the more estrogen your body makes. If you cut the amount of fat in your diet, the amount of estrogen will be noticeably reduced within the very first month. Cancer researchers have taken a great interest in this phenomenon, because lowering the level of estrogen in your blood helps reduce the risk of breast cancer. Less estrogen means less stimulation for cancer cell growth. If a woman eating a Western diet cuts her fat intake in half, her estrogen level will be about 20 percent lower. (Prentice 1990) If you cut the fat even more, your estrogen level will drop further. That is a good change. If your hormone level does not rise too high, it will have less effect on your uterine cells. I hypothesized that a change in estrogen is what gets the credit for the newfound comfort that many women experience when they change their diets. I discussed these findings with Anthony Scialli, M.D., a gynecologist at Georgetown University Medical Center, and we decided to see whether the benefits I had seen in individuals would also be found in larger numbers of women. We tried the diet change in a group of 33 women who suffered from moderate to severe menstrual pain. Every Tuesday evening, they came to the office of my organization, the Physicians Committee for Responsible Medicine, where we discussed how foods affect the body and how to change the diet in order to reduce hormone production. Jennifer Raymond, who produced the recipes for this volume, gave cooking classes. We asked everyone to avoid all animal products and added oils for two months, and to focus on simple, unprocessed foods, such as rice and other whole grains, beans, vegetables, and fruits so that the diet was very rich in natural fiber. As we tracked the results, some women noticed no change. But many noticed a major difference, and for some the change was profound. Their pain was gone or dramatically reduced, something they had not experienced for years. If they needed any pain medicine at all, they needed much less than before. After two months, we asked part of the group to return to their previous diet so we could compare the effects. To our surprise, many were extremely reluctant to do so. They had less pain, they had more energy, and they had lost weight. Although it had taken a couple of weeks to get used to the new way of eating, they had become very attached to it. They began to view meat and other fatty foods as an enemy that had caused their problems. The diet change was designed to do two things. First, it eliminated all animal fats and nearly all vegetable oils. Less fat in the diet means that less estrogen is produced, which is a good thing. Second, plant foods also increase the amount of plant roughage (fiber) in your diet, which helps your body to get rid of excess estrogens. Estrogens are normally pulled from the bloodstream by the liver, which sends them through a small tube, called the bile duct, into the intestinal tract. There, fiber soaks them up like a sponge and carries them out with the wastes. The more fiber there is in your diet, the better your natural "estrogen disposal system" works. Animal products never have any fiber at all. If fish, chicken, yogurt, or other animal products make up any substantial part of your diet, there will be less fiber in the digestive tract. The result is disastrous. The waste estrogens, that should bind to fiber and leave the body, end up passing back into the bloodstream. This hormone "recycling" increases the amount of estrogen in the blood. But you can block it with the fiber in grains, vegetables, beans, and other plant foods that keep waste estrogens headed toward the exit. So, by avoiding animal products and added oils, you reduce estrogen production. And by replacing chicken, skim milk, and other fiberless foods with grains, beans, and vegetables, you will increase estrogen elimination. Putting Foods to Work You can do this yourself. The key is to follow the diet exactly, so that you can see the effect it has for you. Have plenty of:
Avoid completely:
This sounds like a significant change, and it is. However, we have found that, while everyone feels a bit at sea for the first several days, virtually everyone makes the change in about two weeks. Those who have the best time with it are those who experiment with new foods and new food products and who enlist the support of their friends or partners at home. As the benefits kick in—reduced menstrual cramps, incredibly easy weight loss, and increased energy—the diet change is so rewarding that you will only wish you had tried it sooner. It is important to avoid animal products and oily foods completely. Even seemingly modest amounts of them during the course of the month can cause more symptoms at the end of the month. Be sure to have your foods in as natural a state as possible, choosing brown rice instead of white rice and whole grain bread instead of white bread in order to preserve their fiber. Give this experiment a careful try for just one cycle, and you will see what it can do for you. You will very likely start to look at the power of foods in a very different way. Calcium Balance There are parts of the diet, aside from the amount of fat and fiber you have, that can affect how you feel. Calcium, vitamin B6, essential fatty acids, and other factors all play a role. First, calcium. Evidence suggests that getting into better calcium balance can help reduce both menstrual pain and PMS. Not all women notice an effect, but some do. Calcium may particularly help women with milder symptoms; the benefits for those with more severe symptoms are not known. In a study of 33 women, calcium carbonate supplements (1000 milligrams per day) reduced both pain and PMS symptoms. (Thys-Jacobs 1989) Another study of ten women with normal menstrual cycles and only mild menstrual symptoms, a combination of calcium and manganese reduced menstrual pain and premenstrual water retention, and also improved mood and concentration. (Penland 1993) Although these studies show that improving calcium balance can help, it may be that taking more calcium in the diet or in supplements is not the most important issue. Most of the calcium that we consume ends up being excreted. Sixty to 70 percent is not even absorbed by the digestive tract and simply passes right through, and a portion of that which is absorbed ends up being lost in the urine. The key is to reduce calcium losses. As we saw in the chapter on back pain, the amount of calcium your body loses minute by minute is strongly affected by several specific factors. First of all, animal proteins increase calcium losses by increasing the amount of calcium your kidneys remove from the blood and excrete in the urine. When people avoid animal proteins, their calcium losses are cut to less than half what they had been. (Remer 1994) Calcium losses can be further reduced by:
Having said that, you do need calcium in your diet, and the healthiest sources are green leafy vegetables and legumes (the group that includes beans, peas, and lentils), rather than milk, which has no fiber at all and has many other ill effects. Vitamin B6 Vitamin B6 (pyridoxine) has been shown to reduce pain in some research studies. It has been used to increase resistance to pain in people who are withdrawing from overused pain medications, in carpal tunnel syndrome, in nerve pains of diabetes, and other conditions. (Bernstein 1990) It apparently works by increasing the production of neurotransmitters that inhibit pain sensations. B vitamins also appear to play a role in controlling estrogens, by facilitating their removal in the liver. If your diet is low in B vitamins, the amount of estrogen in the blood may rise. (Biskin 1943) Vitamin B6 has also been shown to help with depression, irritability, and other symptoms in some research studies. (Abraham 1987, Kleijnen 1990) The usual B6 dose is in the range of 50-150 milligrams per day. Avoid higher doses, as they can actually cause nerve problems. To treat premenstrual headaches, some people have used a combination of vitamin B6 (50-150 milligrams) and magnesium (200 milligrams) per day. This combination is most effective when used daily, but can also be used for just five days per month. Pyridoxine has been effective when used with GLA (see below) for premenstrual symptoms. (Abraham 1980, Brush 1988) Even though research studies show these supplements to be safe in these doses, I recommend that they be used under the guidance of your physician, who can monitor your progress and tailor your treatment to your needs. Vitamin B6 occurs naturally in whole grains, beans, bananas, and nuts. This is another reason to use whole grains. When they are refined, they lose much of their B6 along with their fiber. The amount of B6 that you need may depend on how much protein is in your diet. The vitamin is used to metabolize protein. The typical European or North American diet is very high in protein from meats, dairy products, and eggs, and it can tend to deplete the amount of B6 you have available. Plant products have adequate protein, but help you avoid the excesses. Essential Fatty Acids As mentioned at the beginning of this chapter, prostaglandins are involved in muscle contractions and menstrual pain. Many of the pain-killing medicines that are commonly used to treat menstrual pain work by inhibiting the effects of prostaglandins. Prostaglandins are made from the fats stored in your cell membranes. In turn, these fats reflect the contents of your plate. There is not very much fat in green, leafy vegetables and legumes (beans, peas, and lentils), but the fat that they have is strongly balanced toward anti-inflammatory omega-3 fatty acids, rather than other fats. If your diet is rich in these foods, and eliminates meats, dairy products, and added oils, you will get the omega-3's you need. (Deutch 1995) Indeed, women whose diets are balanced in favor of omega-3s, rather than other fats, tend to have milder menstrual symptoms. You want to make this change anyway, as it helps you to reduce estrogen production, and the rebalancing of your diet toward omega-3s is an added bonus. Some people adjust their fat balance by adding extra omega-3-rich oils, such as flax oil, to the diet to counteract the "bad" fats in meats and dairy products. Another approach is to use an omega-6 fat called GLA, or gamma-linolenic acid, which suppresses the production of prostaglandins that would otherwise encourage inflammation. The disadvantage of this strategy is that it adds five to six grams of fat to your daily diet, while a low-fat, vegetarian diet does the same thing with no added fat. If, however, the remainder of your diet is very low in fat, the effect of these added oils on your total fat intake will not be great, and their effect on your prostaglandins will be that much more pronounced, since they will have fewer other fats to compete with. Some investigators caution that GLA should not be used if you are or may be pregnant, since it may increase the possibility of miscarriage. Phytoestrogens Certain foods that are common in Asian and vegetarian diets have special effects. Soy products, for example, such as miso soup, tofu, and tempeh, contain very weak plant estrogens, called phytoestrogens, that reduce your natural estrogens' tendency to attach to your cells. (The prefix phyto simply means "plant.") Normally, estrogen attaches to the surface of your cells by hooking onto tiny receptor proteins that allow it to change the chemistry inside the cell. An estrogen molecule is like a jumbo jet that lands at an airport and hooks onto a jetway. It discharges its passengers through the jetway into the terminal, which is suddenly a busy, noisy place. Phytoestrogens, being very weak estrogens, are like a tiny private plane that has few passengers and no cargo, but can still occupy the jetway. They prevent your normal estrogen from attaching and acting on the cell. Plant estrogens do not eliminate all of estrogen's effects, but they do reduce them. The result appears to be reduced breast cancer risk, and possibly reduced menstrual symptoms. Because phytoestrogens are weak estrogens, however, they may have a different effect in women after menopause, whose bodies make much less estrogen. In these women, phytoestrogens may actually have a slight estrogen effect, which may help reduce hot flashes and other menopausal symptoms. Although soy products are particularly rich in phytoestrogens, they are also found in many other legumes, vegetables, and fruits. The more of these foods you include in your routine, the better. Natural Progesterone During the normal monthly cycle, estrogen dominates during the first half of the month, causing the uterine lining to thicken in anticipation of pregnancy. During the second half of the month, a different hormone, progesterone, dominates. Among other jobs, progesterone opposes the actions of estrogen, preventing too much stimulation of the uterus. Progesterone is only made if you ovulate, i.e. an ovary releases an egg. If that does not happen for whatever reason, there is no progesterone to oppose estrogen. In order to restore hormone balance, doctors sometimes prescribe synthetic progesterone derivatives (e.g. Provera). Unfortunately, they have a long list of side effects. An equally effective and much safer form is available without a prescription. Natural progesterone is derived from yams or soybeans, and is an exact duplicate of human progesterone. The most common and convenient brand, Pro-Gest, is a transdermal cream that releases progesterone through the skin. It is available from Transitions for Health (800-648-8211). To use natural progesterone for menstrual pain, use 15 to 20 milligrams per day from day 12 of your menstrual cycle through day 26 (counting the first day of bleeding as day 1), and then stop until the next month. Rather than measuring this amount each day, you may find it easier to simply aim to use up one-third of a two-ounce jar over this period of time. Simply apply the cream to areas of thin skin, covering as wide an area as possible. Allow two to three months to see benefits. Stopping the progesterone in advance of the day you anticipate your period will start allows the normal shedding to occur. If symptoms of premenstrual tension are prominent, you may need a higher dose. Use 30 to 40 milligrams per day, from day 15 to 26, which will consume about half a two-ounce jar each month. After a few months, begin to reduce the dose as symptoms abate. The rationale for the higher dose is that emotional tension is accompanied by the release of the "stress hormone" cortisol, which competes with progesterone for receptors on the cells. Fibroids Underneath the lining of the uterus that is designed to nourish a growing baby is a muscle layer that allows the uterus to contract. Sometimes pockets of these muscle cells overgrow into a knot, called a leiomyoma or, more commonly, a fibroid. Fibroids are not cancerous. Most cause no symptoms at all, and small, symptomless fibroids are present in up to three-quarters of women in the United States. Sometimes, however, they can become large and painful. What starts this process is not known. It does appear, however, that estrogen makes fibroids grow, which is why the usual "treatment" recommended by gynecologists is simply to wait. When menopause arrives, fibroids shrink on their own as the amount of estrogen in your blood naturally drops. As you know by now, you do not have to wait for menopause to get estrogens under better control. The low-fat, high-fiber diet described above reduces estrogens dramatically, and is a good first step in addressing fibroids. In addition, you may wish to consider using natural progesterone. It counteracts the effects of estrogen and can be used to keep fibroids from growing, and perhaps even to shrink them. A typical regimen would be to use 15 to 20 milligrams per day from day 12 to day 26 of your menstrual cycles, which means using up about one-third of a two-ounce jar per month. Endometriosis Sometimes there are specific, identifiable causes of menstrual pain. One of the most common is endometriosis, in which some of the lining cells from the inside of the uterus end up in the wrong place. They are attached to the ovaries, intestinal tract, bladder, or elsewhere. And just as the cells inside the uterus swell and are shed each month, these misplaced cells do exactly the same thing. They swell and bleed, causing pain and infertility. More than 5 million women in North America have been diagnosed with endometriosis, which is about 10 percent of women in their reproductive years. (Ahlborg 1995) It runs in families to a degree, but genetic factors are not strong. If you have endometriosis, there is about a four to five percent chance that your mother or a sister will also have had it. (Moen 1993) After menopause, endometriosis is rare, except in women who take supplemental estrogens as part of hormone "replacement" therapy. Endometriosis starts with cells that are wandering in the wrong direction. Normally, the uterine lining cells pass downward and out of the body during menstruation. But sometimes these cells slip through the fallopian tubes that lead to the abdominal cavity. From there, they can end up virtually anywhere. This happens to some extent in all women, but the immune system spots these out-of-place cells and calls in white blood cells to eliminate them. If they somehow evade your immune defenses and attach in your abdominal cavity, the result is endometriosis. Occasional microscopic clumps occur in women with no symptoms at all. If they are more than minimal, the inflammation and pain can be severe and nearly disabling. (Mangtani 1993, Dmowski 1995, Balasch 1996) The only way to diagnose it is by making a small incision below the navel and actually looking into the abdominal cavity with a slim tube called laparoscope. Doctors who have not done this sometimes dismiss the pain or misdiagnose it. The Endometriosis Association, based in Milwaukee, reports that 70 percent of women diagnosed with the condition were first told by their doctors that there was no physical reason for their pain. Among black women, 40 percent were told that their pain was caused by a sexually transmitted disease. Do Foods Cause Endometriosis? Certain foods appear to make endometriosis more likely. According to researchers at the Harvard School of Public Health, women who have two or more cups of caffeinated coffee (or four cans of cola) per day were found to be twice as likely to develop endometriosis as other women. The reason why caffeine has this effect is unknown. (Grodstein 1993) Foods tainted with certain chemicals appear to encourage the implantation of cells in the abdomen. Polychorinated biphenyls (PCBs) were commonly used in electrical equipment, hydraulic fluid and carbonless carbon paper, and organochlorine pesticides have been commonly used in agriculture. In 1992, German researchers found that women with high blood levels of PCBs had a higher prevalence of endometriosis. (Holloway 1994) These chemicals presumably do their dirty work by impairing your immune defenses against abnormal cells. Indeed, the natural killer cells and other white blood cells that are supposed to maintain a constant look-out for any abnormal cells have been shown to be weakened in women with endometriosis. (Dmowski 1995) In addition, some organochlorines mimic the effects of estrogens. (Koninckx 1994, Ahlborg 1995) These toxins tend to accumulate in animal fat, and the major route of human exposure is through food, particularly fish. They also show up in meats and dairy products. (Ahlborg 1995) Chickens, cattle, pigs, and other animals are fed grains treated with pesticides and sometimes contaminated with other organochlorines, and they tend to concentrate these compounds in their muscle tissues and milk. While there may also be organochlorine pesticide residues on non-organic fruits or vegetables, they are less concentrated and are easier to remove. Organic produce is grown without chemical pesticides. To measure the concentration of organochlorines in a woman's body, researchers sometimes check samples of breast milk. Breast tissue is a natural target for chemicals that dissolve into fat, and, in fact, during breast-feeding, a woman can excrete up to half of all the dioxin she has accumulated in her body tissues. (Koninckx 1994) Unfortunately, the recipient of these chemicals is the nursing baby. (Ahlborg 1995) A vegetarian diet has obvious advantages. By avoiding fish, other meats, and cow's milk, you avoid the foods that harbor most organochlorines. Indeed, researchers have found that vegetarian women have much lower levels of pollutants in their breast milk, compared to other women. (Hergenrather 1981) The earlier in life that a plant-based diet is begun, the better. Happily, bans on some of these compounds have caused exposures to decrease since the 1970s, although the amount in your body drops only very slowly. Foods as a Treatment for Endometriosis Some women with endometriosis improve spontaneously, although most find that their symptoms continue or gradually worsen. Medical treatments rely on anti-inflammatory pain-killers and hormone treatments designed to shrink endometrial tissues: danazol, gestrinone, GnRH agonist analogs, progesterone derivatives, and progesterone-estrogen combinations. Surgical treatments include removing cell clumps, severing pain nerves, and even hysterectomy, sometimes with removal of the ovaries. Surgery to remove endometrial cells has about the same effectiveness as drug treatments, but both are usually temporary measures, as they do not reliably eliminate all of the troublesome cells. (Dawood 1993, Revelli 1995) The dietary treatment is based on the fact that, whatever causes endometriosis to start, it is estrogen that keeps it going. Without estrogen, the clumps of cells do not grow each month; they soon wither away. That means that the dietary approach that reduces estrogens can also be used for endometriosis. In my discussions with gynecologists who have tried this approach, it is clear that, for some patients at least, it can make a big difference. Ronald Burmeister, M.D., a gynecologist in Rockford, Illinois, describes the case of a 24 year-old woman who had had terrible menstrual pain every month since her periods began. She had had laparoscopic surgery twice, but her pain continued. She had tried birth control pills, but they caused depression and other side effects. Hormone-blocking medications were helpful, but the medicine was very expensive and, in any case, could only be prescribed for six months without an increased risk of osteoporosis. After it was stopped, her pain returned. A progesterone derivative helped some but did not abolish the pain. One of her doctors recommended hysterectomy, but she wanted to avoid such a drastic solution. Dr. Burmeister suggested trying a hormone-balancing diet. Using low-fat, purely vegetarian foods, she could reduce her hormone shifts, and, unlike medicines or a hysterectomy, it would not interfere with her efforts to get pregnant. He gave her a set of recipes and recommended several books for further information. Within three months she was noticeably better, and at six months her pain was gone. She stopped the progesterone derivative, and set about seeing if she could become pregnant. Based on this success, Dr. Burmeister made the same recommendation in three other cases, and found that it was helpful in reducing pain. One patient reported that if she deviated at all from the diet, by having some dairy products or a bit of chicken, her pain came right back, just as skipping one or two pills can make a prescription fail. No one has yet done a clinical study on the use of a low-fat vegetarian diet for endometriosis. That should change, because, unlike hormone treatments, it does not interfere with efforts to conceive. It is also cheap and safe, and it brings many other health benefits, too, Aerobic exercise also helps. Women who run, jog, or work out for two hours per week have only half the risk of endometriosis, compared to other women. The reason, presumably, is the well-established ability of exercise to reduce hormone activity. In fact, women who exercise very strenuously and consistently sometimes miss periods altogether. (Mangtani 1993) Exercise also strengthens the immune system, making you better able to eliminate errant cells. Natural progesterone can also be used to oppose estrogen in endometriosis. It is typically used from day 8 to day 26 of the monthly cycle (counting the first day of bleeding as day 1), using up a two-ounce jar each month. This delivers about 40 to 50 milligrams per day. Normally, this dose is continued for about four months, then the dose is reduced as the pain diminishes. Immune-Boosting Foods If endometriosis is caused by an immune system failure to recognize and eliminate out-of-place cells, it may be that immune-boosting foods might help prevent it. You already want to reduce the amount of fat you eat in order to keep your estrogen level lower. Getting away from fat also helps your immunity. (Barone 1989) Researchers have found that fatty foods impair the function of white blood cells. This is true for any kind of fat—animal fat or vegetable oil. It is also true of cholesterol. When researchers add cholesterol to white blood cells in the test tube, they find that their immune strength is diminished. (Cuthbert 1984, Pepe 1986, Traill 1990) A low-fat, zero-cholesterol diet simply means getting your nutrition from plant sources, rather than animal sources, and keeping the added oils to a minimum. Researchers have studied the effect of different diets on the natural killer cells that seek out and destroy abnormal cells, and it is clear that getting away from fat and cholesterol makes a big difference. When blood samples are taken from volunteers and the ability of their natural killer cells to destroy abnormal cells is tested, vegetarians do twice as well as their omnivorous counterparts. (Malter 1989) You can get an extra immune boost from beta-carotene, found in orange vegetables, such as carrots and sweet potatoes, from vitamin E, found in grains and beans, and from vitamin C, which is in many fruits and vegetables. Adenomyosis Adenomyosis is a condition in which the cells that normally line the uterus are found in pockets within the muscle layer of the uterus. This occurs to some extent in up to 40 percent of women, and it probably causes no symptoms at all unless it is fairly deep into the muscle layer. As in the case of endometriosis, the stimulus for the growth of these cells is probably estrogen, (Yamamoto 1993) which again means that reducing estrogen production through diet changes makes good sense. Unfortunately, these diet steps have never been put to the test. One complicating feature may be that the endometrial cells make their own estrogen, and the extent to which diet changes can influence this local production is unknown. (Yamamoto 1993) We have good evidence that diet changes can help women with common menstrual pain, and time will tell if these same changes help women with specific causes of pain, including endometriosis and adenomyosis. There are many other approaches to menstrual pain. Some researchers are beginning to test whether ginger's anti-inflammatory effect helps reduce menstrual pain, when used in doses of one-half to one teaspoon (one to two grams) each day. Unfortunately, unlike motion sickness and arthritis where we have good evidence of its efficacy, tests of ginger for menstrual pain have been limited to individuals. (Srivastava 1993) More and more herbal supplements are also available. It helps to keep an open mind, and to see what they might do for you. The cornerstone of a program to control menstrual pain is a low-fat, vegetarian diet. By avoiding animal products, keeping vegetable oils to a bare minimum, and having plenty of fiber-rich foods in your routine, you will naturally reduce estrogen's effects on the uterus, avoid most chemical pollutants, and boost your immunity. References
* The term "estrogen" actually refers to a group of hormones, including estrone, estradiol, and estriol. To keep things simple, I will refer to them collectively as estrogens. To learn more about using foods
against menstrual pain, For delicious, low-fat, vegan
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