Endo with dietitian Amanda Smith

Endometriosis affects nearly 1 million Aussies at some point in their lives. It’s a difficult, life-altering and (very) painful disease, where tissue that’s similar to the lining of the uterus, grows outside it. 

Someone who knows this all too well is dietitian Amanda Smith — a VIC-based gal who works for Verde Nutrition Co. We’ve shared her wisdom previously, and recently invited her back to talk to us about her personal endo + fertility journey, as well as give us her expertise. 

Verde Nutrition Co is founded by my personal dietitian, Chloe McLeod. The incredible human who helped me realise I had a food chemical intolerance (aka, salicylates) (aka, the whole reason I started Yours Only).

Soooo, let’s let Amanda take the floor, shall we? 

Endometriosis

Amanda’s endo story

Unfortunately my story is very similar to many endo warriors, as it features a large delay to diagnosis. My symptoms first started when I got my period at 14.

I was put on the oral contraceptive pill to help with managing symptoms, which helped for a few years. Symptoms then started to get worse, with extremely painful periods each month which led to missing school/work. I also had gut issues which were put down to IBS, but in hindsight, they were most likely linked. 

I saw another GP when I was 20 and expressed concerns, but an ultrasound showed nothing (actually quite common with endo so please don’t let this discourage you) and referred to a gynaecologist.  

I was unfortunately dismissed by the first gynaecologist I saw as scans were clear and was told to come back when I wanted to start a family.

This left me feeling super deflated. I just dealt with symptoms until I saw another amazing GP who referred me to a specialist at the age of 27, when I was considering trying to conceive in the near future. 

She was absolutely wonderful, warm and validating of my experience and gave me the option of either going ahead with a laparoscopy to investigate/treat endo or try to conceive naturally first. We opted to wait about 12 months before looking at surgery.  

After that time had passed without falling pregnant, I had my laparoscopy and got a diagnosis of stage 3 endometriosis.  

I remember crying when my specialist told me as I woke up from surgery, due to finally feeling like it wasn’t ‘all in my head’ for 14 years.

Can you take us through a dietitian’s role in helping people with endometriosis? 

Absolutely! A dietitian can play a key role in the management of endometriosis in a few different ways. Endo is an inflammatory condition, and we know diet plays an important role in managing inflammation. 

1. Working with a dietitian on developing an anti-inflammatory diet pattern individualised to you can help with reducing inflammation and with endo symptoms as a result.  

2. We can help with reducing (often debilitating) endo symptoms such as bloating, abdominal pain, diarrhoea, constipation, nausea and fatigue. 

For some, this may be as simple as adjusting the types of foods eaten, meal/snack timings or meal composition. For others, it might be identifying and managing food intolerances which are exacerbating endo symptoms.  

3. We can also put in contingency plans for managing endo flares such as more convenient meal and snack options for those harder days.

4. It’s common for those with endo to experience nutrient deficiencies such as iron deficiency, as a result of heavy blood loss, so another key part of our role is correcting these deficiencies.

5. There is evidence for the use of certain supplements in helping to manage endo symptoms.

We know there are so many products marketed at the vulnerable endo community, which can make it so confusing to know what's worth your money.

Working with us means breaking down the evidence to determine what supplements may actually have a clinical benefit for you, and ensure they’re taken safely and at the correct dose.

Do you find that many people don’t realise they could potentially see a dietitian to assist them on their endo journey? 

Yes! We're always here to be your biggest cheerleader and support.

Many people with endo also don’t realise they may be eligible for a Medicare chronic disease care plan which entitles them to subsidised sessions with a dietitian. Additionally, those with private health insurance may be able to get a rebate on dietitian services if it’s included in their extras cover.  

How do you manage day-to-day when going through an endo flare up?

It really depends on what I have on that day and the severity.  

If it’s a manageable flare-up, I will:
1. Utilise heat through a heat pack and warm showers/baths to help with pain/cramping 
2. I’ll ensure I’m staying well hydrated to help manage fatigue
3. Eat nourishing foods regularly to help manage energy levels and nausea
4. Reduce intake of foods that tend to flare up my endo symptoms.  

If it’s a particularly bad flare:
I’ve learnt there’s no point in trying to push through and will take personal leave to rest. Very similar strategies to above, but involves a lot more laying down, trashy tv shows and cuddles from my two dogs.

 

From a dietitian’s perspective, what tips would you give to someone dealing with endo that might help them day-to-day? 

1. I think having convenient meal and snack options ready for the harder days is really important.

This is to ensure you continue to nourish your body during a flare as best you can. This may be:

• Bulk cooking and freezing meals on a day you’re feeling good

• Utilising a meal delivery service or ready-made meals that you can keep on hand 

• For snacks, having a stash of nourishing but long-life snacks is really helpful. Such as nuts, nut/protein bars, roasted fava beans/chickpeas or seeded crackers.

2. Focus on incorporating plenty of plant foods to help with managing inflammation.

Such as fruit, vegetables, legumes, nuts, seeds, wholegrains, herbs, spices and extra virgin olive oil.  

3. Working with a dietitian

This can help to determine what foods may be exacerbating your symptoms, and what foods/dietary pattern works best for supporting your symptoms.  

Remember this is different for everyone - so what has worked for your friend with endo may not be what’s right for you.

4. Try not to over-do the caffeine 

As easy as it can be to turn to caffeine when you’re having an endo flare and EXHAUSTED (I completely get it, even more so now with an 8 month old). This can exacerbate gut symptoms such as bloating, diarrhoea, abdominal pain and nausea.  

Aim to make your drink bottle your bestie instead to stay well hydrated to support energy levels and gut symptoms.

 

PSA: This is not medical advice or a paid collaboration between Yours Only and Verde Nutrition or Amanda Smith. Always consult with your doctor or healthcare team.