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Dr. Laura Pipher

Why I probably WON’T remove your dairy..

I work with tons of patients who suffer from painful periods with or without diagnosed endometriosis. As a naturopathic doctor, one of the cornerstones of foundational treatment with my patients involves discussing evidence based dietary changes to support their symptoms. 

One of the most common questions I get from my patients (or hesitations) is that they LOVE cheese and don’t want to remove their dairy. Well, keep reading if that is you because I have some GOOD news when it comes to dairy & will provide you some evidence as to WHY I probably won’t remove your dairy plus some reasons WHY you may still react to it.

Endometriosis

Endometriosis is an estrogen-dependent disorder  estimated to be in about 10% of reproductive aged women characterized by tissue growth located outside of the uterus. It is a chronic inflammatory condition associated with pelvic pain and infertility. There is often a delay in diagnosis which averages about 7 years so it is quite likely that the condition begins much earlier (1). 

Diet can impact the development and severity of endometriosis through a variety of mechanisms including changes in estrogen, prostaglandin metabolism, inflammation or smooth muscle contractility and adolescence may be a critical window for exposures (1).


The Dairy connection

Several theories exist to describe a link between dairy foods and endometriosis. Women with endometriosis have high levels of several inflammatory markers, and some studies have shown that the intake of dairy foods and dietary calcium is inversely related to oxidative,  inflammatory stress and vascular inflammmation  (1). 

What does the research say?

2019 Study 

Suggest that dairy consumption, specifically yogurt and ice cream intake, in adolescence may reduce the risk of subsequent endometriosis diagnosis(1). 

A 2021 meta-analysis involving 120,706 participants showed(2). 

  • There was a dose depending relationship between  dairy intakes and risk of endometriosis
  • When dairy intake was ≥21 servings/week, there was  a significant reduction in the risk of endometriosis
  • The risk of endometriosis was fond to be significantly reduced when the intake of high fat dairy products was > 18 servings per week (this association was not found with low fat dairy products)
  • Specifically, the intake of cheese was found to decrease the risk BUT high butter intake was associated with an increased risk
 
A 2010 study evaluating 127 females concluded (3)
  • Dysmenorrhea (painful periods) and associated symptoms were found in significantly fewer female students who consumed three or four servings of dairy products per day as compared to participants who consumed no dairy products
 
A 2020 randomized controlled trial evaluated women with PMS & their dairy intake.  The intervention group consumed cheese, yogurt and milk daily for 2 months (4). 
  • The intervention group’s physical functions and mental health post-intervention scores on the quality of life scale were found to be significantly higher than their baseline scores 

 

A 2019 systematic review of of observational studies reported  a positive association between dairy consumption and the reduction of menstrual pain(6).    

Some considerations..

Some of my patients find that despite their best efforts, dairy does not sit well with them, but is this a dairy problem or something else? The reality is that individuals with endometriosis have an increased likelihood of developing conditions such as SIBO and IBS. The increased risk for SIBO and endometriosis due to inflammation which causes alteration of intestinal motility and bacteria(5). 

So what do you do if you are trying to incorporate diary but your digestion doesn’t agree? When I work with patients through my methodology, I focus on digestion BEFORE we do anything else for this very reason, but that doesn’t mean you can’t still try to incorporate it. Start with lactose free dairy products and opt for higher protein options like plain greek yogurt.  

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056553/
  2. https://www.frontiersin.org/articles/10.3389/fnut.2021.701860/full
  3. https://pubmed.ncbi.nlm.nih.gov/20492391/
  4.  https://mattioli1885journals.com/index.php/progressinnutrition/article/view/7688
  5. https://endometriosis.net/clinical/ibs-sibo
  6. https://www.karger.com/Article/Fulltext/495408#:~:text=Five%20studies%20assessed%20the%20association,effect%20on%20dysmenorrhea%20%5B21%5D.

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