Few women make dietary and lifestyle decisions with their reproductive health in mind. It’s usually not until a woman wants to have a child that she starts learning more about the intricate workings of her reproductive system. Even then, nutrition rarely enters the picture.
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As we saw in the previous chapter, a high-fiber, low-fat diet keeps estrogen levels under control and can help ease painful menstrual symptoms. It also can have an effect on the menstrual cycle itself.
To have the best chance of conceiving, each intricate reproductive function, including ovulation, must occur properly each month. It’s a delicate system. As a new cycle begins, your ovaries make estrogen in ever-increasing amounts to ready the uterus for pregnancy.
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As we saw in chapter 2, the majority of people, excluding Caucasians, have trouble digesting dairy products because they do not retain the enzymes for digesting milk sugars after infancy. Even though most Caucasian women—about 85 percent—have the genetic adaptation that allows them to eat dairy products without experiencing intestinal discomfort, it doesn’t necessarily mean that they are protected from the long-term negative effects elsewhere inside the body. Dairy can turn the ovaries into a silent battleground.
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Endometriosis is a disease in which endometrial tissue, which normally lines the uterus, spreads and grows in other parts of the body. During the menstrual cycle, this misplaced tissue swells and bleeds, causing inflammation and pain. Over time this leads to scarring, which can lead to infertility. More than five million women in North America have been diagnosed with endometriosis, about 10 percent of women in their reproductive years.
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Exercise is important as well. Women who work out for just two hours each week have only half the risk of endometriosis as other women. The protection apparently comes from a healthy reduction in hormone activity as well as a boost in immune system functioning.
You will only know for sure whether you have endometriosis after having a medical procedure called a laparoscopy. It allows your doctor to look inside the abdominal cavity through a small incision made below the navel. Current treatments for endometriosis seek to minimize discomfort with anti-inflammatory painkillers.
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When women visit doctors’ offices to evaluate why they are having trouble conceiving, one of the most common findings is that neither ovary is releasing an egg. Normally, ovulation occurs about two weeks into each monthly cycle. But for some women, no egg is released at all. Month after month, there is no possibility of pregnancy.
Most often the cause is a hormonal condition called polycystic ovary syndrome (PCOS), and along with difficulty conceiving come other signs that your hormonal balance is not quite right. You may find masculinizing effects—facial hair or a thinning of hair on your scalp—that can come from a bit too much testosterone, and your periods may be intermittent or may have stopped altogether. You also may find you are having trouble keeping off excess weight.
The first step in treating PCOS is a change in diet. You’ll want to cut the fat to the extent you can, boost fiber-rich foods, and select foods that release their natural sugars gradually. Here are the details.
First, cut the fat. Fatty foods make it hard for insulin to do its job. Think of insulin as a doorman who turns the knob on the door to the cells of your body and escorts protein building blocks and sugars inside. When there is too much fat in your diet, insulin becomes very inefficient. It is as if its hand keeps slipping on a greasy doorknob. When this condition, called insulin resistance, develops, your pancreas makes more and more insulin to try to get its job done. This mounting wave of insulin then causes trouble with your ovaries, poisoning their ability to ovulate and pushing them to make too much testosterone.
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Fibroids occur in about 20 to 30 percent of women over age thirtyfive. These noncancerous growths, developing from the muscle cells that provide a layer of strength in the wall of the uterus, can be microscopic or as large as a grapefruit. They are generally harmless, but they can hinder fertility. A doctor can diagnose fibroids during a pelvic exam or by ultrasound.