Introduction

Do you, or your friend have endometriosis and drink alcohol? Many women struggle with endometriosis, which expresses itself primarily as pain in the pelvic area. While there are treatment options available, endometriosis is a long-term condition.

Endometriosis is a gynaecological condition that can be affected by the alcohol intake of an individual.

If you want to learn more about the link between alcohol intake and endometriosis, keep reading. This article gives an overview of the condition and explains the link between alcohol and endometriosis.

What is endometriosis?

Endometriosis is a gynaecological oestrogen-dependent condition where a tissue like that lining of the womb grows in other places such as the fallopian tube and ovary. One of the consistently observed features of endometriosis is high levels of oestrogen. Oestrogen is a hormone primarily associated with the women's reproductive system. Endometriosis is a chronic inflammation that is the most common cause of chronic pelvic pain and infertility. It affects 6-10% of women of reproductive age, which can significantly influence the quality of life, due to the experienced pain. Some women might cancel plans because of the pain they are feeling.^1, 2

Symptoms

Symptoms of endometriosis can vary from one woman to another. Some women suffer badly while others don't have any noticeable symptoms. Endometriosis's common symptoms are:

• Pain in the tummy and back that can worsen while you have your period.
• Extreme period pain.
• You might also experience pain during or after having sex.
• It might hurt when you pee or poop while you are on your period.
• Nausea.
• Constipation or diarrhoea.
• Blood in poo or pee during your period.
• Struggling to get pregnant.²

Heavy drinking often worsens endometriosis symptoms

It is quite well-known that heavy drinking has many negative effects on our lives and our health. It also impacts endometriosis. Research has shown that heavy alcohol intake increases the risk of endometriosis significantly. It has also been found to worsen endometriosis symptoms.³ 

Ethanol affects oestrogen metabolism

The reason alcohol intake affects endometriosis symptoms and occurrence is that alcohol increases circulating oestrogen levels in the blood. Since endometriosis is an oestrogen-dependent condition, it can be influenced by alcohol intake. Oestrogen levels increase because of the alcohol breakdown in the liver. This is because alcohol increases aromatase, and aromatase converts androgen into oestroge.^.4, 5 

Alcohol can increase oestradiol synthesis

Oestrogen has three forms (estradiol, estrone, and estriol).⁶ Estradiol is the form responsible for uterine tissue growth. It is associated with endometriosis adhesions development and progression in the abdomen.⁷ Alcohol has also been found to affect oestradiol synthesis. Alcohol breakdown in the liver increases estradiol levels as it changes the proportion of liver enzymes. These enzymatic changes lead to reduced estradiol conversion to estrone as a result estradiol accumulates. This accumulation can lead to worsened endometriosis symptoms.^4, 5 

If you’re worried about your or your loved one alcohol intake

If you are worried about your or your friend's alcohol intake, there are many places that offer information and help. It is recommended that you see your healthcare provider and talk to them about your concerns. 

If you are worried about your loved one, a good place to start is by talking to them about it. However, it is good to know that many heavy drinkers are not aware, or rather, are in denial about their alcohol intake being problematic. So, be aware of that, as they might become defensive. Because of that, it can help to involve their friends and family to talk about the problem together.⁸ 

While you can try to be there for your loved one, it is not in your control what they do. Make sure that you take care of yourself while trying to help. 

Places like the UK addiction Treatment Centre, NHS, or Alcoholics Anonymous offer help to find treatment for you or your loved one.^8, 9, 10

Summary

Endometriosis is a chronic inflammation that is dependent on oestrogen levels. Oestrogen levels in the blood are influenced and increased by alcohol intake. As a result, alcohol can cause an increase in endometriosis and its symptoms. Symptoms of endometriosis include heavy period pain, pain in the tummy and back, pain during and after sex, as well as other symptoms, such as nausea, bloody pee or poo, constipation and diarrhoea. 

If you are worried about your alcohol intake, reach out to your healthcare provider to discuss how to move forward. There are many helplines available as well (see above). If you are worried about your loved ones’ alcohol intake, talk to them, involve their friends and family, and try to help them get help.