Does diet affect endometriosis?

Within this article we’ll look at the relationship between diet, nutrition, and endometriosis. Can adjusting what you eat really help with the symptoms of endometriosis?
But first, if you want to brush up on your endometriosis knowledge, check out our article: Most Googled questions on endometriosis.

How can nutrition and your diet affect symptoms of endometriosis?

Did you know that certain foods can influence hormone regulation? Hormone imbalance is a general risk factor for endometriosis.1 Food can affect the production and release of hormones by direct actions on the gut, such as the production and release of hormones to changing circulating gut hormone levels, nervous reflexes, and much more.2
Oestrogen imbalance can negatively affect those with endometriosis. It’s advised by the NHS to try and avoid or limit certain foods, that may promote inflammation in the body and lead to further pain or progression of the disorder. These foods include3
  • alcohol 
  • caffeine 
  • gluten 
  • red meat 
  • saturated and trans fat
The food you consume could play a part in potentially worsening endometriosis or triggering painful flare-ups. For example4:
  • foods that are oestrogenic (promoting oestrus), as oestrogen may trigger endometriosis to grow 
  • ultra processed foods, alcohol, sugars, and fatty foods may cause inflammation, as can dairy products (causing inflammation through hormones) 
  • gluten may cause hormone imbalance
It has also been studied that woman who consume a lot of red meat may be at higher risk of developing endometriosis than those who follow more of a plant-based diet. Replacing red meat with fish, shellfish or eggs has been associated with lower risks of endometriosis in some studies.5

What foods should form part of your diet if you have endometriosis?

Everybody is unique and different, however, in general, a typical anti-inflammatory diet is recommended for women with endometriosis, focusing on eating more fruits and vegetables, fatty fish (omega 3), nuts, seeds, and healthy fats.6 Though, speak to your doctor if you are considering making any major changes to your diet.
As endometriosis is an oestrogen- dependent disease, reducing dietary fat and increasing dietary fibre has been suggested to potentially benefit women with endometriosis. It has been shown that by doing so may reduce circulating oestrogen concentrations.7
The anti-inflammatory properties of healthy plant-based diets may benefit women with endometriosis. However, the general recommendation is for a balanced and varied diet, along with the recommendation to cut out alcohol. Though more research is needed to understand the role of nutrition in endometriosis.
Fish oil capsules in combination with vitamin B 12 have also been associated, in some case studies, to have a positive effect on endometriosis symptoms (particularly with painful cramping).8
Studies have shown that higher intakes of polyunsaturated fatty acids, a gluten-free diet, and a low nickel diet may have a positive impact on pain perception among women with endometriosis. Foods that are high in nickel content include cocoa, chocolate, soya beans etc. Though, further studies are needed to investigate diet and its effect on pain perception in women with endometriosis.9

Why is food and nutrition such a big part of endometriosis?

Bloating is a common and painful symptom of endometriosis. So, it may be beneficial to decrease your intake of foods that trigger bloating.
“Endo belly” has been a term coined to describe server bloating related to endometriosis. It’s most likely to occur during the second half of the menstrual cycle leading up to menstruation, caused by cyclic bloating of the abdomen.10
The NHS recommends the following to reduce bloating11:
  • exercise regularly to improve your digestion and help prevent bloating – exercise can also help when you're feeling bloated 
  • chew with your mouth closed to avoid swallowing air 
  • drink plenty of water 
  • eat foods high in fibre if constipated 
  • eat smaller, more frequent meals instead of large meals 
  • massage your stomach from right to left to release trapped wind
Cutting out excessive fizzy drinks, alcohol, or caffeine, reducing foods that are known to cause gas, avoiding eating large meals late at night before bed or slouching when eating, and eating less processed, sugary, spicy, or fatty foods is also suggested by the NHS.12,13
Decreasing foods that make you bloat could help to prevent worsening your endometriosis symptoms. Another approach to improve bloating (and potentially endo belly) is to follow the low FODMAP diet, as found in a study involving just under 200 women.14
FODMAP is short for – wait for it, it’s a long one – Fermentable Oligo-, Di-, Mono-Saccharides And Polyols, the scientific names for certain groups of carbs known to trigger gastrointestinal symptoms. It has been shown that most individuals with IBS-like symptoms who reduced their intake of FODMAP’s had improved gut symptoms.15,16
Although research has shown changes in diet could help with endo belly, further clinical trials will help understand the role of diet in endometriosis.
There is also evidence of a correlation between low vitamin D levels and endometriosis. Most studies suggested that an increased dietary intake of vitamin D as a preventive measure have been promising.17 However, further research is needed.

The final say

We hope this article has helped you to better understand the relationship between what you eat, and how that may impact endometriosis.
Having knowledge of what foods support good gut health, and foods that may help affect hormones, could help you to manage your symptoms.
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional if you think you might have endometriosis.


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