Endometriosis & Nutrition
Endometriosis and Nutrition: How Diet Can Support Symptom Management
Endometriosis is a chronic and complex inflammatory condition that affects approximately 10% of women of reproductive ages worldwide. Endometriosis is characterised by the presence of endometrial tissue similar to the lining of the uterus growing outside of the womb. Symptoms can vary among patients and fluctuate making a definitive diagnosis difficult. Common symptoms include pelvic pain, fatigue, painful periods, digestive issues, painful intercourse, depression and IBS (irritable bowel syndrome) symptoms such as abdominal pain & discomfort, diarrhoea and constipation and in some cases may impact fertility. While medical treatments like surgery and hormone therapy are often recommended, nutrition can play a powerful role in managing symptoms and supporting overall well-being.
The Link Between Diet and Endometriosis
Research suggests that inflammation, oxidative stress, and estrogen levels influence endometriosis progression. Whilst there is currently no single diet that mitigates symptoms completely. We do know that certain diet strategies can help regulate these factors, potentially reducing symptom severity.
Foods That May Help Manage Endometriosis
🌿 Anti-Inflammatory Foods
Endometriosis is an inflammatory condition, so incorporating anti-inflammatory foods into your diet may help reduce inflammation and period pain too!
Fatty fish (salmon, mackerel, sardines) – Rich in omega-3 fatty acids, which have been shown to reduce inflammation.
Eat the rainbow (abundance of fruit & vegetables) – Packed with antioxidants that combat oxidative stress. Oxidative stress is the result of excessive production of reactive oxygen species (ROS), which can damage cells and tissues leading to increased inflammation.
Extra virgin olive oil, nuts, and seeds – Healthy fats support reproductive hormones and reduce inflammation.
🍓 A Fiber-Rich Diet for Hormonal Balance
Excess estrogen can contribute to increased inflammation, endometrial growth and pain. A high-fiber diet has been shown to help remove excess estrogen from the body, making it a key component of an endometriosis-friendly diet.
Whole grains (quinoa, brown rice, oats, wholegrain breads & cereals)
Legumes (chickpeas, lentils, beans)
Flaxseeds and chia seeds
Fruits and Vegetables
Nuts
🌱 Fibre & the Gut Microbiome
Your gut microbiome plays a crucial role in regulating inflammation, immune function, and hormone metabolism, all of which are key factors in endometriosis. A diet rich in fibre and probiotics can promote a well-balanced microbiome, helping to reduce inflammation and regulate estrogen levels.
Fibre is essential for a healthy gut, as it acts as a prebiotic—fuel for beneficial gut bacteria. When these bacteria break down fibre, they produce short-chain fatty acids (SCFAs), which have anti-inflammatory properties and help regulate the immune response. A well-balanced microbiome supports immune cells, which can help control inflammation linked to endometriosis.
A high-fibre diet that includes vegetables, fruits, whole grains, and legumes can promote microbial diversity, support digestion, and potentially reduce the severity of endometriosis-related symptoms like pelvic pain and bloating.
🦠 Probiotics & Prebiotics for Gut Health
In addition to fibre, probiotic-rich foods like fermented dairy (yogurt, kefir), sauerkraut and kimchi can help maintain a healthy gut microbiome. Pairing these with prebiotic foods (such as garlic, onions, bananas, and oats) helps feed your good bacteria and reduce inflammation.
✨ Why It Matters for Endometriosis
Women with endometriosis often have differences in their gut microbiome (gut dysbiosis) compared to those without the condition, including reduced bacterial diversity and increased inflammatory markers. Since gut health is linked to hormone balance and immune regulation, maintaining a healthy microbiome may help manage and reduce inflammation, support estrogen balance, and improve digestive symptoms commonly associated with endometriosis.
🌞 Vitamin D and Calcium for Immune Support
Vitamin D plays an important role in bone health, immune support. Women with endometriosis adequate vitamin D consumption as been shown to decrease inflammation and improve pelvic pain. Aim for vitamin D-rich foods like:
Fortified dairy or plant-based milk
Egg yolks
Fatty fish (salmon, sardines, trout)
Mushrooms
Beef Liver
Vitamin C & Vitamin E: Powerful Antioxidants for Endometriosis
🍊 Vitamin C
Vitamin C is an essential nutrient that the body cannot produce on its own, meaning we must get it from our diet. It plays a vital role in immune function and acts as a strong antioxidant, helping to protect your cells from damage caused by inflammation.
Sources of vitamin C include fruits like, kiwi, strawberries, and citrus fruits. Cruciferous vegetables like broccoli, brussel sprouts, and capsicum. Surprisingly, fermented cabbage (sauerkraut) contains more vitamin C than many fresh vegetables!
🥜 Vitamin E
Similarly to Vitamin C, Vitamin E must also obtained through diet. Vitamin E is a fat-soluble antioxidant that helps protect your cell membranes from oxidative stress. Since our bodies cannot produce it, we must obtain Vitamin E from food sources such as sun flower seeds, almonds, peanuts, avocado and spinach.
🏥 How Vitamins C & E Help with Endometriosis
A clinical trial involving women with endometriosis-related pelvic pain found that taking Vitamin C (1000 mg) and Vitamin E (800 IU) daily for 8 weeks significantly reduced pain levels, including menstrual cramps and pain during intercourse. This benefit is likely due to the antioxidant properties of these vitamins, which help reduce inflammation and oxidative stress in endometriosis.
Incorporating Vitamin C- and E-rich foods into your diet may help support your immune system and reduce inflammation, potentially improving endometriosis symptoms.
Foods to Limit & Avoid for Endometriosis
🚫 Processed and Red Meats
Multiple studies suggest that diets high in red meat are associated with a higher risk of developing endometriosis. While red meat is a valuable source of essential nutrients like iron and vitamin B12, excessive consumption—especially more than two servings per day—has been linked to a 56% higher risk of endometriosis.
One of the reasons for this increased risk is that red and processed meats are rich in saturated fats, which may contribute to higher estrogen levels and inflammation—two key factors in the development and progression of endometriosis. Additionally, processed meats, such as sausages, bacon, and deli meats, often contain preservatives, additives, and unhealthy fats, all of which can exacerbate inflammation.
👉 What to do instead?
If you enjoy red meat, aim to limit it to twice per week and opt for grass-fed or lean cuts to reduce your intake of unhealthy fats.
Prioritise anti-inflammatory protein sources such as fish, poultry, legumes, and plant-based proteins like tofu or tempeh.
🚫 Trans Fatty Acids
Trans fats are found in highly processed foods, including fast food, fried foods, and many commercially baked goods like pastries, cookies, and cakes. Studies have shown that women who consume high amounts of trans fats are significantly more likely to develop endometriosis due to their strong inflammatory effects.
Trans fats not only promote chronic inflammation but also interfere with hormone regulation, potentially worsening endometriosis symptoms such as pain, bloating, and irregular periods.
👉 What to do instead?
Replace processed snacks with whole-food alternatives like nuts, seeds, or homemade treats made with healthier fats.
Cook with healthy fats such as extra virgin olive oil.
🚫 High Intake of Sugar
Excessive sugar intake can be particularly problematic for women with endometriosis. Diets high in refined sugars—found in sweets, soft drinks, pastries, and processed foods may contribute contribute to increased inflammation.
High sugar consumption may also disrupt gut health, impacting the gut microbiome. Research suggests diets high in simple sugars may lead to a reduction in the diversity of the gut microbiome and an increase in the population of pro-inflammatory bacteria. A healthy microbiome is key to regulating the immune system and inflammation, which may impact the development of endometriosis.
👉 What to do instead?
Limit your intake of refined sugars and sweets. Please note the key word here being limit.
Choose complex carbohydrates (e.g., quinoa, sweet potatoes, whole grains) over simple carbs (e.g., white bread, sugary cereals) to maintain stable blood sugar levels. Complex carbohydrates also serve as fuel for your “good” gut bacteria thus helping to support a healthy gut microbiome.
Balance meals with fiber, protein, and healthy fats to prevent sugar cravings and energy crashes.
Remember, we are still human. Maintaining a healthy relationship with food is important. Majority of peoples first approach to dietary changes are restriction or avoidance. Rather than focusing on what you foods you need to avoid or limit, shift your mindset to foods you can add more of.
Final Thoughts
Nutrition is not a cure for endometriosis, but the right dietary strategies can be a powerful tool in managing symptoms, reducing inflammation, and improving overall well-being. Since every person’s body reacts differently, working with a dietitian can help you find a tailored approach that works for you.
If you’re looking for personalised nutrition guidance for endometriosis, feel free to reach out for a consultation. Looking to catch up in person? No worries, you can find me every Monday and Friday at The Wellness Boutique, located in Burleigh Heads. Booking link listed below https://thewellnessboutique.com.au/nutrition/
References
Abulughod, N., Valakas, S., & El-Assaad, F. (2024) 'Dietary and nutritional interventions for the management of endometriosis', Nutrients, 16(23), p. 3988. Available at: https://doi.org/10.3390/nu16233988
Moran, L.J., Doran, D.A., and Takashima, S. (2023) 'The role of dietary fibers and complex carbohydrates in gut microbiome health', Nutrients, 4(4), p. 34. Available at: https://www.mdpi.com/2673-4184/4/4/34
Parazzini, F., Chiaffarino, F., Surace, M., Chatenoud, L., Cipriani, S., Chiantera, V., Benzi, G. and Fedele, L. (2004) 'Selected food intake and risk of endometriosis', Human Reproduction, 19(8), pp. 1755–1759. Available at: https://doi.org/10.1093/humrep/deh395
Physicians Committee for Responsible Medicine (PCRM) (n.d.) Endometriosis, Nutrition Guide for Clinicians. Available at: https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342065/all/Endometriosis#4
Szczepanik, J. and Dłużewska, M. (2024) 'The importance of diet in the treatment of endometriosis', Women, 4(4), pp. 453–468. Available at: https://doi.org/10.3390/women4040034
World Health Organization (WHO) (n.d.) Endometriosis. Available at: https://www.who.int/news-room/fact-sheets/detail/endometriosis