Endometriosis Diet: What to Eat and Avoid

Barbie Cervoni MS, RD, CDCES, CDN, is a New York-based registered dietitian and certified diabetes care and education specialist.

Aviv Joshua, MS, RDN, LDN, is a clinical dietitian based in Miami, Florida, with over 10 years of experience in nutrition, geriatrics, and health care.

Diet alone cannot cure or treat endometriosis. However, dietary changes may assist in maintaining, treating, and recovering from the condition. Food can affect hormone levels, inflammation, and weight, all of which are factors that impact the progression and severity of endometriosis.

Foods rich in antioxidants and omega-3 fatty acids, such as fruits, vegetables, nuts, seeds, and fatty fish, can reduce inflammation, therefore, helping to reduce pain from endometriosis.

This article discusses dietary changes for endometriosis, foods that help to fight inflammation, when to seek medical help, and more.

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A nutritious eating plan is an important component of overall health and longevity. If you have endometriosis and are having trouble controlling your symptoms, adopting some dietary changes to reduce inflammation may help manage your pain.

In addition, changing your diet may increase your chances of getting pregnant if you're trying to conceive. However, results are very individual and will differ based on the stage and severity of your endometriosis.

Chronic pelvic and abdominal pain is a common symptom of endometriosis. Ongoing pain may mean you are experiencing a great deal of inflammation. Though changing your diet won't completely alleviate your symptoms, there is no harm in trying.

Some people with endometriosis have flare-ups before or during menstruation. Others experience symptoms constantly, randomly, or with changes, often increasing in frequency and worsening with time.

Changing your eating habits during these times may help, especially if you experience digestive problems like constipation. Increasing fiber and fluid intake can help treat constipation.

One study evaluated the effects of a Mediterranean-style diet in women with a previous laparoscopic diagnosis of endometriosis and postoperative endometriosis-associated pain.

Participants followed an eating plan that included fresh vegetables, fruit, white meat, fatty fish, soy products, magnesium-rich foods, and cold-pressed oils. They were asked to avoid sugary drinks, red meat, sweets, and animal fats. Researchers found significant improvements in the condition, including:

People with endometriosis are at increased risk of having problems with fertility. If you are trying to conceive, what you eat can positively impact your fertility.

Research shows eating a diet that includes low-mercury seafood about twice per week, whole grains, fruits, and vegetables may improve fertility in both men and women.

In addition, certain nutrients are required for a healthy pregnancy, including:

Endometriosis can cause endo lesions within the pelvis and other body parts outside the pelvis. Lesions are frequently found on the ovaries, ligaments, peritoneal surface, bowel, and bladder.

Although no specific endometriosis diet exists, certain foods high in antioxidants are encouraged to reduce inflammation. The Mediterranean diet has proved capable of decreasing markers of inflammation. This eating style consists of fruits, vegetables, legumes, whole grains, fatty fish, olive oil, nuts, and seeds while limiting trans fat, saturated fat, and sugary foods.

Foods that contain magnesium and zinc can help you reduce inflammation. Magnesium-rich foods include whole grains, legumes, nuts, seeds, dairy products, and green leafy vegetables. Meanwhile, oysters, beef, pumpkin seeds, eggs, dairy products, fortified breakfast cereals, oats, whole grains, and legumes contain zinc.

Endometriosis growth is stimulated by estrogen. Eating foods that help remove estrogen and prevent levels from getting too high may prove beneficial. Fiber-rich foods can help pull estrogen out of the body through bowel movements. Foods high in fiber include fruits, vegetables, whole grains, nuts, seeds, and legumes.

Foods with omega-3 fats help calm inflammation, which may reduce the severity of symptoms and potentially reduce the progression of endometriosis. Omega-3 fatty acids are found in fish, such as salmon, sardines, tuna and walnuts, flaxseeds, chia seeds, plant-based oils, and fortified foods.

One study linked a higher intake of dairy products, such as milk, yogurt, and cheese, to a lower risk of endometriosis. The association appeared greater when intake was more than three servings per day. Researchers believe this association may occur because these foods are rich in calcium, vitamin D, and magnesium.

It is important to speak to a healthcare provider before taking any supplements. You want to ensure that the supplements you are choosing do not interfere with any current medications you are taking, that they are from a reliable source, and that their dosages are not too high.

The type of supplements you choose will depend on what result you are looking to achieve. If you are trying to conceive, you should take a prenatal vitamin that contains folic acid and choline. Other supplements that may be recommended include zinc, magnesium, probiotics, vitamin C, vitamin D, quercetin, curcumin, vitamin E, and omega-3 fatty acids.

Research suggests that foods high in trans fat and sugar can increase inflammation. Higher intakes of trans fat have also been associated with a greater chance of developing endometriosis.

Foods high in trans fat include:

It doesn't mean you can never eat these foods again, but limiting your intake may help. It also opens up more room for other foods, such as fresh fruits and vegetables, which can be beneficial.

Phytoestrogens are naturally occurring estrogen-like compounds found in plants. Dietary sources of phytoestrogens are found in fruits, vegetables, spinach, sprouts, beans, cabbage, soybeans, grains, and oilseeds (such as flaxseed). There are different classes of phytoestrogens, including isoflavones, coumestans, lignans, and flavonoids.

The data on phytoestrogens and endometriosis is complex and inconsistent. Some research suggests that phytoestrogens can have an anti-estrogen effect and help reduce inflammation, while other research has found the opposite.

The complexity resides in how much estrogen a person has and the types and amounts of phytoestrogens consumed. Many studies are short and include animals, which makes it hard to formulate one answer. Researchers acknowledge the need for studies longer in duration.

Natural remedies, like complementary and alternative medicine (CAM), are interventions not part of standardized care. In treating endometriosis, these natural approaches may include:

Ask a healthcare provider if these approaches can help you.

Having meal ideas to work from can help you change your eating patterns. It can save you time, money, and stress. You don't need to eat precisely this way. Use these suggestions as a guide for planning and preparing meals rich in anti-inflammatory foods, fiber, and micronutrients:

Breakfast:

Lunch:

Dinner:

Snacks:

Working with a registered dietitian (RD) is important when creating an eating plan and making dietary changes while managing a condition. They can customize individualized eating by taking into consideration all of your personal needs, medical history, culture, and food preferences.

RDs can also examine your eating history to ensure an adequate intake of important vitamins and nutrients (protein, fat, and carbohydrates). They can assess if supplements are necessary and guide you on how to take them safely.

Changing your dietary habits may not cure endometriosis, but research shows that eating a diet rich in certain nutrients can help reduce inflammation. You don't have to overhaul your entire diet at once. Simply start by making small changes and see how you feel. If you need assistance, consider working with a dietitian who can customize a plan that suits your needs and goals.

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By Barbie Cervoni MS, RD, CDCES, CDNBarbie Cervoni MS, RD, CDCES, CDN, is a New York-based registered dietitian and certified diabetes care and education specialist.