By Amanda Stuart, DPT, PHRC Los Angeles
Endometriosis is a chronic condition affecting millions of women worldwide, causing severe pelvic pain, painful periods, and even infertility. While medical and surgical interventions exist, many women seek additional ways to manage their symptoms—one of the most promising being dietary changes.
Research suggests that diet influences inflammation, hormone levels, and gut health, all of which play a role in endometriosis. By adopting certain dietary strategies, women with endometriosis may experience reduced pain and improved well-being. Here’s a breakdown of the most effective dietary interventions and the key nutrients that help alleviate symptoms.
The Role of Diet in Endometriosis:
Endometriosis is influenced by three major factors:
- Inflammation – Chronic inflammation exacerbates pain and lesion growth.
- Estrogen Levels – Excess estrogen fuels endometriosis progression.
- Gut Microbiome – An imbalanced gut can worsen symptoms and hormone regulation.
The good news? Your diet can help regulate all three!
The Most Optimal Diets for Endometriosis:
1. Mediterranean Diet
This diet is rich in whole foods, vegetables, fruits, nuts, seeds, healthy fats (like olive oil), and lean proteins (such as fish). It has been shown to:
- Reduce inflammation, which can ease pelvic pain by lowering prostaglandin levels.
- Provide antioxidants that protect against oxidative stress, reducing mast cell activation.
- Improve hormone balance by reducing excess estrogen levels, limiting estrogen-driven lesion growth.
2. Anti-Inflammatory Diet
Similar to the Mediterranean diet, an anti-inflammatory diet emphasizes:
- Fruits and vegetables – High in fiber and antioxidants, which lower systemic inflammation and oxidative stress.
- Omega-3 fatty acids (found in fish, flaxseeds, walnuts) – Help reduce inflammatory prostaglandins (PGE2) that contribute to pain.
- Herbs and spices (like turmeric and ginger) – Natural anti-inflammatory agents that suppress mast cell activation.
- Whole grains – Provide fiber that supports gut health and estrogen metabolism.
3. High-Fiber Diet
A fiber-rich diet aids in hormone balance and digestion by:
- Supporting a healthy gut microbiome by enhancing diversity, which plays a role in estrogen metabolism and mast cell down regulation.
- Binding to excess estrogen and removing it from the body, lowering estrogen-driven inflammation.
- Reducing inflammation and regulating blood sugar levels, preventing insulin spikes that may exacerbate inflammation.
Good sources of fiber include:
- Leafy greens (spinach, kale)
- Berries (blueberries, raspberries)
- Legumes (lentils, chickpeas)
- Whole grains (quinoa, brown rice)
4. Gluten-Free Diet
Studies suggest that some women with endometriosis experience less pain after removing gluten from their diet. Gluten can increase gut permeability, leading to systemic inflammation and mast cell activation, which can worsen pain and immune dysregulation.
5. Low-FODMAP Diet
For those with endometriosis and digestive issues like bloating and IBS, a Low-FODMAP diet may be helpful. It eliminates certain fermentable carbohydrates that can cause gut irritation, increase mast cell activation, and worsen visceral pain hypersensitivity.
Key Nutrients for Endometriosis Relief:
Omega-3 Fatty Acids
– Found in: Salmon, walnuts, flaxseeds, chia seeds
– Benefit: Reduces inflammation and prostaglandins that cause pain.
Vitamin D
– Found in: Fatty fish, fortified dairy, sunlight exposure
– Benefit: Modulates the immune system and reduces inflammatory markers.
Antioxidants (Vitamin C & E, Resveratrol, Curcumin)
– Found in: Berries, citrus fruits, green tea, turmeric
– Benefit: Lowers oxidative stress and inflammation in endometriosis lesions.
Magnesium
– Found in: Nuts, seeds, leafy greens
– Benefit: Helps with muscle relaxation and pain relief.
Probiotics
– Found in: Yogurt, sauerkraut, kimchi, kefir
– Benefit: Supports gut health, which plays a role in hormone balance and immune function.
Foods that may worsen symptoms of Endometriosis:
Processed Foods
High in unhealthy fats, sugar, and additives that increase inflammation.
Red Meat
Linked to increased estrogen and prostaglandin levels with resulting inflammation.
Dairy
Can increase serum estrogen, progesterone and IGF-1 increasing mast cell activation.
Alcohol & Caffeine
Can increase inflammation and disrupt hormone balance.
By adjusting dietary habits, women with endometriosis can influence this cycle positively, reducing pain and improving their quality of life.
Final Thoughts:
While diet alone is not a cure for endometriosis, it can be a powerful tool in managing symptoms. By incorporating anti-inflammatory, fiber-rich, and hormone-balancing foods while avoiding inflammatory triggers, many women report significant relief.
If you are considering dietary changes, working with a healthcare provider or nutritionist can help tailor a plan to your individual needs. Every woman’s body is different, and finding the right diet that works for you can take some trial and error.
Have you tried any dietary changes for endometriosis? Share your experiences in the comments below!
References
Abulughod, N., Valakas, S., & El-Assaad, F. (2024). Dietary and Nutritional Interventions for the Management of Endometriosis. Nutrients, 16(3988). DOI: 10.3390/nu16233988.
Resources
Endometriosis Awareness Month: Lessons Learned
How First-Line Therapies for Endometriosis Impacts Your Pelvic Health
Clinical Manifestations of Endometriosis
March is Endometriosis Month; Current News and Updates
Setting Up for Success after Endometriosis Excision Surgery
Virtual and In Person Services at PHRC
We offer both in-person services and virtual. The physical therapists at PHRC have undergone extensive continuing education to best help people with endometriosis. Often people do not understand their symptoms until they stumble upon our website, blog, or social media channels. Some people have a diagnosis but they do not have a pelvic floor physical therapist locally to help them. Other times people have a pelvic floor physical therapist but for some reason are not getting better or feel stuck in their treatment plans. Others just want another opinion from trusted experts. Whatever your individual needs are, we are here for you and ready to help!
Jandra Mueller of PHRC Encinitas developed the first course for physical therapists to help patients manage their care more effectively and successfully.
Jandra recently teamed up with iCareBetter, an endometriosis advocacy group, to start Endometriosis Unplugged, a podcast dedicated solely to endometriosis.
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Check out our recently published e-book titled “Vulvodynia, Vestibulodynia, and Vaginismus,” designed to empower and inform individuals on their journey towards healing and understanding.
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Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
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