8 Endometriosis Diet Tips That May Help You Manage Your Symptoms

Endometriosis is a condition in which cells that are similar to the tissue that forms the lining of the uterus grows outside of the uterus, leading to symptoms including intense pelvic pain before and during your period, diarrhea, and pain during sex.

Dealing with endometriosis can be a regular lesson in frustration. There are treatments available, but they may not work well for everyone. If you've tried them and still need relief, perhaps an endometriosis-focused diet may help.

While going on a special diet won't cure endometriosis and may not even ease your symptoms, experts say it's worth a shot, in combination with other protocols. "Dietary changes alone should not be considered a first-line treatment for true endometriosis," Amanda N. Kallen, MD, an assistant professor of obstetrics and gynecology at the Yale School of Medicine, told Health.

Several processes that are linked to endometriosis, such as inflammation and estrogen activity, can be impacted by your diet, Jessica Shepherd, MD, a Texas-based OB-GYN, told Health.

"Eating a healthy diet can [also] make you feel more comfortable and healthy overall, and there are some studies evaluating whether dietary changes can be a complementary therapy as well," Christine Greves, MD, a board-certified OB-GYN at the Orlando, FL, Winnie Palmer Hospital for Women and Babies, told Health.

Although there are no clear recommendations at this point for eating a special diet when you have endometriosis, it's generally thought that some changes may help. Healthcare providers say these dietary adjustments are worth considering.

Limit Trans Fats

Trans fats can naturally occur in animal products or be added to processed foods for taste and texture. But trans fats "can raise your bad (LDL) cholesterol levels and lower your good (HDL) cholesterol levels," according to the American Heart Association. Eating trans fats also raises your risk of developing heart disease, stroke, and type 2 diabetes.

"A high intake of trans fats and potentially of animal fats is associated with a higher risk of endometriosis," said Dr. Shepherd. "Fried, processed, and fast foods contain trans fats, which appear on food labels as "partially hydrogenated oils."

Avoid Gluten

Gluten is a protein found in most grains, and it usually works as a binder in breads and baked goods, according to a March 2017 Journal of Gastroenterology and Hepatology article. For some individuals, having a gluten-free diet may ease endometriosis symptoms.

A 2021 study published in The Journal of Alternative and Complementary Medicine investigated how people with endometriosis managed their symptoms through their diets. The researchers found that avoiding gluten was one of the top diet choices that helped relieve symptoms related to gastrointestinal disturbances, mood, and sleep.

Furthermore, researchers of a May 2017 BMJ article linked gluten to body inflammation, which may be a factor in exacerbating endometriosis pain, said Dr. Greves.

Eat a Low-FODMAP Diet

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are short-chain carbohydrates that your small intestine has trouble absorbing, according to MedlinePlus.

When some people eat these foods, which include dairy-based milk and yogurt, wheat products, asparagus, onions, apples, and pears, they can struggle with digestive disturbances such as stomach cramps, diarrhea, and bloating. Low-FODMAP foods include eggs, meat, some cheeses (brie, cheddar, feta), almond milk, rice, eggplant, cucumbers, grapes, and strawberries.

An April 2017 study of 160 women published in The Australian & New Zealand Journal of Obstetrics & Gynaecology found that 72% of those with endometriosis reported a more than 50% improvement in bowel symptoms after four weeks on a low-FODMAP diet. Just 49% of people with irritable bowel syndrome reported improvement. "The low FODMAP diet appears effective in women with gut symptoms and endometriosis," the researchers concluded.

Eat Less Red Meat

The exact reason for the link between red meat and inflammation isn't clear, but research indicates a connection. And inflammation may exacerbate endometriosis, said Dr. Greves.

An August 2018 study published in the American Journal of Obstetrics and Gynecology reported that higher red meat consumption was correlated with a higher risk of being diagnosed with endometriosis. Women who consumed more than two servings of red meat per day had a 56% higher risk for endometriosis, compared to women who ate one or fewer servings per week. Eating poultry, fish, shellfish, and eggs was not related to endometriosis risk, the study found.

Stock Up on Fruits

A study published in April 2018 in Human Reproduction analyzed data from 70,835 women and found that those who ate more fruits—and just one serving or more per day—had a lower risk of developing endometriosis than those who didn't. The association was particularly pronounced for citrus fruits. Women who ate one or more servings of citrus fruits a day were 22% less likely to develop endometriosis compared to women who consumed less than one serving per week. People with endometriosis tend to have lower levels of Vitamin A, the study reported, and high-fruit diets contain Vitamin A nutrients.

It's hard to say whether consuming fruits after you actually have endometriosis will ease symptoms, but Dr. Greves pointed out that eating foods that are good for your overall health may simply make you feel better as a whole—and that may make it easier to handle endometriosis discomfort.

Eat Iron-Rich Foods

It's common to struggle with fatigue and weakness when you have endometriosis. An August 2018 article published in the journal Comparative Medicine pointed to low levels of iron as a potential cause. According to the National Institutes of Health (NIH), iron "is an essential component of hemoglobin, an erythrocyte (red blood cell) protein that transfers oxygen from the lungs to the tissues," and having low iron levels can cause symptoms such as fatigue and trouble concentrating.

The only way to know for sure if you're struggling with low iron is to see your healthcare provider for a blood test. If you do, in fact, have low iron levels, or anemia, your provider may recommend that you take a supplement or try to eat more iron-rich foods. These include beans, dark leafy greens (like spinach, seafood, and iron-fortified foods, such as cereal.

Choose Foods High in Omega-3 Fatty Acids

"The literature suggests that an increased consumption of omega-3 has a positive effect on endometriosis," said Dr. Shepherd. Omega-3 fatty acids are important components of the membranes that surround each cell in your body, according to the NIH. They also help give your body energy and keep your heart, lungs, and other important organs working well.

Eat Antioxidant-Rich Foods

Antioxidants are either human-made or natural substances that may prevent or delay some types of cell damage, according to the National Center for Complementary and Integrative Health (NCCIH). It's not entirely clear why antioxidants may be helpful for endometriosis treatment, but Dr. Greves said that their ability to fight inflammation may be relevant. "The hope is that (they) could act on the inflammatory process and reduce the pain," said Dr. Greves.

In a March 2022 Acta Biomedica review of nutrients and their effects on endometriosis symptoms, researchers reported that as the search for optimal therapy continues, the "therapeutic benefits of dietary supplements are being investigated." Using them along with other treatments may "result in a synergistic effect by their anti-inflammatory, anti-oxidant, anti-proliferative, and immune-modulatory characteristics." If you want to add more antioxidants to your diet, having more fruits and vegetables is a good way to go.

A Quick Review

Healthcare providers say that a healthy diet isn't considered a first-line treatment for endometriosis—but eating well may help with your symptoms. Dr. Kallen said that dietary changes "can be a reasonable part of a multi-pronged treatment approach" for endometriosis.

"Eating a healthy diet doesn't hurt and may actually make (you) feel better," said Dr. Greves. "In turn, it may give (you) more strength when having the discomforts of endometriosis."

If you're still in pain, even during or after you've made diet changes, talk with your healthcare provider and keep the dialogue open.