Ease Endometriosis with Your Diet: Food Tips | Signos

Endometriosis can be a debilitating condition affecting up to 10 percent of women. Learn what an endometriosis diet should and shouldn't include here.

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by
Caitlin Beale, MS, RDN
— Signos
Health & Nutrition Writer
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Updated by

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Science-based and reviewed

Published:
April 23, 2024
February 2, 2023
— Updated:

Table of Contents

Period pain is accepted as a normal part of life by many women. But just because it's common doesn't mean it should be ignored. Pain related to menstrual cycles is often overlooked or dismissed for years. Women are just given pain pills or birth control to manage it. The truth is that endometriosis could be the underlying cause, and it takes specialized care to diagnose and treat it.

Endometriosis is a painful and often debilitating condition that affects around 10% of women. It is characterized by the growth of endometrial tissue in regions outside the uterus. Some women may not even know they have it, but for many, it's life-altering.

Supporting symptoms and addressing the root causes of endometriosis is vital to reduce pain and inflammation, and one way to do this is through diet. Food can't cure endometriosis, but following an endometriosis diet can be essential to symptom management. Here's what you should know.

What is Endometriosis?

Endometriosis occurs when the tissue that lines the uterus (the endometrium) travels to parts of the body like the abdomen, intestines, fallopian tubes, and ovaries. 1

The menstrual cycle is controlled by hormones that shift throughout the month. Uterine tissue outside the uterus will still respond to these shifting hormones, causing bleeding and shedding. The result is pain, inflammation, and scar tissue.

Over time, scar tissue eventually builds up to become adhesions. Adhesions are bands of endometrial tissue that form lesions and attach to other organs, like the bladder or bowel. As a result, people living with endometriosis can experience severe, debilitating pain with symptoms such as: 1

  • Pelvic pain
  • Pain with sex
  • Pain with bowel movements and urination
  • Heavy and/or irregular periods
  • Pain during ovulation
  • Fatigue
  • Irritable bowel syndrome (IBS) symptoms like diarrhea, bloating, or constipation
  • Low back pain 
  • Lower abdominal cramps
  • Infertility

What Causes Endometriosis?

The root cause of endometriosis is not entirely clear. Still, experts believe hormone imbalance is at least part of the problem. Since the uterine tissue responds to estrogen, someone with higher than normal levels of estrogen (sometimes called estrogen dominance) may be at an increased risk of endometriosis.

Inflammation is also believed to be involved in endometriosis, so anything that may increase inflammation in susceptible individuals—including diet, lifestyle, or exposure to environmental toxins—may be a factor. Certain environmental toxins can also act like xenoestrogens which means they increase estrogen in the body by mimicking the hormone.

Food vs. Endometriosis: How to Naturally Ease Endometriosis with Your Diet

Diet won't cure endometriosis by itself, but it can help reduce some symptoms of endometriosis. Nutrition can support healthy estrogen levels by upregulating the body's natural detoxification system. Estrogen is broken down to be eliminated in the gut, so eating foods to support healthy digestion and gut health is also essential.

Food can also help ease some IBS-like symptoms that endometriosis can cause. For example, food sensitivities or intolerances are very common with endometriosis, as the adhesions can attach to the intestines. Women with endometriosis are more likely to be diagnosed with IBS. An endometriosis diagnosis is also often missed because symptoms are assumed to be related to IBS.

One study found that following a low-FODMAP diet (an elimination diet that helps people with IBS) helped women by more than 50 percent. FODMAPs are short-chain carbohydrates that can cause bloating and diarrhea because they draw water into the intestine and are easily digested by gut bacteria.

Not everyone with endometriosis needs to follow a low-FODMAP diet, but an anti-inflammatory endometriosis diet benefits nearly everyone. Here's a list of the top nutrients that can help reduce endometriosis-related inflammation:

4 Anti-Inflammatory Foods For Endometriosis

1. Fiber

Breakfast with fiber

Fiber is critical for blood sugar balance, which impacts healthy hormones. Insulin, the hormone that lowers blood sugar, could stimulate the growth of endometrial cells, at least in cell culture studies. According to these studies, eating higher glycemic carbohydrates without fiber that lead to spikes in insulin and blood sugar could increase the risk of endometriosis, but more research on people is needed.  

Fiber also supports a healthy gut so it can remove estrogen from the body via stool. One study found that eating more fruit was linked to a lower risk for endometriosis, especially citrus fruit.

One caveat: If you have endometriosis but struggle with IBS symptoms, fiber can sometimes make you feel worse. If this sounds like you, it's helpful to work with a registered dietitian trained in addressing gut disorders and food sensitivities who may help you slowly increase intake or implement the low FODMAP diet to find your individual food triggers.

Fiber-rich foods include:

  • Fruits
  • Vegetables
  • Whole grains (brown rice, whole wheat, oats, amaranth)
  • Legumes (beans, lentils, chickpeas)

2. Healthy Fats

Certain types of fat appear to increase inflammation, while others, like omega-3 fatty acids, may help decrease inflammation in the body. Some research suggests that eating more omega-3 fatty acids (along with more vegetables) could help with symptoms. A recent review also concluded similar findings where omega-3 fatty acids may help reduce pain related to endometriosis.9

Healthy fat options include:

  • Fatty fish (salmon, sardines, tuna)
  • Avocado
  • Nuts, nut butter, and seeds (walnuts, chia, and flaxseeds)
  • Olive oil

3. Micronutrient-Rich Plants

Vitamins and minerals like zinc, vitamin A, and vitamin C have all been implicated as powerful inflammation fighters and endometriosis defense tools. To get enough, aim for a variety of plant foods that are minimally processed and full of these vitamins and minerals. Some options include:

  • Leafy greens (also contain compounds to support estrogen detoxification)
  • Nuts and seeds (pumpkin seeds, almonds)
  • Legumes (beans, edamame)

4. Antioxidants

Antioxidants are free radical scavengers, which means they help protect your cells from damage and help reduce endometriosis-related inflammation. Studies suggest that antioxidants may help women with pelvic pain associated with endometriosis.  

While many studies focus on antioxidant supplements, you can find antioxidants in many foods, especially brightly colored or aromatic plant foods. Some options include:

  • Berries
  • Citrus fruits
  • Dark chocolate
  • Olive oil
  • Herbs and spices

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6 Foods to Avoid With Endometriosis

The foods listed above support inflammation reduction, so the foods to avoid (or limit as much as possible) include those that may increase the inflammatory response in the body. Studies repeatedly point to trans fats as problematic for endometriosis.10 Trans fats are banned from the US food supply because they are harmful, but small amounts can still end up in processed products.

Eating these foods every once in a while may not be an issue for you, but overall you may want to limit the following:

  • Alcohol. Research indicates a strong relationship between alcohol and endometriosis, although how much is still a question. A recent review found moderate alcohol intake is connected to increased symptoms of endometriosis, possibly due to inflammation. 
  • Trans fat. One study found a nearly 50 percent increased risk of endometriosis for those who eat more trans fat. Small amounts of trans fat can still be found in some packaged foods, but you'll also find it in fried foods.
  • Red meat. Eating more red meat is also linked to endometriosis, possibly because of inflammation and high saturated fat. 
  • High glycemic carbs. As you read earlier, high glycemic carbs trigger a fast insulin and blood sugar rise. This response could adversely impact hormone levels. 
  • Coffee. Some studies suggest a relationship between caffeine and endometriosis, while others find no increased risk. You may need to experiment to see how coffee affects you. It's also worth mentioning that coffee can be a gut irritant, so if you struggle with GI symptoms, you may want to wean off.
  • Gluten. Gluten is a protein found in foods that contain wheat, rye, and barley, and can be a gut irritant and endometriosis trigger. Gluten-free diets are tricky because they've been glamourized in recent years, but in the case of people with endometriosis, it may be helpful. One study found that women who removed gluten from their diet significantly decreased pain related to endometriosis.  Gluten is not problematic for everyone but is a common food sensitivity when gut health is compromised.

Can Supplements Help with Endometriosis?

Supplements may help with endometriosis symptoms, cooling inflammation, and supporting healthy hormones. For example, an omega-3 supplement can provide the fatty acids needed for endometriosis relief if fish isn't your favorite.

Some supplements are especially potent anti-inflammatories to help endometriosis symptoms. N-acetyl-cysteine (NAC) supports antioxidant and anti-inflammatory activity in the body. One study found that women who took NAC significantly reduced pain to the point they canceled surgery, with some reported no symptoms. Curcumin, the active ingredient in turmeric, is a known anti-inflammatory, and magnesium may also be beneficial for endometriosis pain.11

Melatonin, a supplement usually taken to help with sleep, may also help with endometriosis symptoms, including pelvic pain, painful periods, and pain during sex—reducing the need for drugs for pain. It acts as an antioxidant to protect against free radical damage and inflammation

These are only some options you could use to support endometriosis symptoms. Supplements can be helpful, but if you plan to use any of the above, it's best to meet with a healthcare practitioner specializing in endometriosis to help you choose the best product and dosage for your needs.

What to Do for Endometriosis Pain: 6 Ways to Ease It

Over-the-counter or prescription pain medications are often prescribed to endometriosis sufferers. Still, other options exist if you want to reduce or stop taking medication. Absolutely no judgment if you rely on pain meds to manage endometriosis, but if you've been looking for alternatives in addition to some of the above supplements, here's how to naturally treat endometriosis pain:

  • Pelvic floor and physical therapy
  • Meditation
  • Yoga
  • Acupuncture
  • Gentle movement 
  • Mindfulness and stress reduction

Learn How to Improve Your Health with Signos

No single diet or lifestyle intervention will solve endometriosis, especially in severe cases. Combining medical (when needed) and alternative strategies can effectively reduce endometriosis pain, but it takes time and experimentation to find what works best for you. For further support, make sure you enlist the help of someone who understands the complexities of endometriosis and can help you develop an endometriosis diet, lifestyle, and health plan tailored to your unique needs.

If following an anti-inflammatory diet is new to you, or you just need extra guidance to hold you accountable, Signos can help. Using a continuous glucose monitor (CGM) paired with the Signos app for real-time feedback can help you personalize your diet to your body.

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References

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About the author

Caitlin Beale is a registered dietitian and nutrition writer with a master’s degree in nutrition. She has a background in acute care, integrative wellness, and clinical nutrition.

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