What’s the best diet for endometriosis? The science so far

We’ve gathered together some key ingredients that could be game-changers for your meal plan, highlighting some of the emerging benefits.

Endometriosis is strongly linked to our hormones, especially oestrogen and progesterone. The condition is oestrogen-dependent, which means that this hormone can both contribute to the development of the disease and make symptoms worse.^3-5

Plus, endometriosis can create progesterone resistance – progesterone is a hormone that plays a role in the menstrual cycle.⁶ This low level of progesterone can put the body into a state of inflammation, which is basically when the immune system kicks into gear to protect us against a perceived threat.⁷

Inflammation is thought to contribute to endometriosis, and likewise, endometriosis can also cause inflammation. In any case, inflammation can make your symptoms worse.^8-11

It’s important to note that, due to the aforementioned lack of research in this area, there’s no concrete evidence on the long-term effectiveness of following an endometriosis diet plan nor eating any particular food for endometriosis.¹²

Not all diets will work for everyone, so it’s beneficial to speak to a dietician or registered nutritionist before starting a diet plan as some can be restrictive. This said, keeping a food diary of foods that work well for your body and symptoms can help.

By looking at the science of how certain foods impact the body – such as anti-inflammatory and FODMAP foods or foods that support progesterone production – and then coupling that with what we already know about the condition, we can get a better idea of what might help.

Although again very limited, emerging research in this area suggests that anti-inflammatory foods may be helpful for people living with endometriosis.^18,19

Anti-inflammatory foods, like fruit and vegetables, contain plant chemicals (phytochemicals), fibre and antioxidants – all of which limit inflammatory signals caused by the immune system.^12,19-21

One of the best ways to ensure you’re getting a varied amount of fruit and veg in your diet to potentially ease endometriosis-related symptoms is to make your plate as colourful as possible.

Alongside fruits and vegetables that are rich in antioxidants, some other great anti-inflammatory foods can include:^12,21,22

Whether these types of anti-inflammatory foods are thought to help with endometriosis or not is an ongoing research space with more evidence-backed data needed to clarify. But did you know most of us are still not getting our five a day? So it’s still beneficial to eat a variety of foods.^28,29

But gut health doesn’t only play a role in inflammation. It can also help us improve the balance between oestrogen and progesterone.^31,32

This is because we have a special family of bacteria in our gut which work along with the liver to metabolise oestrogen, so that we maintain healthy levels in the body. This is especially important for people with endometriosis, who often have too much oestrogen (often referred to as oestrogen dominance) and too little progesterone (also known as progesterone resistance).^31,33,34

So, what can we eat to keep our gut happy? As fibre can help to nourish and balance our gut microbes and potentially reduce inflammation, eating a variety of fresh vegetables and fruits is key to support your body.^35-38

Some other high-fibre foods to add to your grocery list include:^38,39

If your liver isn’t working as it should, researchers have found that it can stop oestrogen from being metabolised and therefore cause it to build up in your body.^41,43 As endometriosis is an oestrogen-dependent condition, the higher your oestrogen levels are, the worse your symptoms are likely to be.⁴⁴

It’s thought that one of the better ways to support your liver is to limit your alcohol intake. Since alcohol can also contribute to inflammation in the body, it’s generally considered a good idea for people with endometriosis to reduce their alcohol intake anyway.^45,46,47

FODMAP stands for ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols’. Sticking to a low-FODMAP diet – which aims to reduce carbs that are harder to digest – might help with digestive endometriosis symptoms according to some small studies, including painful bloating.^16-51,52

One study, for example, saw people with both IBS and endometriosis trial a low-FODMAP diet. The vast majority of participants in the study benefited from the change in diet. However, significantly more women with endometriosis reported symptom improvement compared with women with IBS alone (72% vs 49%).⁵²

So what sort of foods should you be eating as part of a low-FODMAP diet? Here are some great options that might be worth prioritising if you choose to follow this diet:⁵³

On the flip side, there are certain high-FODMAP foods that may be beneficial to cut down on if you have endometriosis. However, research into the effectiveness of avoiding high-FODMAP foods and its effect on endometriosis needs further research. Eating a well-balanced diet rich in all the nutrients you need is key for your health so do not overly restrict or avoid certain foods unless advised to do so by your doctor.

High-FODMAP foods include:

Before starting a low-FODMAP diet, we would always recommend speaking to your doctor or a qualified nutritionist beforehand.

For more on this, check out hormone health: the best and worst foods to balance your hormones.

However, if you’re concerned about your symptoms or are confused about the right nutritional route for you, speak to your doctor or healthcare provider. They’ll be able to advise you on the best approach for your individual circumstances.