Altering your diet is an efficient self-management strategy that can help to relieve multiple gastrointestinal symptoms often associated with endometriosis, such as painful bowel movements or endo-belly. We've included a list of the most commonly followed nutrition strategies, but no research has shown that one method is more beneficial than the other.
1- Reducing fat intake
Saturated fats and trans fats are both pro-inflammatory, and also cause oestrogen imbalances. So limiting these is often recommended for those living with endometriosis.
- Trans fats typically come wrapped in plastic packaging and can be fried or frozen. These include many fast-food products, fried foods, or commercially available baked good. Examples include frozen pizza, doughnuts, stick margarine, and anything fried or battered.
- Saturated fats are mainly found in animal-based products and red meats, like beef, pork, eggs, and even tropical oils like coconut or palm. Small amounts of poultry or fish is preferred over diets heavy in red meat, and incorporating organic meat can help you avoid additives or hormones that may contribute to inflammation. One study showed that women who consumed more than two servings of red meat per day doubled their risk for endometriosis, compared to women who consumed 1 serving a week . Interestingly, poultry, fish, shellfish, and eggs had no risk for endometriosis.
Full-fat dairy also contains saturated fats, however, dairy also contains beneficial micronutrients such as calcium, magnesium, and vitamin D. Since consumption of high-fat dairy increases oestrogen levels and also can contribute to abdominal discomfort or ‘’endo-belly’’, you could see how you personally tolerate dairy by taking it out of your diet for a few weeks and observing any noticeable changes.
2- Patient advice
A research survey done on women with endometriosis summarised their dietary changes, where 64% of participants stated changing their diet helped reduce their pelvic pain. Many participants followed the FODMAP diet . This strategy involves taking out foods that are difficult for your body to digest; these lead to increased gas production and abdominal pain (i.e. garlic, onions, dairy, beans, apples are the most common). Each food is taken out individually and you can monitor how your symptoms are impacted, then re-introduce them once you find the culprit.
Members of our Endometriosis Panel have provided some advice on dietary adjustments for symptom management. If you already have any sensitivities or allergies to foods, eating these may trigger endometriosis flare-ups, so make sure you completely steer clear of those in your everyday diet. They also recommended heavy plant-based meals, and even going strictly vegan. Research supports this diet for reducing symptoms of severe dysmenorrhea .
3- Dietician's advice
Some advice was given by dieticians for a patient with endometriosis:
- They recommended to remove the following: caffeine, alcohol, garlic, onions, chili, dairy, gluten, corn, sugar, processed food, red meat, eggs, pork, peanuts, legumes, and brassicas.
- They also recommended to increase the following: leafy greens, fiber, and fish, especially salmon for its rich source of omega-3 fatty acids.
Although some women prefer to outright eliminate these foods from their diet, it may be difficult at first. Dieticians recommend focusing on moderation and slowly over time reducing them from your diet. This may involve identifying alternatives to your favourite snacks and foods. You might even want to try an ‘Organic-Only Diet’ for 3 months to see any effects that certain food additives (pesticides, hormones, and antibiotics) have on inflammation, and whether adjusting your diet can help with your symptom management.
It is always important to replace key nutrients if you are eliminating certain foods and this can be best done in consultation with a nutritionist.
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 Yamamoto, Ayae et al. “A prospective cohort study of meat and fish consumption and endometriosis risk.” American journal of obstetrics and gynecology vol. 219,2 (2018): 178.e1-178.e10. doi:10.1016/j.ajog.2018.05.034
 Ellis, Katherine et al. “The experiences of endometriosis patients with diagnosis and treatment in New Zealand.” Frontiers in global women's health vol. 3 991045. 31 Aug. 2022, doi:10.3389/fgwh.2022.991045