Food has long been used to help treat, prevent and stave off disease, and for good reason. It may not be the magic cure we’d all like it to be, but diet truly can make a difference in the management of all sorts of conditions – even those that have relatively little to do with the digestive system.

Endometriosis is a prime example. While following a specific diet may not take away the pain of lesions and growths, some foods and nutrients have been shown to reduce the impact of the condition on the body and support general wellbeing.

On the other hand, certain foods have been shown to amplify certain symptoms. This means diet can play a role in the severity of flare-ups, including those caused by the condition’s co-morbidities.

Below, we explore exactly what that means – including the foods and nutrients to seek out when building an endometriosis-friendly diet. 

“Endometriosis is a ‘nutrient hungry’ condition,” explains Lorna Driver-Davies, head of nutrition at the supplement brand Wild Nutrition. “The biological and physiological drain the body is placed under to manage the effect of the lesions means many of those with endometriosis have been shown to have low nutrient status.”

In particular, research has shown that women with endometriosis tend to have depleted levels of vitamin D, zinc, vitamin A and vitamin B12. Low levels of iron and magnesium are also common – the former due to the excess levels of bleeding the condition can cause, and the latter due to the stress it exerts on the body.

Eating well can also support women with endometriosis to recover better from surgical interventions, and help with both direct and indirect symptoms, such as fatigue, sleep issues and migraines. Conditions such as IBS, rheumatoid arthritis and lupus – all of which women with endometriosis have been shown to be at higher risk of developing – can also be supported, in part, through dietary interventions.  

Targeting specific foods and nutrients is key to building an endometriosis-friendly diet, Driver-Davies explains. Her recommendations include:

1. Get plenty of omega 3 fatty acids

Endometriosis is a condition characterised by inflammation, which means optimising the number of anti-inflammatory nutrients in your diet should be the goal.

Omega 3 is a key one to target, Driver-Davies says. “Omega 3 is an anti-inflammatory and research shows a diet rich in omega 3 can reduce the development and progression of endometriosis and help with symptoms,” she explains. 

“It’s very common for endometriosis sufferers in the UK to be low in omega 3 because Brits don’t love eating fish as much in comparison to Europeans, but it’s important.” 

While omega 3 supplements are widely available, most people should be able to get all the omega 3 you need from your diet alone. Key sources of omega 3 include oily fish (such as mackerel, herring, sardines and salmon) as well as nuts and seeds (such as flaxseed, chia seed and walnuts).  

2. Take inspiration from the Mediterranean diet

The Mediterranean diet is famed for its anti-inflammatory properties, so it can have a positive effect on the inflammation associated with endometriosis.

“I am a big fan of the strong science behind this diet,” Driver-Davies says. “Its benefits for people with endometriosis make sense since its approach is anti-inflammatory, encouraging healthy fat intake, whole foods and plenty of colourful fruit and vegetables. Other research on fruit and vegetable intake has also been found to benefit endometriosis, such as increased antioxidant support.”

The Mediterranean diet is wide and varied, so it’s easy to keep things interesting. You just want to make sure you’re getting lots of fruit and vegetables as well as whole grains and healthy fats. 

3. Up your fibre intake

A high-fibre diet isn’t just good for improving your gut health – it can also relieve symptoms of endometriosis, Driver-Davies explains. The two benefits are linked because of the role our gut plays in regulating our oestrogen levels, high levels of which can exacerbate endometriosis symptoms such as cramping and pain.

This is all because of something called the estrobolome – a specific group of bacteria within the gut microbiome responsible for producing the enzyme that helps our body to regulate oestrogen. When the estrobolome is functioning well, this enzyme helps to stop excess levels of oestrogen being absorbed into the bloodstream, instead ensuring it passes through as waste.

Increased fibre intake can positively impact this process by feeding the bacteria, ensuring they stay happy and healthy. But that’s not all.

“Fibre helps to keep bowel movements regular, which helps to make sure oestrogen is removed and does not build up,” Driver-Davies says. “It also helps to feed the gut microbiome required for a healthy immune system.” 

This is important because the immune system has been shown to play a role in the development of endometriosis, so taking steps to support immune health may make a difference to the severity of symptoms. Enhancing the health of the gut microbiome can also help

It is worth noting that one study found that cruciferous vegetables such as brussels sprouts and cabbage could slightly increase someone’s risk of developing endometriosis, despite these plants being high in fibre and containing a compound which can aid oestrogen metabolism. However, more research is needed to decipher whether this link is of legitimate concern. 

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