Diet and Endometriosis: What’s Hype & What’s Helpful?

What is endometriosis?

Endometriosis is a chronic inflammatory condition. It happens when tissue similar to the lining of the uterus grows elsewhere in the body. This tissue responds to hormonal changes during the menstrual cycle, like uterine tissue does. This causes inflammation, pain, and sometimes scar tissue.

It most commonly affects the lining of the pelvis, the ovaries, and deeper tissues involving organs such as the bowel, bladder, or rectum. In rarer cases, endometriosis can occur outside the pelvic area, including the chest or lungs.

Who does endometriosis affect?

Endometriosis affects around 1 in 10 women and people assigned female at birth. Symptoms vary widely. Some people experience severe, life-limiting pain, while others have few or no symptoms.

Common symptoms of endometriosis include:

• Painful periods
• Pelvic pain
• Heavy menstrual bleeding
• Bloating, bowel changes, or nausea
• Fatigue
• Pain during or after sex
• Fertility challenges

Diagnosis can take time, as symptoms often overlap with other conditions. The only definitive diagnosis is made via laparoscopy. This is a type of keyhole surgery that's used to look at the stomach and pelvis, in order to diagnose and treat some medical conditions.

There isn't any cure for endometriosis. Instead, treatment aims to help manage symptoms and reduce long-term impact.

Is there such a thing as an endometriosis diet?

Endometriosis is linked with chronic inflammation, and research suggests diet may influence both the risk of developing the condition and how symptoms are experienced once it occurs.

But there is no single diet that works for everyone with endometriosis. The condition is complex, and dietary needs vary between individuals.

The most helpful foundations include:

• eating regularly
• ensuring adequate energy intake
• gently shifting towards a Mediterranean-style eating pattern.

This means adding more:

• fruit
• vegetables
• fibre-rich carbohydrates
• omega-3 fats (from foods like oily fish, nuts and seeds)
• overall variety

versus focusing on restriction, which is a common trap that people fall into. Supporting gut health, stabilising blood sugar, and reducing overall inflammation can influence hormones, immunity, and symptoms together.

Supporting symptom management

When it comes to managing symptoms overall, the strongest evidence supports the Mediterranean diet and plant-based diets, which are both known for their anti-inflammatory properties.

A Mediterranean dietary pattern emphasises vegetables, fruit, wholegrains, pulses, nuts, seeds, olive oil, herbs and spices, alongside regular oily fish and moderate amounts of dairy, eggs, and poultry.

Research consistently links these dietary patterns with reduced inflammation, improved gut health, and better symptom management in endometriosis.

What if I have gut symptoms too?

Gut symptoms are really common in people with endometriosis. The condition is linked with changes in how the gut and immune system function. There's also evidence of changes in the gut microbiome, visceral hypersensitivity (where internal organs become more sensitive to pain), and a higher likelihood of irritable bowel syndrome (IBS).

Before making specific food changes to manage gut symptoms, trying simple strategies can make a meaningful difference. These include

• regular balanced meals
• adequate energy intake
• good hydration
• eating in a calm, unhurried way

In my experience, these are often overlooked but can help reduce bloating and digestive discomfort. Fibre quality and diversity also matter. A Mediterranean-style pattern naturally increases fibre from a wide range of plant foods, supporting digestion, gut bacteria diversity, and oestrogen clearance. 

If you have a sensitive gut, this may mean increasing fibre gradually, prioritising soluble fibre (from foods like oats, fruit and chia seeds), and spreading fibre intake across the day.

For some people with both IBS and endometriosis, a low FODMAP approach can be helpful. FODMAPs are short-chain sugars found in some carbohydrate foods, which can trigger IBS symptoms.

One study found that 72% of women with both conditions experienced at least a 50% improvement in bowel symptoms following a low-FODMAP diet.

However, a FODMAP diet is not a first step or long-term diet to follow. Even if it does help, foods should be reintroduced over time, as prolonged restriction can reduce microbiome diversity and worsen gut sensitivity.

I heard that I should avoid dairy and gluten if I have endometriosis. Is that true?

Before removing any food from your diet, it’s helpful to understand which symptoms you’re trying to change. From there, a Dietitian can help you work out whether conditions like IBS or lactose intolerance might be contributing to your symptoms.

There is some evidence that a gluten-free diet may reduce pain for some people with endometriosis. But it's not clear whether this relates to gluten itself or to reducing FODMAPs like fructans, which are found in gluten-containing foods like bread. 

There is no strong evidence to support routinely cutting out dairy, with some studies suggesting higher dairy intake may reduce the risk of endometriosis. However, lactose intolerance is a common reason people try to reduce dairy in endometriosis. Even if you are lactose intolerant, avoiding all dairy isn’t usually necessary, and many people can still tolerate lower-lactose options.

What to Remember

Research suggests that overall eating patterns, especially Mediterranean-style or more plant-based approaches, may help reduce inflammation and support gut and hormone health in people with endometriosis.

There isn’t one single diet that works for everyone. Some people find that cutting back on foods like gluten or dairy helps their symptoms. But the best way to approach this is with support from a dietitian to avoid overrestriction or missing out on important nutrients.

The most helpful way to manage endometriosis symptoms is usually a plan that is personalised, balanced and flexible. And ideally guided by a registered dietitian with experience in endometriosis.

Where can I go for trusted help and advice on endometriosis?

It’s not always easy to know which information to trust. Here are some reliable sources for learning more about endometriosis:

• Endometriosis UK
• The Endometriosis Foundation
• NHS Endometriosis page
• British Dietetic Association Food Fact Sheets
• Guts UK for all things digestive health

You can learn more about Laura Vincent, an endometriosis specialist dietitian, and her work over on her website.