Here are the key foods that people with endometriosis should eat or avoid to help manage symptoms of inflammation and pain
Endometriosis is an oestrogen-dependent inflammatory condition, so dietary support should focus on reducing inflammation, supporting oestrogen metabolism and optimising gut health.
- Foods that aid liver detoxification – One of the liver’s key roles is to metabolise oestrogen. If this process is impaired, oestrogen can recirculate in the body, which may exacerbate symptoms. Including plenty of foods that support liver detoxification can therefore be beneficial. These include fresh herbs and spices (particularly turmeric and cumin), cruciferous vegetables such as broccoli, kale and cauliflower, as well as lemon and extra virgin olive oil.
- Fibre rich foods – Fibre helps the body bind and eliminate surplus oestrogen via the digestive tract. It also supports blood-sugar balance and gut health. Good sources include vegetables, fruit, legumes and wholegrains.
- Probiotic foods – Emerging research suggests that a diverse gut microbiome may influence the onset and progression of endometriosis. Including probiotic-rich foods such as live yoghurt, kefir, kimchi, sauerkraut and miso may help support microbial balance and modulate inflammation.
- Foods rich in Omega-3 fatty acids – Omega-3s help regulate inflammation in the body and may reduce symptom severity. Sources include ground flaxseeds, chia seeds, walnuts and oily fish such as salmon, sardines and mackerel. Studies have also shown that omega-3 fatty acids can significantly reduce menstrual and pelvic pain in women with endometriosis.
What foods should be avoided and why?
While no single food causes endometriosis, certain foods may worsen inflammation and aggravate symptoms.
- Limit caffeine (particularly coffee) and alcohol – Both can affect the liver’s ability to clear oestrogen efficiently. They have also been shown to increase inflammation in the body and may exacerbate pain associated with endometriosis.
- Trans fats – Trans fats promote systemic inflammation and can worsen symptoms. They are commonly found in highly processed foods such as shop-bought biscuits, pastries, doughnuts, crisps, margarine and frozen pizzas.
- High sugar foods – Excess sugar can trigger inflammatory pathways and cause blood-sugar spikes, which may disrupt hormonal balance and intensify pain. High sugar foods include sweets, fizzy drinks, ice cream, cakes, sweetened yoghurts and some ultra-processed snack bars.
- Aspartame – Some research suggests that aspartame may increase inflammation in certain individuals. It is commonly found in diet drinks, sugar-free biscuits, sweets, yogurts, and chewing gum.
- Red meat – In particular processed meats such as sausages and bacon, which have been shown to promote inflammation and may worsen symptoms for some women.
Should certain foods be eaten/avoided at different times in the cycle?
Before and during period (Luteal/menstrual phase). Include:
- Magnesium rich foods – Magnesium acts as a natural muscle relaxant, helping to ease uterine cramping and regulate inflammatory prostaglandins. Magnesium-rich foods include bananas, spinach, kale, swiss chard, almonds, cashews, pumpkin seeds, black beans, edamame, lentils, chickpeas and dark chocolate (70% cocoa or higher).
- Increase vitamin B6 rich foods – Vitamin B6 supports oestrogen metabolism and has been shown to reduce the intensity of cramps, while also helping to stabilise mood.
Before and during period (Luteal/menstrual phase). Avoid or limit:
- Caffeine and alcohol – Both can worsen inflammation and may intensify endometriosis-related pain, particularly around menstruation.
During period (menstrual phase):
- Increase iron rich foods to replenish lost iron – Dark green leafy vegetables, seeds and pulses such as lentils and beans are good plant-based sources. Pair with vitamin C-rich foods (for example, lemon juice or peppers) to enhance iron absorption.
- Omega-3s – Continue prioritising anti-inflammatory omega-3 rich foods during menstruation to help reduce cramping and pelvic pain.
Where possible, it is advisable to limit the inflammatory foods listed above throughout the month.
Are there any supplements people with endometriosis should be taking alongside their food?
Supplementation should always be individualised and ideally discussed with a qualified practitioner, but the following may be supportive:
- Omega 3 fish oils (if you are vegan, you can supplement with flaxseed oil) – For their anti-inflammatory properties.
- Magnesium glycinate – A highly absorbable form of magnesium that is gentle on digestion and can help ease muscle cramps and reduce pain.
- Vitamin B6 – Supports oestrogen regulation and may help reduce inflammation and pelvic pain.
- Vitamin D3 – Research suggests that women with endometriosis often have lower vitamin D levels compared to those without the condition.
- A broad spectrum probiotic – May help reduce bloating, support gut health and help modulate inflammation and oestrogen balance.
Credit: Zoe Hill, Women’s Health Nutritional Therapist (zoehillnutrition.com)
