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Making diet changes may help you manage your endometriosis. This includes eating more fruits, vegetables, whole grains, and healthy fats while limiting your intake of red meat, processed foods, and alcohol.

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Endometriosis is estimated to affect 10%–15% of females of reproductive age worldwide (1).

It’s a condition involving the reproductive system in which endometrium-like tissue grows outside the uterus in areas like the ovaries, abdomen, and bowel. Normally, endometrial tissue is only found inside the uterus (2).

The symptoms may include painful periods and heavy bleeding, pain during intercourse, painful bowel movements, and infertility. The cause of endometriosis is unknown, and there is currently no cure (2).

However, certain foods may increase or decrease the risk of endometriosis, and some people find that making dietary changes can help reduce symptoms.

Here are 7 diet changes that may aid in managing endometriosis.

1. Increase your intake of omega-3 fats

Omega-3 fats are anti-inflammatory fats that can be found in fatty fish and other animal and plant sources (3).

Certain types of fats, such as plant oils containing omega-6 fats, may promote pain and inflammation. However, omega-3 fats are believed to have the opposite effect, acting as the building blocks of your body’s inflammation- and pain-relieving molecules (4).

Given that endometriosis is often associated with increased pain and inflammation, having a high ratio of omega-3 to omega-6 fats in the diet may be especially beneficial (5).

What’s more, a 206 study in rats showed that treatment with omega-3 may significantly reduce endometrial tissue (6).

Another 2021 review of studies suggests that omega-3 fats may have anti-inflammatory properties and might help encourage the regression of endometriosis symptoms (7).

Furthermore, a 2010 observational study found that people who consumed the highest amounts of omega-3 fats were 22% less likely to have endometriosis compared to those who consumed the lowest amounts (8, 9).

Lastly, researchers have found that taking omega-3 supplements could significantly decrease menstrual pain (10, 11, 12).

However, though increasing your intake of omega-3 fats from foods or supplements may be beneficial, the evidence is inconclusive, and more research is needed.

Omega-3 fats have anti-inflammatory properties, and they have been shown to help decrease menstrual pain. What’s more, a high omega-3 fat intake has been associated with a reduced risk of endometriosis.

2. Cut down on red meat

Red meat, especially processed meat, has been linked to a higher risk of certain diseases. What’s more, increased red and processed meat intake may contribute to inflammation, which is often associated with endometriosis (13, 14).

In fact, one observational study found that people who ate more than two servings per day of red meat had a 56% higher risk of endometriosis than those who consumed one serving or less per week (15).

On the other hand, a study of 156 people found that higher consumption of red meat was actually associated with a lower risk of endometriosis (16). However, these results were based on a food frequency questionnaire given to Iranian women. The average meat consumption in the Iranian population is much lower than in the Italian and American populations.

Some research also suggests that greater red meat intake could increase estrogen levels in the blood (17).

Since endometriosis is an estrogen-dependent disease, higher levels of estrogen in the blood may increase the risk of the condition (18).

Still, there is currently not enough research about red meat and endometriosis to make a solid recommendation.

In one study, red meat has been associated with a higher risk of endometriosis. Red meat may also lead to increased inflammation and estrogen levels.

3. Eat plenty of fruits, vegetables, and whole grains

Fruits, veggies, and whole grains contain vitamins, minerals, and fiber.

These foods and their benefits may also be especially important for those with endometriosis.

In fact, a high fiber intake may lower estrogen levels, which could help manage endometriosis (19).

They are also rich in antioxidants.

One older study found that people with endometriosis who followed a high-antioxidant diet for 4 months experienced increased antioxidant capacity and decreased markers of oxidative stress (20).

Another study found that taking antioxidant supplements significantly decreased menstrual pain, painful intercourse, and pelvic pain severity in people with endometriosis (21).

However, findings have not been consistent. For instance, one study found that a high intake of citrus fruits was tied to a 22% lower risk of endometriosis, while cruciferous vegetable consumption was linked to a 13% higher risk (22).

While more research is needed on how fruit and vegetable intake may affect endometriosis, enjoying various fruits, vegetables, and whole grains may be beneficial.

Fruits, vegetables, and whole grains are packed with dietary fiber, which may help lower estrogen levels. They also provide vitamins, minerals, and antioxidants, which may help ease pain and oxidative stress.

4. Limit caffeine and alcohol

Health professionals often recommend that people with endometriosis reduce their intake of caffeine and alcohol.

Several studies have found that people with endometriosis tend to consume higher amounts of alcohol than those without the condition (23, 24).

Yet, this doesn’t prove that high alcohol intake causes endometriosis. For example, it could mean that people with endometriosis tend to drink more alcohol due to the disease.

Furthermore, another study has found no link between alcohol intake and endometriosis (25).

Similarly, the potential link with caffeine is unclear.

While a few studies have found that caffeine or coffee intake was associated with a higher risk of endometriosis, a 2021 systematic review, and meta-analysis concluded that caffeine intake does not increase the risk of the condition (26, 27).

Although there is no clear evidence linking caffeine or alcohol to the risk or severity of endometriosis, some people may still prefer to reduce or limit their intake.

Though research has turned up mixed results, some studies suggest that caffeine and alcohol may be associated with an increased risk of endometriosis. While this evidence is by no means conclusive, some people may still prefer to reduce their intake.

5. Cut down on processed foods

Minimizing your intake of processed foods is a good idea for almost anyone, and doing so may also help manage endometriosis.

Processed foods are often high in fat, sodium, and sugar yet low in essential nutrients, including fiber (28).

What’s more, some research suggests that regular consumption of processed foods could also be linked to increased levels of inflammation (29).

As a result, limiting your intake of foods such as pastries, chips, crackers, candies, and fried foods may help minimize endometriosis-related pain.

For even more impact, replace processed foods with those likely to help manage endometriosis, such as fatty fish, whole grains, or fresh fruits and vegetables.

Processed foods are low in important nutrients and fiber. They have also been linked to increased inflammation, which could contribute to symptoms of endometriosis.

6. Try a gluten-free or low-FODMAP diet

Certain diets may help reduce the symptoms of endometriosis.

Gluten-free diet

A gluten-free diet is not often recommended for individuals who do not have celiac disease or specific gluten sensitivity. It is restrictive and can be low in fiber and nutrients, plus high in refined starches (30).

However, there is some evidence that a gluten-free diet may benefit individuals with endometriosis. In a 2021 study of various dietary interventions, participants found that following a gluten-free diet over a period of 6 months helped relieve endometriosis pain with a score of 6.4 out of 10 (31).

This study did not include a control group, so the placebo effect cannot be accounted for.

Nevertheless, another 2015 study of 300 women found similar results, and it did include a control group. One group took only medication, while the other took medication and followed a gluten-free diet (32).

At the end of the study, the group following the gluten-free diet experienced significant reductions in pelvic pain (33).

Low FODMAP diet

A low FODMAP diet may also be beneficial for people who have endometriosis.

This diet was designed to relieve intestinal symptoms in people with irritable bowel syndrome (IBS). It involves avoiding foods high in FODMAPs, a term that stands for fermentable oligo-, di-, and monosaccharides and polyols (34).

Gut bacteria ferment FODMAPs, resulting in the production of gas that causes pain and discomfort in those with IBS (35).

A study in people with either IBS or IBS and endometriosis found that a low FODMAP diet improved IBS symptoms in 72% of those with both endometriosis and IBS, compared to 49% in those with IBS alone (36).

Both the gluten-free diet and low FODMAP diet can be restrictive and somewhat difficult to manage. However, they may offer relief for endometriosis symptoms.

If you decide to try one of these diets, it’s a good idea to meet with a dietitian to create a plan that works for you.

A few studies have shown that a gluten-free diet may help reduce endometriosis symptoms, while a low FODMAP diet may reduce IBS symptoms in those who have endometriosis and IBS.

7. Soy may be beneficial

Some endometriosis diets recommend eliminating soy from your diet. This is because soy contains phytoestrogens, which are plant compounds that can mimic estrogen (37).

However, it’s largely unknown how phytoestrogens affect endometriosis.

Some evidence suggests they may be harmful. For example, one 2015 study found that females fed soy formula as infants had more than double the risk of endometriosis than those who were not fed soy formula as infants (38).

In addition, a few older animal studies and case reports have reported negative effects associated with taking soy supplements (39, 40, 41).

Yet, many studies that have examined dietary soy intake in people with endometriosis have found exactly the opposite.

For example, one study found that soy intake was not associated with the risk of endometriosis, while another showed that it could actually be linked to a reduced risk (42, 43).

Researchers have proposed that rather than increasing estrogen-like effects in the body, phytoestrogens have the opposite effect, blocking the effects of estrogen and reducing endometriosis (44).

The little evidence that exists seems to support this theory. However, more research is needed before conclusions can be made about the effects of soy and other phytoestrogens on endometriosis.

Some sources recommend avoiding soy, but it’s not clear whether this is beneficial. While some evidence suggests that soy may have negative effects on endometriosis, other studies have found that it decreases the risk of endometriosis.

The bottom line

There is no cure for endometriosis, and surgical or medical treatments remain the most effective methods of managing the condition.

However, making dietary changes is a complementary approach that may help some people manage their symptoms.

Remember that just as symptoms of the disease vary from person to person, treatments that work best for one person may not be right for another.

Take your time to experiment with the tips above to find the approach that’s right for you.