What to eat when you have endometriosis ?
Well, although there are few scientific studies directly linking beneficial or exacerbating foods to endometriosis, diet seems to play a significant role (Parazzini et al., 2013).
By understanding the mechanisms involved in this disease (inflammation, estrogenic environment, endocrine disruptors, for example), one can adopt a diet that acts on these factors.
For instance, inflammation is a real issue in the onset and development of endometriotic cells. Interestingly, there are more studies linking diet and inflammation.
Additionally, the first step is to implement a health-promoting diet that aims to limit:
- Inflammation (optimizing the omega-6/omega-3 ratio, stabilizing blood sugar, consuming antioxidants, and reducing the Maillard reaction)
- Exposure to endocrine disruptors (both in food and daily products)
- Estrogenic environment
If these steps aren’t sufficient, you can take it further by eliminating gluten-containing products and dairy. Studies are still limited, but initial observational and qualitative studies show promise (Karlsson et al., 2020).
For individuals with both endometriosis and Irritable Bowel Syndrome (IBS), a low FODMAP diet can be utilized (ensuring all 3 stages of the method are followed).
Some dietary supplements may be used based on individual needs and current diet/lifestyle.
What to eat when you have endometriosis, the key points
If you’ve recently been diagnosed and don’t know where to start, I recommend working on the following points:
- Limit/avoid processed foods in favor of homemade foods
- Emphasize vegetables, preferably choosing organic options (or at least prioritize salad, carrots, peppers, and cucumbers, which are among the most treated produce items)
- Ensure consumption of plant-based omega-3s (ALA): cold-pressed virgin oils like rapeseed, hemp, and walnut, around 1-2 tablespoons per day, and animal-based omega-3s (EPA and DHA): sardines, mackerel, herring, salmon.
If you don’t like these foods, consider supplementing with 500 mg of EPA and DHA. Be sure to choose a quality supplement, as taking omega-3s from polluted fish is counterproductive. The EPAX label ensures quality. For vegetarians or vegans, algae-based supplements are available.
- Limit your intake of animal fats: fatty meats, processed meats, full-fat dairy products, cream.
- Include specific anti-inflammatory spices & herbs
Can the Low FODMAPs diet be recommended for endometriosis ?
A study investigated the effects of a low FODMAP diet in 160 women with Irritable Bowel Syndrome (IBS)*, of which 36% also had endometriosis (Moore et al., 2017). After 4 weeks on a low FODMAP diet, 72% of the women reported significant symptom improvement.
Therefore, a low FODMAP diet could benefit women with both IBS and endometriosis.
Note, however, that this diet should not be the first approach.
There are dietary and lifestyle foundations to establish before diving into this method, as it can impact the microbiota and mental health (Hill et al., 2017).
*Using Rome II, III, and IV criteria for IBS diagnosis.
Should you go gluten-free ?
While the scientific evidence for gluten exclusion remains to be proven, qualitative studies (capturing experiences rather than numerical analysis) have shown that women perceive significant symptom improvement.
If symptoms don’t improve after implementing the “rules” mentioned above, a gluten-free diet can be tested for 3 months. However, a study involving 156 women with endometriosis revealed that a gluten-free diet followed for 12 months significantly reduced symptoms for 75% of them (Marziali et al., 2012).
Hence, it’s likely that a gluten-free diet needs to be tested over an extended period to observe its benefits.
