Can Diet Help Manage Endometriosis Symptoms? A Look at the Science
Living with endometriosis means constantly navigating pain, fatigue, bloating, and other symptoms that can impact every part of your life. When medical treatments don’t provide full relief, or aren’t accessible, it’s natural to look for other ways to feel better. As both a researcher and someone living with endo, I’ve often wondered whether dietary changes could help manage symptoms. If you’ve had the same question, you’re not alone.
You may have come across articles or advice suggesting that certain foods can “cause” or “increase the risk of” or “cure” endometriosis. But endometriosis is a complex, multifactorial disease, and the idea that food alone can prevent or reverse it is both misleading and potentially harmful. You did not cause your condition by eating the wrong things.
Instead, let’s focus on a more empowering question: Can dietary changes help manage endometriosis symptoms like pelvic pain, bloating, or fatigue? While high-quality research is still limited, a handful of clinical studies suggest that certain nutrients and supplements may offer relief. Here’s what we know so far, and what you might consider discussing with your care team.
How I Reviewed the Evidence
Many studies on diet and endometriosis rely on biomarkers, like inflammatory markers or circulating estrogen levels, rather than actual symptom relief. While these can offer insight into biological processes, they don’t always reflect what patients care about most: less pain, better quality of life, and improved function. For this review, I focused only on peer-reviewed studies that measured clinical endpoints, such as reduced pelvic pain, through the gold standard study design: randomized controlled trials. I found five studies that met these criteria. Here's what they suggest:
Healthy Fats
One randomized trial by Signorile et al. found that a supplement containing omega-3 and omega-6 fatty acids, along with a strict dietary plan (which included reducing meat by 50% and avoiding soy, aloe, and oats), was associated with a reduction in chronic pelvic pain. While it’s hard to isolate which factor made the difference, omega-3 fatty acids (found in fatty fish, walnuts, flaxseed, and certain oils) have known anti-inflammatory properties and may be worth trying as part of a balanced diet.
Vitamin D
Two dietary intervention trials (Mehdizadehkashi et al. and Almassinokiani et al.) found that 50,000 IUs of vitamin D supplementation was associated with improvements in endometriosis pain. These findings suggest that maintaining adequate vitamin D levels through diet or supplementation may be beneficial. Always consult your physician before starting supplements.
Antioxidants
Two studies (Santanam et al. and Sesti et al.) explored antioxidant supplementation, such as vitamins A, C, and E. Both found reductions in pain among people with endometriosis. Antioxidants help counter oxidative stress, which may play a role in endo-related inflammation and pain.
The Bottom Line
While there's no one-size-fits-all “endo diet,” some nutritional strategies show promise for managing symptoms:
Consider adding more omega-3-rich foods to your diet, such as salmon, mackerel, herring, sardines, anchovies, flaxseed, chia seeds, walnuts, and olive or canola oil. You could also talk to your doctor about whether omega-3 supplements might be right for you.
Talk to your doctor about vitamin D supplementation, especially if your levels are low.
Explore antioxidant support through diet (think colorful fruits and vegetables) or supplements, again, under medical guidance.
Keep in mind that dietary changes don’t work the same way for everyone. What brings relief for one person might not help another. Endometriosis is a complex disease, and dietary tweaks are just one of many tools that might support your well-being.
What about after excision surgery? Do I have to stay gluten-free, dairy-free, or low-FODMAP forever?
This question comes up often, and it’s an important one. The short answer? There’s no high-quality evidence saying you should continue a restrictive diet after excision surgery. In fact, there are no randomized controlled trials evaluating whether gluten-free, dairy-free, or low-FODMAP diets reduce endometriosis-related pain, either before or after surgery.
Although these diets are widely discussed in the endometriosis community, I didn’t include them in the earlier review of clinical evidence because they didn’t meet the inclusion criteria for that section (which focused specifically on randomized controlled trials that measured symptom relief using validated clinical endpoints, like pain reduction or improved quality of life). Most of the available research on these diets is observational, based on self-reported outcomes, and lacks control groups or rigorous study designs.
For example, a 2012 quasi-experimental study by Marziali et al. reported that 75% of participants who tried a gluten-free diet experienced reduced pain, but the study had no control group and didn’t assess outcomes after excision. A 2021 Dutch observational study found that participants perceived symptom improvements after eliminating gluten, dairy, or soy and increasing vegetable intake, but again, the data are based on self-reports rather than blinded, controlled comparisons. And while low-FODMAP diets are well supported in the IBS literature, the only study linking them to improved endometriosis symptoms focused on patients with both IBS and endo.
One of the largest and most recent international surveys on diet and endo (2025) found that, not surprisingly, dietary changes are common among people with endometriosis. Most participants focused on eliminating specific items (like gluten, dairy, caffeine, or alcohol) rather than following structured diets like low-FODMAP. This reflects a broader reality: people are often left to navigate diet decisions through trial and error, because evidence-based dietary guidelines for endometriosis simply don’t exist yet.
So what does this mean for life after excision? It means there’s no universal rule. Some people still benefit from avoiding certain foods, especially if symptoms haven’t fully resolved or if other GI issues are present. Others reintroduce foods they once avoided and feel completely fine. The key is figuring out what works best for you, based on how your body responds, not based on fear or rigid rules that aren’t backed by science.
A Final Note: What About Diet and Endometriosis Risk?
Like I mentioned at the very beginning of this post, some studies suggest that dietary patterns may influence the risk of developing endometriosis. For example, research from the Nurses’ Health Study, a large and well-respected prospective cohort study, found that women who consumed more omega-3s and dairy had a lower risk of endometriosis, while those who ate more red meat or trans fats had a higher risk.
These findings offer helpful clues, but it’s important to remember that observational studies like these can’t prove cause and effect. They can be influenced by things like unmeasured confounding (when other lifestyle or health factors affect results) and selection bias (when the people included in the study aren’t representative of the broader population). These kinds of limitations make it difficult to draw firm conclusions about risk.
And most importantly: You did not cause your endometriosis by eating the “wrong” things. Diet is just one of many influences, and endometriosis is a complex, multifactorial disease. This post focused on a more empowering question: what can help you feel better right now?
Be kind to yourself. Managing endometriosis isn’t about perfection. It’s about finding the tools, strategies, and support that help you feel more like yourself again.
For more details, check out the table I created summarizing each study’s design, population, findings, and limitations. The table includes two tabs: one focused on randomized controlled trials examining how diet may help manage endometriosis symptoms (the focus of this article), and a second tab that summarizes high-quality studies on diet and endometriosis risk. To ensure the second tab reflects the strongest available evidence, I excluded studies that are less robust for assessing diet-disease relationships in humans, such as pilot studies, case-control studies, animal studies, ecological studies, and qualitative research.
For questions or more information on diet and endometriosis, contact Leah at info@whrac.org.