Endometriosis & Nutrition: Gentle, Evidence-Based Tips for Managing Symptoms

Endometriosis & Nutrition: Gentle, Evidence-Based Tips for Managing Symptoms

Living with endometriosis can feel overwhelming. And you might find yourself wondering “what should I be eating to manage my symptoms?”

The truth is, while there’s no single “endo diet,” food and nutrition can play an important role in reducing inflammation and supporting overall wellbeing. In this blog, we’ll explore how endometriosis affects digestion and health, along with practical, non-diet nutrition strategies to help you feel nourished and supported.

What Is Endometriosis?

Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the uterus grows outside it. Symptoms vary person to person but some common ones include:

• Severe period pain

• Heavy periods

• Chronic pelvic pain - Including pelvic region, lower back and legs

• Fatigue

• Fertility challenges

• Digestive issues such as bloating, constipation, or diarrhoea

• Pain when urinating

Approximately 1 in 7 individuals are affected, but diagnosis often takes years.

Endometriosis & the Gut: Understanding the Connection

85–90% of people with endometriosis experience digestive symptoms. These often include bloating, constipation (or incomplete evacuation), diarrhoea, gas, nausea, cramping, and abdominal pain. For many, these symptoms can feel just as disruptive as pelvic pain.

Why Does Endometriosis Affect the Gut?

The link between the gut and endometriosis is still being researched, but several factors may contribute to these IBS-like symptoms:

• Pelvic floor dysfunction – tension in the muscles surrounding the bowel can affect movement.

• Endometrial tissue or adhesions – growths on or near the bowel may trigger pain or altered bowel habits.

• Medications or supplements – some treatments can cause digestive side effects.

• Stress and psychological factors – anxiety and stress can worsen gut sensitivity.

• Undernourishment – not eating enough can slow digestion and intensify symptoms.

• Visceral hypersensitivity – the gut may become more sensitive to pain signals.

• Dysbiosis – imbalances in gut bacteria may play a role in both endometriosis and gut symptoms.

Often, it’s not just one factor but a combination of influences that drives these symptoms.

Why Improving Constipation Matters in Endometriosis

Managing constipation isn’t just about comfort-it can directly impact endometriosis symptoms by:

• Reducing pain - from the pressure constipation places on the uterus and bladder.

• Supporting estrogen clearance - constipation can slow the excretion of estrogen, allowing it to be reabsorbed, which may worsen endometriosis symptoms.

• Improving gut function overall - regular bowel movements can ease bloating, cramping, and other IBS-like symptoms.

Nutrition Tips for Endometriosis Management

Nutrition can play an important role in improving endometriosis symptoms by reducing inflammation, supporting the clearance of excess hormones through the bowels (as mentioned above), easing gut-related symptoms, and optimising key nutrients to maintain energy levels.

1. Focus on Anti-Inflammatory Foods

Evidence suggests that an anti-inflammatory or Mediterranean-style diet may help manage endometriosis symptoms. This way of eating is rich in antioxidants, which can help reduce inflammation- a key contributor to many endo-related symptoms.

Aim to include:

• Fatty fish (salmon, sardines, trout) for omega-3s

• Plenty of colourful fruits and vegetables

• Extra virgin olive oil - use regularly in cooking or as a salad dressing

• Wholegrain sources of carbohydrates (e.g., oats, brown rice, quinoa)

• Legumes and beans

• Nuts and seeds + avocado - add daily for healthy fats and fibre

• Herbs and spices - use often for flavour and added antioxidants

• Your favourite foods - remember, this way of eating is about adding in nourishing foods to support wellbeing, not cutting foods out

NOTE: We acknowledge that the Mediterranean Diet is often presented in a way that overlooks the rich diversity of food from many different cultures. However, its core principles can be adapted to complement various traditional ways of eating around the world.

2. Support Gut Health

Gut symptoms are common in endo. Support your digestion with:

• Adequate fibre from oats, legumes, wholegrain bread and veggies

• Eat and drink regularly

• Fermented foods like yoghurt, sauerkraut, kefir

More here: How to improve your gut health: Dietitian-backed tips for better digestion & wellbeing

3. IMPROVE CONSTIPATION

The essentials that can help to improve constipation:

• Regular eating, including breakfast, to get things moving in the morning

• Staying well-hydrated

• Getting enough fiber through food and/or supplements

• Daily movement

• Toileting techniques, such as using a toilet stool or working with a pelvic floor physio

• Diaphragmatic breathing

4. Avoid Over-Restriction

Cutting out entire food groups rarely solves endo pain. Instead of restriction, we encourage a focus on adding in nourishing foods that support energy, mood, and hormone balance.

What About Gluten, Dairy & Soy?

Cutting out gluten, dairy, or soy is not something we would typically recommend for managing endometriosis. These foods provide important nutrients that can actually help improve symptoms. None of them are inherently inflammatory-despite what some media sources may claim (eyeroll).

In fact, soy products such as tofu, soy milk, and edamame have been shown to help regulate estrogen levels in the body, which may be beneficial for those with endometriosis.

That said, some individuals may notice that reducing certain foods helps with symptom management—and that’s okay. The key is ensuring all essential nutrients are still being met elsewhere in the diet, which is where working with a dietitian can be especially helpful.

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Nervous System Support For Endometriosis

The nervous system plays a key role in how we experience pain. Supporting it is just as important as focusing on nutrition when it comes to managing endometriosis symptoms. Gentle strategies to care for your nervous system may include:

1. Prioritising rest and quality sleep, which allows the nervous system to reset

2. Gentle movement such as walking, yoga, or stretching to regulate stress hormones

3. Breathing or mindfulness practices to help calm the body and mind

4. Gut centred hypnotherapy - there is evidence to show that this can be equally as effective for managing IBS as the low FODMAP diet!

5. Seeking professional support (eg. psychologist, dietitian, GP)

Final Thoughts

While nutrition can’t cure endometriosis, it can play an important role in supporting symptom management. Remember: there’s no one-size-fits-all “endo diet.” The best approach is one that fits you, your lifestyle, and your unique symptoms.

If you’re living with endo and struggling to know what to eat, you don’t have to figure it out alone. Book an appointment with a TWC dietitian to get personalised, evidence-based support for your nutrition, gut health, and mental wellbeing.