Endometriosis diet: Foods to eat and avoid

Endometriosis is a condition in which cells similar to the tissue that lines the uterus develop outside of it. This causes symptoms such as severe pelvic discomfort before and during menstruation, diarrhoea, and pain during sex. Endometriosis can be linked to inflammation and oestrogen levels. The symptoms of endometriosis can be managed by eating a diet rich in anti-inflammatory fruits, vegetables, and whole grains. These provide essential vitamins, minerals, and fibre. Lean protein sources like fish, chicken, and beans can also be helpful. Also, opt for healthy fats from nuts, seeds, and olive oil, which may reduce inflammation. Diet does not cure endometriosis but it can help with symptoms. Here’s what to eat for endometriosis and what to avoid.

What is endometriosis?

Endometriosis is when tissue comparable to the lining of the uterus (known as the endometrium) begins to grow outside the uterus. This tissue can be found on the ovaries, fallopian tubes, outer surface of the uterus, or other organs in the pelvic cavity, as found in a study published in the Cureus Journal. “During the menstrual cycle, this tissue behaves like normal endometrial tissue – it thickens, breaks down, and bleeds. However, because it’s outside the uterus, the blood cannot exit the body like menstrual blood, leading to inflammation, pain, and the formation of scar tissues or adhesions, explains gynaecologist and obstetrician Dr Kanupriya Jain.

Also Read: All about endometriosis

Symptoms of endometriosis

The symptoms of endometriosis can vary in severity and may include:

• Pelvic pain: The most common symptom, often associated with menstrual periods, is known as dysmenorrhea. Pain may begin before and last for days into a menstrual period.
• Pain during intercourse: Pain during or after sex is common with endometriosis.
  Pain with bowel movements or urination: These symptoms are often experienced during menstrual periods.
• Excessive bleeding: Heavy menstrual periods (menorrhagia) or bleeding between periods (menometrorrhagia).
• Infertility: Endometriosis is found in 20-40 percent of infertile women, as per John Hopkins Medicine.
• Other symptoms: Fatigue, diarrhoea, constipation, bloating, and nausea, especially during menstrual periods.

Endometriosis and diet: What’s the link?

While there is no definitive dietary cure for endometriosis, certain dietary patterns may influence the severity of symptoms and overall disease management. Adopting an anti-inflammatory, balanced diet can potentially help manage symptoms and improve overall quality of life. Individual responses to dietary changes can vary, so it is essential to find a personalised approach that works best for you, says Jain.

Which food should you eat if you are suffering from endometriosis?

If you are suffering from endometriosis, incorporating certain foods into your diet can help manage symptoms and improve overall health. Here are some foods to consider, as suggested by dietician Gauri Anand.

Anti-inflammatory foods

1. Fatty fish: Salmon, mackerel, sardines, and other fatty fish are rich in omega-3 fatty acids, which have anti-inflammatory properties.
2. Nuts and seeds: Walnuts, flaxseeds, chia seeds, and almonds provide omega-3s and other healthy fats that reduce inflammation.
3. Olive oil: Extra virgin olive oil is a healthy fat that can help reduce inflammation.

High-fibre foods

1. Whole grains: Brown rice, quinoa, barley, and oats are high in fibre, which supports digestive health and helps regulate hormones.
2. Fruits: Berries, apples, pears, and oranges are rich in fibre and antioxidants.
3. Vegetables: Leafy greens (spinach, kale), cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), and other high-fibre veggies support gut health and reduce inflammation.

Antioxidant-rich foods

1. Berries: Blueberries, strawberries, raspberries, and blackberries are high in antioxidants, which help fight inflammation and oxidative stress.
2. Dark chocolate: In moderation, dark chocolate (with at least 70% cocoa) provides antioxidants and can be a healthy treat.

Foods rich in vitamins and minerals

1. Leafy greens: Spinach, kale, and Swiss chard are rich in vitamins A, C, K, and folate, which support overall health and reduce inflammation.
2. Nuts and seeds: In addition to omega-3s, they are rich in magnesium, which can help reduce muscle cramps and pain.
3. Citrus fruits: Oranges, lemons, and grapefruits are high in vitamin C, which supports the immune system and reduces inflammation.

Fermented foods

1. Yoghurt: Look for unsweetened, probiotic-rich yoghurt to support gut health.
2. Kefir: This fermented milk drink is a good source of probiotics.
3. Sauerkraut and kimchi: Fermented vegetables that provide beneficial bacteria to support digestive health.

Lean proteins

1. Legumes: Beans, lentils, and chickpeas are high in protein and fibre, which help manage blood sugar levels and support gut health.
2. Poultry and fish: Lean sources of protein that are less likely to promote inflammation compared to red meat.

Herbal teas

1. Ginger tea: Ginger has anti-inflammatory properties and can help reduce pain and nausea.
2. Turmeric tea: Turmeric contains curcumin, which has strong anti-inflammatory effects.

Some diet tips to manage endometriosis

• Balanced meals: Ensure each meal includes a balance of protein, healthy fats, and fibre to stabilise blood sugar levels and reduce inflammation.
• Hydration: Drink plenty of water throughout the day to stay hydrated and support overall health.
• Limit processed foods: Reduce consumption of processed and sugary foods, which can increase inflammation.
• Avoid trans fats: Minimise intake of trans fats found in many fried and processed foods.
• Moderate soy intake: While soy contains phytoestrogens, which can have mixed effects, moderate intake is generally safe. Opt for whole soy foods like tofu and edamame over processed soy products.

By focusing on a diet rich in anti-inflammatory, fibre, and nutrient-dense foods, individuals with endometriosis can help manage their symptoms and support their overall health.

Which food should you avoid in endometriosis?

If you are suffering from endometriosis, avoiding certain foods can help manage symptoms and reduce inflammation. Here are some foods to avoid or limit, as explained by Anand.

Red meat and processed meats

1. Red meat: Beef, pork, and lamb can promote inflammation due to their high levels of saturated fats.
2. Processed meats: Sausages, bacon, ham, and deli meats contain preservatives and additives that can exacerbate inflammation and hormonal imbalances.

High-fat and fried foods

1. Trans fats: Found in many fried foods, baked goods, and processed snacks, trans fats can increase inflammation.
2. Fried foods: French fries, fried chicken, and other fried foods contain unhealthy fats that can promote inflammation.

Refined carbohydrates and sugary foods

1. Refined grains: White bread, white rice, pastries, and other refined grains have been stripped of their fibre and nutrients, leading to spikes in blood sugar and increased inflammation.
2. Sugary foods and beverages: Soda, candy, baked goods, and other sugary foods can cause inflammation and negatively impact blood sugar levels.

Dairy products

1. High-fat dairy: Whole milk, cheese, and butter can increase inflammation and may exacerbate symptoms for some individuals with endometriosis. However, low-fat or plant-based dairy alternatives may be better tolerated.
2. Lactose: Some people with endometriosis may also have lactose intolerance, which can worsen gastrointestinal symptoms.

Caffeine and alcohol

1. Caffeine: Excessive caffeine intake can disrupt hormone levels and worsen symptoms. Limiting coffee, tea, and energy drinks can be beneficial.
2. Alcohol: Alcohol can increase oestrogen levels and inflammation. Limiting or avoiding alcohol can help manage symptoms.

Soy Products

1. Processed soy: Soy-based products like soy milk, tofu, and edamame contain phytoestrogens, which can mimic oestrogen in the body. While the effects are debated, it’s generally advisable to consume these in moderation and focus on whole, unprocessed forms of soy.

Gluten

1. Gluten-containing grains: Some individuals with endometriosis report symptom improvement when following a gluten-free diet. This includes avoiding wheat, barley, rye, and foods made from these grains.

Processed and preservative-laden foods

1. Preservatives and additives: Foods high in preservatives, artificial additives, and colourings can contribute to inflammation and should be limited.

Omega-6 fatty acids

1. Certain vegetable oils: Oils high in omega-6 fatty acids, such as corn oil, soybean oil, and sunflower oil, can promote inflammation if consumed in excess. Opt for oils with a better balance of omega-3 and omega-6 fatty acids, such as olive oil.

It is best to eat the right foods and avoid certain foods to manage endometriosis symptoms. You should consult your doctor to know the right diet plan if you have the condition and avoid complications.