Summary:
This review article examines dietary strategies for managing endometriosis, a chronic, estrogen-dependent inflammatory condition affecting more than 190 million females worldwide. Common symptoms include pelvic pain, painful menstruation, bowel movements and urination, painful intercourse, infertility and reduced quality of life. Its development involves genetic, environmental, hormonal and immune factors, with inflammation contributing to pain. Current treatment primarily involves hormonal medication and pain management, with surgery used when these approaches are ineffective. However, persistent or recurrent pain is common, leading to increased use of dietary and other non-medical strategies. This review focuses on the Mediterranean and low-FODMAP diets. A systematic review of nine dietary interventions found that Mediterranean, low-FODMAP and gluten-free diets were associated with 25-50% reductions in pain. A prospective observational study of 35 females also found that a personalised Mediterranean diet improved several pain-related symptoms, while studies of low-FODMAP diets reported improvements in gastrointestinal symptoms, bloating, pain and quality of life. Overall, this review suggests that dietary approaches may help manage endometriosis-related pain and gastrointestinal symptoms.
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Abstract:
Endometriosis (ENDO) is a chronic, estrogen-dependent condition affecting over 190 million females worldwide. Characterized by cyclic pelvic pain, infertility, and systemic inflammation, its symptoms profoundly impact quality of life, interfering with mental health, relationships, education, work, and sexual well-being. Despite this burden, treatment options remain limited. For symptom relief many females turn to self-management strategies, particularly dietary modifications. This review explores the relationship between ENDO, quality of life, and diet. First, we summarize the ENDO classification and assessment. Second, we provide an overview of the pathophysiology and etiology of ENDO including current diagnosis methods. Lastly, we review evidence on anti-inflammatory and elimination diets, such as the Mediterranean and Low-FODMAP diets, which are adopted to reduce ENDO-associated pain through inflammatory and estrogen-mediated mechanisms. Retrospective studies suggest the adoption of diets with anti-inflammatory properties may improve ENDO symptoms and quality of life, yet high-quality randomized controlled trials remain scarce. Before clinical recommendations regarding dietary management strategies for ENDO are developed, rigorous and comprehensive randomized trials are needed.
Article Publication Date: 14/01/2026
DOI: 10.1152/advan.00198.2025
