Endometriosis is a chronic inflammatory condition that affects an estimated 1 in 10 women of reproductive age. It often leads to pain, inflammation, and fertility challenges. [Studies](https://pubmed.ncbi.nlm.nih.gov/23419794/) show that between 30-50% of women with endometriosis experience infertility. While medical treatments such as surgery and hormonal therapy are commonly used, diet and nutrition can play a crucial role in managing symptoms and supporting fertility.

## Understanding endometriosis and fertility

This chronic condition affects an estimated 1 in 10 women of reproductive age. Research indicates that between [30-50% of women](https://www.sciencedirect.com/science/article/abs/pii/S1521693424000476#:~:text=However%2C%20approximately%2030%E2%80%9350%25,endometriosis%20%5B5%2C6%5D.) with endometriosis experience infertility. Managing the condition effectively is crucial for those trying to conceive.

### How can diet influence endometriosis and fertility?

As endometriosis presents differently in every individual, there is no universal "best diet." However, because endometriosis is associated with chronic inflammation, an anti-inflammatory approach—such as the Mediterranean diet—can be beneficial. [Studies](https://pmc.ncbi.nlm.nih.gov/articles/PMC9259892/#sec8) suggest that the Mediterranean diet, which is rich in fibre, lean proteins, and healthy fats while low in processed foods and refined sugars, may help reduce inflammation and endometriosis-related pain.

## Key nutrients to focus on for endometriosis and fertility

### 1. Whole grains

Whole grains like brown rice, quinoa, oats, barley, and whole wheat pasta help maintain healthy oestrogen levels. Oestrogen plays a significant role in the development and progression of endometriosis. High-fibre whole grains assist in oestrogen metabolism, reducing excess oestrogen levels that could contribute to endometrial tissue growth outside the uterus.

Whole grains also provide essential B vitamins, such as B6 and [folate](https://www.conceivio.com/resources/why-taking-folate-3-months-before-conception-is-crucial), which support hormone regulation and reproductive health. Additionally, these grains have a low glycaemic index, helping to stabilise blood sugar levels, which is crucial for managing inflammation and hormonal balance.

Aim to fill ¼ of your plate with high-quality whole grains at each meal, replacing refined grains like white rice and white bread with their whole-grain counterparts.

### 2. Fruits and vegetables

Fruits and vegetables are rich in antioxidants and fibre, which help combat oxidative stress and reduce inflammation in the pelvic region. Oxidative stress has been linked to the progression of endometriosis and infertility.

A diet high in brightly coloured fruits and vegetables ensures a diverse intake of phytonutrients, including:

- **Vitamin C** (found in citrus fruits, strawberries, and bell peppers) – supports immune function and reduces inflammation.
- **Beta-carotene** (found in carrots, sweet potatoes, and spinach) – aids in hormone balance and supports the luteal phase of the menstrual cycle.
- **Flavonoids** (found in berries, apples, and onions) – have anti-inflammatory properties that may reduce endometriosis-related pain.

Cruciferous vegetables like kale, Brussels sprouts, cabbage, and broccoli are especially beneficial. They contain compounds like indole-3-carbinol, which aid in oestrogen metabolism and detoxification. However, some women with endometriosis also suffer from irritable bowel syndrome (IBS), so introducing cruciferous vegetables gradually may help prevent bloating and discomfort.

### 3. Animal-based proteins

While protein is essential for overall health and fertility, the type of protein consumed can make a difference. Studies suggest that high intake of red meat, particularly processed meats like bacon and sausages, may worsen inflammation and contribute to the progression of endometriosis.

Instead, focus on lean animal proteins such as:

- **Fish** (salmon, sardines, mackerel) – rich in omega-3 fatty acids, which have anti-inflammatory properties.
- **Poultry** (chicken, turkey) – provides high-quality protein without excessive saturated fat.
- **Eggs** – contain choline, a nutrient important for foetal development and hormone regulation.

Dairy products can also be included, as studies suggest that dairy intake is not harmful to endometriosis and may even reduce the risk of developing the condition. However, if lactose intolerance is an issue, lactose-free dairy options or fortified plant-based alternatives can be used.

### 4. Plant-based proteins

Replacing some animal-based proteins with plant-based alternatives can help lower inflammation. Legumes, nuts, seeds, and soy-based products are excellent sources of protein while also providing fibre and essential micronutrients.

**Best plant-based proteins for endometriosis:**

- **Lentils and beans** – rich in fibre, iron, and plant-based protein.
- **Tofu and tempeh** – soy-based proteins that contain phytoestrogens, which may help balance oestrogen levels in the body.
- **Chia seeds and flaxseeds** – excellent sources of plant-based omega-3s, which reduce inflammation and support hormone balance.

### 5. Omega-3 rich foods and healthy fats

Omega-3 fatty acids have been [linked](https://pubmed.ncbi.nlm.nih.gov/39358652/) to a lower risk of endometriosis. They are known for their anti-inflammatory properties and may help alleviate endometriosis-related pain and improve fertility outcomes.

**Sources of omega-3s and healthy fats:**

- Fatty fish (salmon, sardines, mackerel)
- Chia seeds, flaxseeds, and walnuts
- Extra virgin olive oil
- Avocados

Reducing trans fats and excess saturated fats is also important, as these have been linked to increased inflammation and worsened endometriosis symptoms.

### 6. Herbs and spices

Anti-inflammatory herbs and spices can enhance flavour while providing medicinal benefits. Turmeric, in particular, contains curcumin, which has been shown to reduce inflammation and suppress endometrial cell growth in some studies. Ginger and cinnamon are also excellent choices for reducing menstrual pain and inflammation.

### 7. Gut health support

Emerging research suggests that gut bacteria may influence oestrogen metabolism and inflammation in endometriosis. A balanced gut microbiome is essential for overall reproductive health.

**Ways to support gut health:**

- Include probiotic-rich foods such as kefir, yoghurt, kimchi, and sauerkraut.
- Eat prebiotic foods like garlic, onions, and bananas to feed beneficial gut bacteria.
- Reduce intake of highly processed foods and artificial sweeteners, which can negatively impact gut health.

## Foods to limit or reduce

Certain foods may exacerbate inflammation and worsen endometriosis symptoms. To support overall health and fertility, consider reducing:

- **Red and processed meats** – Limit intake to one to two servings per week.
- **Excess alcohol consumption** – Moderate alcohol intake, as excessive drinking has been linked to increased oestrogen levels.
- **Highly processed foods** – Avoid foods high in trans fats, added sugars, and artificial preservatives.
- **Sugary drinks and fruit juices** – Opt for whole fruits instead of juices to reduce sugar intake and increase fibre consumption.
- **Excess caffeine** – Limit total caffeine intake to 200 mg per day (approximately two coffees or three to four cups of tea).
- **High-sodium foods** – Excess salt may negatively impact gut bacteria and contribute to inflammation.

By making informed dietary choices, individuals with endometriosis can take proactive steps towards better health and improved fertility outcomes.

## The role of specific diets in managing endometriosis

### Should I go gluten-free?

For individuals with coeliac disease, eliminating gluten is essential. However, for those without coeliac disease, the evidence supporting a gluten-free diet for endometriosis is mixed. One study found that 75% of women with endometriosis who followed a gluten-free diet for 12 months experienced a significant reduction in pain. However, the study did not analyse inflammatory markers, so the exact impact of gluten on inflammation remains uncertain.

If considering a gluten-free diet, work with a dietitian to ensure adequate nutrient intake and avoid deficiencies.

### Do I need to avoid dairy?

There is no strong evidence that dairy negatively impacts endometriosis or fertility. In fact, research suggests that regular dairy intake may lower the risk of developing endometriosis. Additionally, high-fat dairy foods have been associated with a decreased risk of anovulatory infertility.

However, some individuals with endometriosis also have IBS or lactose intolerance, making dairy difficult to digest. In such cases, choosing lactose-free dairy products or fortified plant-based alternatives can help maintain calcium and vitamin D intake.

## How dietary choices can support fertility with endometriosis

Diet plays a crucial role in managing endometriosis and supporting fertility. While there is no single "best" diet, prioritising anti-inflammatory, nutrient-dense foods can help reduce pain, regulate hormone levels, and improve reproductive outcomes. Women with endometriosis may benefit from focusing on antioxidant-rich, fibre-dense, and healthy-fat-containing foods while minimising processed foods, added sugars, and unhealthy fats.

While dietary changes can complement medical treatments, they should not replace professional care. For personalised nutrition guidance, consider working with a registered dietitian specialising in fertility and endometriosis. By making informed dietary choices, individuals with endometriosis can take proactive steps towards better health and improved fertility outcomes.

Discover how diet can help manage endometriosis, reduce inflammation, and support fertility for improved reproductive health.

What Is the Best Diet for Endometriosis and Fertility?

What Is the Best Diet for Endometriosis and Fertility?