Endometriosis affects millions of women worldwide. It is a chronic condition in which tissue similar to the uterine lining grows outside the uterus, often leading to pelvic pain, heavy periods, and challenges with fertility.
Although surgery and medication remain the foundation of treatment, growing evidence shows that nutrition can play a valuable supporting role.
The right dietary approach can help reduce inflammation, correct nutrient deficiencies, ease symptoms, and improve overall quality of life.
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Endometriosis is largely influenced by inflammation and estrogen-driven tissue growth. Diet has a direct impact on both.
Foods rich in trans fats, highly processed omega-6 fats and refined carbohydrates tend to promote inflammation, while diets abundant in omega-3 fatty acids, fibre, antioxidants and plant-based compounds help calm inflammatory processes.
A Mediterranean-style eating pattern, rich in oily fish, legumes, whole grains, colourful fruits and vegetables, nuts, seeds and olive oil, while lower in red and processed meats, sugary foods and overly processed snacks -- supports immune balance, improves estrogen metabolism through the gut and liver, and stabilises blood sugar levels.
Many women with endometriosis also experience specific nutrient deficiencies, often linked to heavy bleeding or chronic inflammation.
Iron deficiency is particularly common due to heavy periods, and can present as persistent fatigue, pale skin, breathlessness with minimal effort, brittle nails or a fast heartbeat. Testing iron levels through a CBC and ferritin test is essential.
Low vitamin D is also widespread and may worsen pain and inflammation, often showing up as fatigue, low mood or muscle aches.
Deficiencies in B12 and folate can lead to tiredness, numbness, cognitive fog or mouth ulcers, especially in women who follow restrictive diets.
Antioxidants such as vitamins C and E, selenium and zinc are often inadequate, which may increase oxidative stress and worsen pain or lesion growth.
In addition, low intake of omega-3 fatty acids can lead to a more inflammatory internal environment, contributing to generalised pain and stiffness.
Improving nutrition can meaningfully influence endometriosis outcomes. Anti-inflammatory diets and higher omega-3 intake have been linked to reduced pelvic pain.
Correcting deficiencies -- particularly iron, vitamin D and folate -- supports reproductive health and may enhance fertility or the response to fertility treatment.
Many women also experience better energy and mood once anaemia and micronutrient gaps are addressed.
Good nutrition reduces complications and promotes faster recovery after surgery, thanks to adequate protein and nutrients like vitamin C and zinc that support wound healing.
Over time, an anti-inflammatory diet also protects long-term health by lowering the risk of cardiovascular and metabolic diseases that may be worsened by chronic inflammation or certain hormonal treatments.
Improving diet begins with simple steps. Testing for iron stores, vitamin D, B12 and folate provides a clear starting point. Emphasising whole and minimally processed foods helps reduce inflammation naturally.
Regular consumption of oily fish, nuts, seeds, fruits and vegetables, alongside reduced intake of processed meats and refined sugars, creates a favourable internal environment.
Women with heavy bleeding benefit from regular inclusion of iron-rich foods such as red meat (if tolerated), poultry, legumes and dark leafy greens, ideally combined with vitamin C-rich foods to enhance absorption.
Supporting estrogen clearance through the gut and liver can be achieved through adequate fibre and cruciferous vegetables like broccoli and kale.
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Lifestyle factors such as maintaining a healthy weight, managing stress, getting enough sleep, and avoiding smoking and excess alcohol also influence inflammation and hormonal balance.
Endometriosis is a deeply individual condition, so nutritional care must be personalised. Co-existing conditions such as IBS, food intolerances, medication use and fertility goals all shape the best dietary approach.
Nutrition cannot replace medical or surgical care, but when integrated thoughtfully, it becomes a powerful tool that reduces symptoms, corrects deficiencies, supports fertility and enhances quality of life. For many women, nutrition becomes a practical and empowering way to manage endometriosis day by day.
Kamara Daniel, is an award winning nutritionist at Bwindi Community Hospital.
