Is Food the New Medicine for Endometriosis Pain?

Endometriosis is a painful, chronic condition affecting nearly 200 million people worldwide, primarily women and people assigned female at birth. It’s defined by the presence of endometrial-like tissue growing outside the uterus, often leading to symptoms like chronic pelvic pain, infertility, severe menstrual cramps, and gastrointestinal issues resembling IBS (irritable bowel syndrome), such as bloating, constipation, and diarrhoea.

Traditional treatment includes hormonal therapy, pain medications, and surgery, but none of these are universal solutions, and many patients report that the treatments are only partially effective or come with significant side effects. As a result, a growing number of individuals are turning toward dietary modifications to manage their symptoms.

What Our Survey Found: Diet, Pain, and Endometriosis

To bridge the knowledge gap between anecdotal advice and scientific evidence, our research team launched an international online survey in partnership with a Scottish endometriosis support group. The aim? To understand if and how people with endometriosis are using diet to manage pain.

·         Survey Respondents: 2,599 individuals from 51 countries

·         Age Range: 16–71 years

·         Common Symptoms:

o    Pelvic pain: 97%

o    Abdominal bloating: 91%

We asked participants to rate their average pelvic and abdominal pain over the last month using a 0–10 pain scale. Responses were diverse, but most reported pain levels that affected their ability to concentrate, sleep, or perform daily tasks.

Crucially, 83% of respondents reported making dietary changes to ease symptoms. Of those, 67% said their pain improved.

Table 1: Most Common Dietary Changes & Reported Effectiveness

Dietary Change	% of Participants Who Tried It	% Reporting Pain Improvement
Reduced alcohol intake	54%	53%
Gluten-free diet	48%	45%
Dairy-free diet	46%	45%
Reduced caffeine intake	44%	43%
Reduced sugar/processed foods	41%	50%

Note: Many respondents tried more than one diet simultaneously.

The findings suggest that dietary changes, especially those targeting inflammatory foods, may play a role in symptom reduction. However, these results are self-reported and not from clinical trials, which makes it difficult to confirm causality.

Why Might Diet Work? The Role of Inflammation

One key insight from recent research is that chronic inflammation may significantly contribute to endometriosis-related pain. Inflammation—typically a natural immune response—can become harmful when overstimulated, as is often the case in endometriosis. This heightened immune activity may lead to:

·         Nerve sensitisation

·         Amplified pain perception

·         Disruption of gut-brain communication

Certain foods—like gluten, dairy, and alcohol—can promote inflammation, especially in individuals with gut sensitivities. The metabolic byproducts of these foods, once broken down by gut bacteria, may leak into the bloodstream and cause systemic inflammation, including in the pelvic region.

By removing or reducing these potential inflammatory triggers, some patients may experience reduced pain and better gut function.

Table 2: Inflammatory Potential of Common Foods

Food Type	Inflammatory Potential	Mechanism
Gluten	Moderate to High	Gut irritation, increases zonulin, leaky gut
Dairy	Moderate	Casein and lactose sensitivities
Alcohol	High	Liver strain, gut barrier disruption
Processed Sugar	High	Promotes insulin resistance and inflammation
Caffeine (excessive)	Moderate	Alters cortisol levels, affects digestion

Limitations of the Study

While this was the largest survey of its kind, some limitations must be acknowledged:

·         The survey was only in English, potentially limiting global participation.

·         All data were self-reported, making them subject to bias and recall error.

·         There was no control group, meaning the effects could be placebo-related.

·         Dietary changes were often made in combination, making it hard to isolate the impact of each food.

These factors mean we cannot say for certain that dietary changes caused the improvements in pain.

What’s Next? From Survey to Science

The promising findings of our survey point to the urgent need for clinical research. That’s why we are now launching a large-scale clinical study involving over 1,000 participants.

This new study will include:

·         Stool and blood samples to analyse microbiome and inflammation markers

·         Detailed food intake logs

·         Daily pain and symptom tracking

·         Monitoring of supplements, probiotics, and medications

Our goal is to identify personalised, evidence-based dietary strategies that can be integrated into a holistic care plan for endometriosis management.

Conclusion: Is Food the Future of Endometriosis Care?

While diet is not a cure, our survey reveals a clear trend: many people with endometriosis are already turning to nutrition to manage their pain, with mixed but often positive results.

If future clinical studies confirm a causal link between certain dietary patterns and pain reduction, nutrition could become a cornerstone of personalised treatment, minimising reliance on invasive treatments and enhancing quality of life.

Until then, those with endometriosis may consider cautiously experimenting with dietary changes, ideally in consultation with a dietitian or healthcare provider familiar with inflammatory conditions.

References

1.       World Health Organization. (2024). Endometriosis: Key facts.

2.       Horne, A. W., et al. (2023). “Patient-led dietary modifications in endometriosis management.” Journal of Women’s Health Research.

3.       Ferguson, M., & Rees, M. (2021). “Inflammation and pain pathways in endometriosis.” Clinical Gynecology Review, 29(2), 102-110.

4.       National Institute for Health and Care Excellence (NICE). (2020). Endometriosis: Diagnosis and management guidelines.

5.       Baibakova, T. (2024). Image via Shutterstock.