Dietary changes could reduce the pain of endometriosis for half of those living with the disease, a major new international study suggests.
In the largest survey ever conducted on diet and endometriosis—encompassing 2,599 participants—researchers found that 45% of those who cut out gluten and the same proportion who eliminated dairy experienced an improvement in their pain. Additionally, 43% of those who reduced caffeine intake and 53% of those who cut back on alcohol reported less pain.
Professor Philippa Saunders, senior author and professor of reproductive steroids at the University of Edinburgh, called the findings groundbreaking. “It really feels like we are on the cusp of something pretty big with understanding how diet affects endometriosis symptoms,” she said.
“It is so important for women if they feel they can do something for themselves to tackle the pain of endometriosis – that is tremendously empowering.”
Understanding Endometriosis and Its Challenges
Endometriosis occurs when tissue similar to the uterine lining grows elsewhere in the body, often causing severe pain. Affecting one in 10 women of reproductive age in the UK, it remains under-researched and poorly understood.
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Diagnosis can take nearly seven years due to lack of awareness and adequate diagnostic tools. Treatment options are limited—surgical procedures are often temporary solutions, and hormonal therapies are not well tolerated by all patients.
Dietary Interventions and Gut Health
The new study, published in JAMA Network Open, surveyed individuals from 51 countries, including 1,115 from the UK. Participants were asked about dietary changes and supplements they used to manage their symptoms.
Researchers believe improvements in pain could be due to changes in gut microbiota. Cutting out gluten and dairy may reduce inflammation by altering the gut’s bacterial composition.
Caffeine’s impact is thought to stem from its effect on sleep, which can exacerbate pain. Meanwhile, alcohol may mimic the effects of estrogen—known to fuel endometriosis—hence reducing alcohol intake could potentially lower symptom severity.
The Role of Inflammation in Endometriosis
The condition typically causes pelvic pain, particularly during menstruation, but may also result in sciatic, breast, and widespread joint pain. Endometrial tissue outside the uterus can grow new nerve cells and heighten pain sensitivity. These pain signals are intensified by inflammation—making anti-inflammatory dietary strategies a key focus.
About 40% of participants reported reduced pain after cutting out processed foods such as ready meals, sweets, and ice cream. These foods are known to influence gut bacteria that can trigger inflammation. Additionally, 30% found relief after eliminating garlic and onion, which may help alleviate “endo belly,” or the uncomfortable bloating associated with the condition.
Cautions and Future Research
Medical professionals stress that any significant dietary changes should be made in consultation with a healthcare provider. While the survey data is promising, the study relied on self-reported outcomes and did not establish causality.
Larger, randomized clinical trials are needed to verify the effects of dietary interventions, measuring both inflammation and pain reduction.
Francesca Hearn-Yeates, lead researcher, emphasized the importance of patient-driven discoveries: “This condition is so under-researched and there is so much to discover. Gut bacteria may play a significant role in symptoms, and that explains why many women experiment with dietary changes—which, we found, appear to work for many.”
Expert Opinions
Jo Hanley, specialist adviser at Endometriosis UK, welcomed the study: “We follow with interest studies on the potential impact and role of diet and nutrition in the management of endometriosis.”
“An anti-inflammatory diet can help reduce the body’s inflammation response,” she added. “That includes foods like fruit, vegetables, beans, chickpeas, wholegrains, nuts, seeds, and olive oil, with some fish and poultry.”
“Foods that contain refined sugars, unhealthy fats, dairy, red and processed meats can create inflammation in the body,” she warned, suggesting that patients keep a food and symptom diary to identify triggers.
Professor Ying Cheong of the University of Southampton acknowledged the value of the study but urged caution: “While these self-reported benefits are promising, further clinical research is needed to confirm the true impact of specific dietary changes.”
Dr Nilufer Rahmioglu, senior research scientist at the University of Oxford, agreed, stating: “This study provides valuable insights into the lived experiences of individuals with endometriosis who have explored dietary modifications. While it cannot assess causality, it highlights the need for further rigorous research into these potential non-hormonal strategies.”
Conclusion
Though not yet a definitive cure, the study represents a significant step forward in exploring non-invasive, non-hormonal strategies for managing endometriosis. With future clinical trials, dietary therapy may one day become a key component of holistic endometriosis care.
