Endometriosis and Nutrition – Sara Widdowson


Endometriosis is a condition where the endometrial tissue, which normally lines the uterus, grows in other sites in the pelvis, such as the ovaries, bladder, bowel and fallopian tubes.  Blood filled cysts may form on the ovaries.  These patches of tissue respond to hormones in the same way as the uterine lining, growing and shedding each cycle, and can be responsible for pain, inflammation, and infertility.

Common Symptoms:

* Intense period pain, or pain after a period

* Bloating, constipation, diarrhea -IBS

* Infertility

* Pain with sexual intercourse

* Heavy menstrual bleeding

* Lower backache


Dietary & Lifestyle Advice

The aim of nutrition therapy is to reduce common causes of gut irritation for those with symptoms such as bloating, changes in bowel habits and abdominal pain. It also aims to reduce PMS- type symptoms by increasing foods that promote progesterone health. Nutrition advice for Endometriosis should be as individual as each women that is diagnosed is unique in terms of her food preferences, lifestyle, medical history, symptoms and treatment. This resource was designed to give you basic information regarding nutrition for Endometriosis which is a great place to start. If you would like more specific or individual information you are welcome to make contact via the contact details provided.


Bowel Health Advice

  • Boost your dietary fiber intake to 30g/day  to bulk up bowel motions and reduce bloating. Sources of dietary fiber are varied but include flaxseed, psyllium husk, LSA, oat bran, fruits, vegetables (skin on) and legumes.
  • Include functional foods that contain probiotics such as Acidophilus yoghurt – great for promoting friendly gut bacteria
  • Reduce caffeine intake. Caffeine is not only found in coffee but also tea, coke and chocolate. Try decaffeinated beverages or peppermint tea (which doubles as a reliever of bloating)
  • Focus on meal regularity- regular meals reduces your speed of eating and portion sizes (as you have not let yourself get too hungry in between meal times)
  • Minimize alcohol (in particular cider and beer)
  • Avoid aggravating foods that take longer to digest, such as saturated fats and highly processed foods, trim off all visible fats from meat, and avoid fish and chips and other deep fried foods
  • Avoid artificial sweeteners which are known to ferment in the gut and result in bloating (in particular sugar alcohols such as sorbitol, mannitol and xylitol which are found in protein powders, sugar free products and gum or breath mints)
  • Aim to exercise daily.  Exercise increases transit of stools through the colon and will help to prevent bacterial build up by reducing the time bacteria is in the colon. Gentle movement such as yoga and walking can also help with stress management.


Anti-inflammatory Nutrition & Lifestyle Advice

  • Increase fresh fish intake for its anti-inflammatory benefits. Ideally including oily fish twice a week is best, or you could look at supplementing with fish oil, krill oil or flaxseed oil as a safe and effective way to get the health benefits of omega-3
  • Reduce intake of wheat and dairy, common sensitivities in those with Endometriosis (note it is important that you replace dairy products with appropriate alternatives for bone health and include plenty of other fiber sources if removing wheat products. You may find a Dietitian consultation helpful for this).
  • Increase intake of colourful vegetables – looking at breakfast and lunch meals is a great way to start this. Can you add vegetables to these meals such as spinach with poached eggs or including an additional handful of vegetables to your lunch time salad/sandwich?
  • Consider sleep and stress management as key components of self-care when living with Endometriosis. Increased stress levels lead to hormone changes in your body which contribute to inflammation and gut issues. Consider sources of stress in your life; which can you control or reduce and which are non-negotiable? i.e. it might not be possible to reduce hours or change responsibilities at work but could you say “no” a little more in your life? Think of what lights you up and how could you include more of these things?


Key Nutrients

  • Vitamin D and Calcium for bone health. This is particularly important if you are reducing or removing dairy products from your diet or if you are on certain medications such as Zoladex which increases your risk of Osteoporosis if used long term. Non-dairy food sources of Calcium include tofu, fortified non-dairy milks, almonds, figs and dark leafy greens. Vitamin D is found in small amounts in foods and our best source is sunlight.
  • Magnesium for production of the body’s own sex hormones (in particular progesterone) and for improving bowel health. Food sources include green leafy vegetables, legumes, nuts and seeds.
  • Omega-3 fatty acids for anti-inflammatory properties and pain management. Food sources include oily fish (salmon and mackerel) and flaxseed oil.


Sara Widdowson

Dietitian & Nutrition Consultant

Oxford Women’s Health    


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