The Best and Worst Foods for an Anti-Inflammatory Endometriosis Diet

Heavy periods, pain and nausea. The symptoms of endometriosis aren’t just distressing, they interfere with your day-to-day life.

When you have endometriosis, cells that are very similar to the cells from your endometrium (lining of your uterus) grow in other parts of your body. The cells may stick to your bladder, fallopian tubes or other organs. Then, the cells try to shed during your period — but the blood has nowhere to go.

The trapped blood from the misplaced cells causes inflammation of nearby organs and tissues. This inflammation can lead to endometriosis symptoms like pain, fatigue and digestive problems, as well as, in some cases, infertility.

But an endometriosis diet could be the key to relief from the agony. Registered dietitian Courtney Barth, RD, explains which foods could help fight endometriosis symptoms and which ones make them worse.

How does food affect endometriosis?

Inflammation and high estrogen levels can make endometriosis symptoms worse. And your diet can influence both factors.

“Food plays an important role in helping your body fight inflammation and balance estrogen,” says Barth. “Many people find that the right diet can significantly reduce endometriosis symptoms.”

Fiber helps remove excess estrogen

Estrogen is a key hormone, and you need some of it for normal functioning. But too much estrogen can aggravate endometriosis symptoms like cramping and pain. That’s where food and fiber can come to the rescue.

“Your body gets rid of excess estrogen in the stool,” explains Barth. “You should have a healthy bowel movement every day. If you don’t, you probably have constipation, and your estrogen levels could be too high.”

Kick constipation — and extra estrogen — to the curb by filling up on fiber. “Adults should eat 35 grams of fiber every day,” says Barth.

You can boost your fiber by eating more:

• Fruits and vegetables, but eat the whole food and avoid juice.
• Ground flaxseed, which you can add to smoothies or home-baked foods.
• Legumes, like beans, lentils and chickpeas.
• Vegetables.
• Whole grains, like whole-wheat pasta and brown rice.

Just be sure to increase your fiber intake gradually. “Adding a lot of fiber at once can cause bloating, gas and digestive discomfort,” says Barth. “Raise your fiber intake slowly and drink plenty of water to minimize these side effects. Ground flaxseed is packed with fiber, so don’t eat more than 3 tablespoons per day.”

Fats that fight inflammation

Endometriosis is an inflammatory condition, so inflammation makes symptoms worse. Omega-3 fats can calm inflammation from endometriosis. Good food sources of omega-3s include:

• Fatty fish, such as salmon, sardines and tuna.
• Nuts and seeds, like walnuts, chia seeds and flaxseed.
• Plant oils, such as flaxseed oil and canola oil.

Monounsaturated fats also have anti-inflammatory power. They’re found in:

• Avocadoes.
• Nuts and seeds.
• Olive oil.
• Peanut butter.
• Safflower oil.

Minerals that can help relax muscles and regulate your cycle

Calcium gets a lot of attention as an important mineral. But if you have endometriosis, make sure you’re also getting magnesium and zinc.

“Magnesium helps with menstrual cramps,” says Barth. “It’s a natural muscle relaxer.” Magnesium-rich foods include:

• Dark chocolate (but stick to small amounts, as it usually contains added sugar).
• Leafy greens, like arugula, dark lettuce, kale and spinach.
• Legumes, like black beans and edamame.
• Nuts and seeds, especially almonds and pumpkin seeds.

Zinc regulates your menstrual cycles, which is important for hormonal balance. “Zinc helps your body ovulate, or release an egg,” explains Barth. “When you ovulate, you produce progesterone, which balances out estrogen. Ovulating is also necessary if you’re trying to get pregnant.”

The highest sources of zinc are animal sources. So if you eat a vegetarian or vegan diet, ask your doctor if you should take a zinc supplement. Good sources of zinc include:

• Poultry, like chicken or turkey.
• Red meat, but limit this to two low-fat servings per week.
• Shellfish, like oysters, crab and lobster.

Learn what foods to eat to help with endometriosis.

Foods to avoid with endometriosis

Certain foods can worsen endometriosis pain by boosting inflammation or estrogen levels. Limit or avoid:

• Alcohol: Wine, beer and spirits can make endometriosis symptoms worse. At most, have one or two drinks per week.
• Caffeine: Limit your daily caffeine to 400 milligrams or less. One cup of coffee can have over 100 milligrams, depending on how it’s brewed.
• Fatty meat: Some red meat is good, but limit your overall saturated fat intake to 10% of your daily calories.
• Processed foods: Many packaged foods contain pro-inflammatory ingredients like added sugar, saturated fat and trans fat. They’re also low in the stuff you need like fiber, zinc, magnesium and healthy fats.
• Sugary drinks: Fruit juices, sodas and energy drinks are often high in sugar, which makes inflammation worse. Aim for less than 26 grams of sugar each day.

Does gluten or dairy make endometriosis worse?

Some people with endometriosis find that a gluten-free or dairy-free diet helps them feel better. But it depends on the person.

“If you’ve tried eating healthier and it’s not enough, then cutting out gluten or dairy is often the next step,” says Barth. “I usually recommend going gluten-free or dairy-free for at least a month. Then slowly add it back into your diet and see if your symptoms come back.”

You can also pinpoint problem foods with the low-FODMAP diet. “The low-FODMAP diet is designed for people with irritable bowel syndrome, but it can work with endometriosis, too,” says Barth. “If you follow it closely, you might find that certain foods trigger your endometriosis symptoms.”

Can supplements help with endometriosis?

It might be tempting to pop some pills instead of updating your diet. But don’t be quick to try supplements for endometriosis unless your doctor gives you the go-ahead.

“Your doctor can run tests to see if you’re deficient in certain nutrients,” says Barth. “Then, if your doctor recommends it, take supplements to fill any nutritional gaps. Supplements should be based on your health needs, not a one-size-fits-all approach.”

Endometriosis diet recipes

Looking for some endometriosis-friendly meals? Try these recipes:

• Breakfast: A dairy-free breakfast with healthy fats and fiber is a great way to kick off your day. Try this tropical breakfast bowl.
• Lunch: This black bean salad is chock-full of fiber and anti-inflammatory fats.
• Dinner: This baked fish recipe has healthy fats and a fiber-rich veggie.
• Snack: When you need a bite between meals, try this elemental granola recipe. It’s full of nuts and seeds that pack plenty of good-for-you nutrients.

Food is powerful medicine

Endometriosis can be debilitating, but one part of managing it could be as close as your kitchen. “If endometriosis is interfering with your life, try changing your diet,” says Barth. “It won’t hurt, and it could really help.”