Endometriosis affects an estimated 1 in 10 women of reproductive age worldwide, yet it often goes undiagnosed for years. While surgery and medications are common treatment options, emerging research shows that nutrition can play a powerful role in reducing symptoms, improving hormone balance, and lowering inflammation associated with this condition.
In this post, we’ll break down what endometriosis is, how it affects the body, explore three evidence-based nutrition strategies backed by clinical research, and cover practical food tips to help you apply this research in your everyday life.:
What is Endometriosis?
Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining (endometrium) grows outside the uterus — commonly on the ovaries, fallopian tubes, pelvic cavity, and sometimes beyond. Unlike regular menstrual tissue, these lesions do not shed naturally during your cycle, leading to inflammation, scarring, and pain.
Common Symptoms
- Severe pelvic pain, especially during menstruation
- Heavy or irregular periods
- Pain during intercourse
- Digestive issues and bloating (“endo belly”)
- Infertility or trouble conceiving
While the exact cause remains unclear, hormonal imbalance, oxidative stress, immune dysfunction, and chronic inflammation are central to the disease process (Abbott, 2023).
Nutrition-Based Strategies for Endometriosis Management
1. Antioxidant Vitamins C + E
Oxidative stress — an imbalance between free radicals and antioxidants — plays a key role in the progression of endometriosis. Women with the condition often show higher markers of oxidative damage, contributing to inflammation, pain, and fertility issues.
How They Work
Vitamin C is a water-soluble antioxidant that neutralizes free radicals and supports collagen production.
Vitamin E is fat-soluble and protects cell membranes from oxidative damage.
Together, these vitamins reduce pelvic inflammation and improve pain control.
What the Research Shows
Amini et al. (2021) conducted a randomized, triple-blind, placebo-controlled trial showing that women with endometriosis who supplemented with 1,000 mg vitamin C + 800 IU vitamin E daily for 8 weeks had significant reductions in oxidative stress markers and reported less pelvic pain.
Zheng et al. (2023) performed a meta-analysis confirming that antioxidant vitamin supplementation decreases endometriosis-related pelvic pain.
Bechara et al. (2022) further support the role of antioxidants in tissue healing, emphasizing improved cellular repair in inflammatory conditions.
Practical Tips
- Foods rich in Vitamin C: Oranges, strawberries, kiwi, bell peppers, and broccoli.
- Foods rich in Vitamin E: Almonds, sunflower seeds, avocado, and spinach.
- Supplementation: Under medical guidance, combining 500–1,000 mg vitamin C with 400–800 IU vitamin E may enhance benefits.
2. Omega-3 Fatty Acids & Anti-Inflammatory Diets
Endometriosis pain and progression are strongly linked to chronic inflammation. Omega-3 fatty acids, especially EPA and DHA, are well-known for their anti-inflammatory effects and play a significant role in balancing prostaglandins — hormone-like compounds involved in pain regulation.
How They Work
Omega-3s reduce pro-inflammatory cytokines and promote anti-inflammatory mediators.
They help shift prostaglandin production toward pathways that decrease cramping and pelvic pain (Sienko et al., 2024).
What the Research Shows
Nodler et al. (2020) conducted a randomized, placebo-controlled trial showing that adolescent girls with endometriosis who took omega-3 supplements experienced improved pelvic pain scores compared to placebo.
Sienko et al. (2024) found that omega-3 supplementation combined with resveratrol significantly reduced lesion size and inflammatory markers in women with endometriosis.
Sverrisdóttir et al. (2022) highlighted that omega-3 intake is linked to improved pain perception and quality of lifein women with endometriosis.
Practical Tips
- Eat omega-3-rich foods: Salmon, sardines, tuna, flaxseeds, chia seeds, and walnuts.
- Use anti-inflammatory cooking oils: Olive oil or avocado oil.
- Supplementation: A daily dose of 1,000–2,000 mg combined EPA + DHA is commonly studied, but always consult your provider.
3. Phytoestrogens & Plant-Based Foods
Endometriosis is an estrogen-driven condition, meaning that excess estrogen can fuel lesion growth and symptoms. Certain plant compounds, called phytoestrogens, can modulate estrogen activity by binding to estrogen receptors in a weaker way than natural estrogen, helping balance hormone levels.
How They Work
Isoflavones (found in soy, flaxseeds, and legumes) compete with stronger estrogens for receptor binding.
They promote detoxification of estrogen into less inflammatory metabolites.
These compounds may slow endometriosis lesion growth by influencing estrogen-regulating enzymes (Tarumi et al., 2025).
What the Research Shows
Tsuchiya et al. (2007) found that soy isoflavone supplementation improved endometriosis-related symptoms and may be particularly beneficial for women with certain estrogen receptor gene variants.
Mitsunami et al. (2025) reported that women consuming higher amounts of soy-based foods had a lower risk of laparoscopically confirmed endometriosis.
Cai et al. (2021) reviewed clinical findings and concluded that phytoestrogens show promise in balancing estrogen activity but effectiveness varies by individual hormonal profiles.
Practical Tips
- Add phytoestrogen-rich foods: Flaxseeds, edamame, tofu, lentils, and chickpeas.
- Start small if introducing soy and choose organic, minimally processed sources.
- Pair with a high-fiber diet to support estrogen elimination via the gut.
Lifestyle Tips for Supporting Endometriosis Naturally
Go Mediterranean: Studies show the Mediterranean diet, rich in vegetables, fruits, olive oil, legumes, and fish, is associated with reduced endometriosis-related inflammation and pain (Yang et al., 2023).
Limit processed foods: Reduce refined sugars, red meat, and trans fats, which are linked to worsened inflammation.
Support gut health: A healthy microbiome enhances estrogen metabolism, so include probiotics and high-fiber foods.
Stay active: Gentle exercise improves circulation, lowers inflammation, and may ease pelvic pain.
Takeaway
Endometriosis can be challenging, but nutrition offers real, science-backed tools for managing pain, inflammation, and hormonal imbalance. Antioxidants, omega-3s, and phytoestrogens work through different — but complementary — mechanisms to support healing and improve quality of life.
Small, consistent dietary changes can have a big impact when paired with medical care, and working with a provider, nutritionist, and wellness coach can help you create and walk in a plan that’s right for your unique needs.
References
Amini, L., Chekini, R., Nateghi, M. R., Haghani, H., Jamialahmadi, T., Sathyapalan, T., & Sahebkar, A. (2021). The effect of combined vitamin C and vitamin E supplementation on oxidative stress markers in women with endometriosis: A randomized, triple-blind placebo-controlled clinical trial. Pain Research & Management, 2021, 5529741. https://doi.org/10.1155/2021/5529741
Zheng, S. H., Chen, X. X., Chen, Y., Wu, Z. C., Chen, X. Q., & Li, X. L. (2023). Antioxidant vitamins supplementation reduce endometriosis-related pelvic pain in humans: A systematic review and meta-analysis. Reproductive Biology and Endocrinology, 21(1), 79. https://doi.org/10.1186/s12958-023-01126-1
Sienko, A., Cichosz, A., Urban, A., Smolarczyk, R., Czajkowski, K., & Sienko, J. (2024). The effect of two anti-inflammatory dietary components, omega-3 and resveratrol, on endometriosis. Ginekologia Polska, 95(7), 573–583. https://doi.org/10.5603/gpl.97573
Nodler, J. L., et al. (2020). Supplementation with vitamin D or ω-3 fatty acids in adolescent girls and young women with endometriosis (SAGE): A double-blind, randomized, placebo-controlled trial. The American Journal of Clinical Nutrition, 112(1), 229–236. https://doi.org/10.1093/ajcn/nqaa096
Tsuchiya, M., et al. (2007). Effect of soy isoflavones on endometriosis: Interaction with estrogen receptor 2 gene polymorphism. Epidemiology, 18(3), 402–408. https://doi.org/10.1097/01.ede.0000257571.01358.f9
Mitsunami, M., et al. (2025). Soy consumption and the risk of laparoscopically confirmed endometriosis in a prospective cohort study. Fertility and Sterility. https://doi.org/10.1016/j.fertnstert.2025.06.028
Cai, X., Liu, M., Zhang, B., Zhao, S. J., & Jiang, S. W. (2021). Phytoestrogens for the management of endometriosis: Findings and issues. Pharmaceuticals, 14(6), 569. https://doi.org/10.3390/ph14060569
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