Diet and Endometriosis: What Does The Evidence Say? Part 2

Read Part 1 here.

This article looks at the evidence around endometriosis and the consumption of gluten, dairy, coffee, fruit, and vegetables.

Diet is a popular tool for women with endometriosis, but when food groups are removed completely from the diet, there’s less opportunity to obtain the nutrients our body needs. That’s why women following an endometriosis diet and eliminating certain foods need to pay extra attention to nutrition to make sure they’re not missing out on nutrients.

Fruit and vegetables

A large 2018 study found that fruits, in particular higher consumption of citrus fruits are protective against risk of endometriosis.1

The same 2018 study also found that certain vegetables such as cruciferous vegetables (such as cauliflower and brussel sprouts), peas, and corn were linked with an increased risk of surgically diagnosed endometriosis.1 The reason why certain vegetables could be causing problems is that they may aggravate gastrointestinal symptoms in some people, which can worsen endometriosis pain. Interestingly, a low FODMAP diet which limits quantities of high FODMAP foods (such as the above mentioned vegetables) has been shown to help women with endometriosis and irritable bowel syndrome.2

One study found that increased consumption of fruit was associated with a higher risk of endometriosis; it’s thought the reason for this is exposure to pesticides rather than the actual fruit itself, as fruit contain nutrients that are protective against endometriosis.1,3 Another study found that fruit and vegetable intake was linked to a lower risk of endometriosis.3

The bottom line:

Fruit and vegetables are nutritious and should be eaten regularly. If possible, buy organic produce or wash fruit and vegetables thoroughly. If your symptoms worsen after eating certain foods, see a qualified nutritionist.


There are two studies that looked at gluten and endometriosis and both found that a gluten-free diet improved the symptoms of endometriosis.4,5


Dairy is another type of food that’s commonly avoided with endometriosis; however, the research shows dairy consumption is linked to a lower risk of development endometriosis; The reason for this may be that dairy is a good source of protective nutrients such as vitamin D.3

Some women with endometriosis find that avoiding dairy helps their symptoms, this could be for a few reasons: milk products can be high in lactose and some people might not absorb it well, others may find that the A1 protein in milk causes gastrointestinal symptoms and as a result worsens endometriosis pain.6

The bottom line:

If dairy causes symptoms for you, try avoiding cow’s dairy and consume goat’s or sheep’s dairy instead to see if things improve, if not talk to a qualified nutritionist.

Alcohol and coffee

Alcohol is a potential risk factor for developing endometriosis, but when it comes to coffee the results of studies are mixed. The problem with both alcohol and products rich in caffeine, is they increase estrogen which is a concern, as endometriosis is an estrogen dependent disease.3

The bottom line:

It’s best to keep alcohol and coffee intake low.

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