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What Is the Relationship Between Alcohol and Endometriosis?

Endometriosis is commonly associated with symptoms such as increased menstrual pain, painful intercourse, abnormal vaginal bleeding, intestinal distress, infertility, and chronic pain in the lower back and pelvis.1

For women with endometriosis, many doctors recommend a balanced, healthy diet that is free from added hormones, soy, and inflammatory fats. To help manage painful symptoms associated with the disease, some doctors will even suggest an elimination diet that is free from dairy, gluten, and added sugars.2

But what about alcohol consumption? Can women with endometriosis safely consume alcohol?

Alcohol and endometriosis risk

There is no identified cause of endometriosis.2 Still, some studies have shown a correlation between alcohol consumption and the risk of developing endometriosis.3,4 Compared with women who do not have endometriosis, as well as with women with other gynecological problems, women who consume alcohol may have a greater incidence of endometriosis.4 However, it has not been confirmed or refuted whether increased alcohol consumption could be a direct cause of the disease, or whether the increased consumption exacerbates the existing condition.3,4

Alcohol and endometriosis symptoms

It is generally recommended to limit alcohol consumption if you have endometriosis.2 Alcohol increases estrogen levels.5 In addition, consuming excess amounts of alcohol forces your liver to work harder. Since estrogen is metabolized and broken down by the liver, impaired liver function can prevent estrogen from metabolizing properly. For patients with endometriosis, this buildup of estrogen in the body can inflame the uterine tissue and lead to increased symptoms.6

Alcohol, endometriosis, and infertility

Women with endometriosis can have a harder time conceiving than women who do not have endo.1 In fact, 50% of women with with infertility are diagnosed with endometriosis.7 While the cause of infertility in women with endometriosis is not known, it is understood that patches of endometriosis can block off or disrupt the reproductive organs, and the uterine layer where implantation occurs may not develop as it should to support pregnancy when endometriosis is present. Similarly, alcohol consumption has been linked to infertility in clinical trials. For women with endometriosis who consume excess amounts of alcohol, the risk of infertility is even greater.8

Can I still have an occasional cocktail?

Moderate alcohol consumption may be safe for patients with endometriosis. Still, there is no consensus on what amount is considered safe. Some experts recommend no more than one drink per day, while others are more conservative, recommending no more than one to two servings per week.2,9 Talk to your doctor about what would be best for you.

  1. USDHHS. Endometriosis. https://www.womenshealth.gov/a-z-topics/endometriosis. Accessed September 25, 2018.
  2. Yeung P, Catanzaro R. Saint Louis School of Medicine Department of Obstetrics, Gynecology, and Women’s Health. Center for Endometriosis. The Anti-inflammatory and Elimination Diet for Adults Living with Endometriosis. http://obgyn.slu.edu/uploads/centerforendo/Combined%20Anti-Inflammatory%20and%20Elimination%20Diet%20for%20Adults%20Living%20with%20Endometriosis%20booklet.pdf. Accessed September 26, 2018.
  3. Parazzini F, Cipriani S, Bravi F, et al. A metaanalysis on alcohol consumption and risk of endometriosis. AJOG. 2013;209;106e1-106e10. https://www.ajog.org/article/S0002-9378(13)00528-0/abstract. Accessed September 26, 2018.
  4. Perper MM, Britkopf LJ, Breitstein R, et al. MAST scores, alcohol consumption, and gynecological symptoms in endometriosis patients. Alcohol Clin Exp Res. 1993;(2):272-8. https://www.ncbi.nlm.nih.gov/pubmed/8488967. Accessed September 26, 2018.
  5. Emanuele MA, Wezeman F, Emanuele NV. National Institute on Alcohol Abuse and Alcoholism. Alcohol’s effects on female reproductive function. https://pubs.niaaa.nih.gov/publications/arh26-4/274-281.htm. Accessed September 26, 2018.
  6. The Endometriosis Diet. Decrease alcohol. http://www.endometriosisdiet.com.au/endometriosis-diet/how-dietary-changes-can-reduce-the-impact-of-endometriosis/decrease-alcohol/. Accessed September 26, 2018.
  7. Macer, ML, Taylor, HS. Endometriosis and Infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility. Obstetrics and Gynecology Clinics of North America. 2012;39(4): 535–549.
  8. Grodstein F, Goldman MB, Cramer DW. Infertility in women and moderate alcohol use. Am J Public Health. 1994;(84):1429-1432. https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.84.9.1429. Accessed September 26, 2018.
  9. Endometriosis Foundation of America. This doctor says you can have a cocktail with your endo. https://www.endofound.org/this-doctor-says-you-can-have-a-cocktail-with-your-endo. Accessed September 26, 2018.

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