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How to Treat Endometriosis With Dietary Changes

With over two decades of experience in medicine, Melissa Flagg writes patient education articles, keeping you informed about your health.

Fig. 1: Smooth muscle

Fig. 1: Smooth muscle

Do You Have Endometriosis?

We all know changing our diet can change our health. We are what we eat after all. As with many chronic disorders, endometriosis can be treated with diet.

Usually managed with medication or surgery, endometriosis is very painful and has destroyed the quality of life for many women who suffer from it. But it doesn’t have to ruin your life.

What Is Endometriosis?

In order to answer this question, we need a quick anatomy lesson.

The uterus is made up of many layers. The wall of the uterus, or myometrium, is made up of smooth muscle (Figure 1). The cells of smooth muscle are long and tapered and lack the visible striation, or bands, characteristic of cardiac and skeletal muscles. Smooth muscle can be found in the walls of visceral organs, or organs with cavities. This type of muscle allows certain organs to move things along with powerful contractions.

For example, menstrual cramps are caused by the uterus contracting rhythmically to expel the uterine lining. Similarly, labor pains are the uterus contracting to move the fetus down the birth canal.

Figure 2: The Layers of the uterus. The layers of the uterus also show vasculature (blood vessels).

Figure 2: The Layers of the uterus. The layers of the uterus also show vasculature (blood vessels).

The wall of the uterus is lined with the endometrium, also called the uterine mucosa. The endometrium has two layers: an epithelial, glandular layer and a stromal layer penetrated by the glands of the epithelial layer (Figure 2).

The endometrium is extremely sensitive to the hormones estrogen and progesterone, which cause it to increase in thickness, size, and vascularization (amount of blood vessels) in preparation for pregnancy. This is the beginning of the menstrual cycle.

Endometriosis is a disorder in which endometrium cells grow outside of the uterus. They are usually limited to the pelvic area, but, on rare occasions, may migrate to other areas of the body. The most common places for these rogue cells are the ovaries, fallopian tubes, bowel, and sometimes the bladder.

Since the endometrium thickens and becomes highly vascularized approximately every 28 days, this disorder tends to worsen during menstruation. The rogue cells respond to hormones just like the cells inside the uterus. But, they have no way out of the body, unlike the endometrium inside the uterus, which is shed monthly (the period). The trapped cells cause the surrounding tissues and organs to become irritated and inflamed causing the characteristic discomfort of the disorder.

Symptoms of Endometriosis

Common symptoms are:

  • Dysmenorrhea, or pain associated with the period
  • Pain experienced during sexual intercourse
  • Bowel movements and urination may become painful
  • Bleeding during the period becomes excessive
  • Infertility

Other symptoms may include nausea, fatigue, diarrhea, constipation, or excessive bloating, which may worsen during a period. Pain levels may vary from woman to woman. Some women with mild cases of the disorder have excruciating pain, while those with more advanced cases may have no pain, or other symptoms, at all.


The cause of endometriosis remains elusive. However, it is thought that retrograde menstruation may be a cause.

Retrograde menstruation can be described as menstrual blood, which contains the endometrial cells, flowing backward into the fallopian tubes and out into the pelvic viscera (cavity). These cells attach themselves to the surrounding tissue and organs in the pelvic area, and they continue to thicken and bleed as they normally would during a menstrual cycle.

Another possible cause is a mutation of the cells lining the abdominal wall. These cells are direct descendants of embryonic cells, which are able to become just about any cell type. What causes these cells to mutate into specifically endometrial cells still remains a mystery.

Endometriosis Treatment Options

Treatment typically involves the use of analgesics (pain relievers), hormone therapy (including contraceptives), and surgery. However, many women have found changing their diet has drastically improved their symptoms.

The goal of changing the diet is to reduce estrogen and prostaglandin levels. Prostaglandins are polyunsaturated fatty acid compounds that are part of the eicosanoid group of fatty acids, which regulate cellular functioning in response to injury.

Some prostaglandins regulate the inflammatory process, which is why NSAIDs (non-steroidal anti-inflammatories), such as Ibuprofen, are effective in treating pain caused by endometriosis. Other prostaglandins regulate functions such as labor contractions and fertility. Still, other prostaglandins regulate the relaxation of the uterine muscles.

Whole grains are an excellent souce of Omega-3 fatty acids.

Whole grains are an excellent souce of Omega-3 fatty acids.

Treatment of Endometriosis With Diet

Consuming foods that are high in Omega-3 fatty acids helps to stimulate the production of these regulators. Good sources of omega-3s are:

  • Fish and fish oils
  • Walnuts and other nuts
  • Flaxseed and Flaxseed Oils
  • Olive oils

While increasing the intake of Omega-3s, consumption of bad fats such as those found in butter, animal products, and dairy, will help decrease the prostaglandins that cause the uterus to contract.

Green leafy vegetables, such as spinach, provide much needed fiber.

Green leafy vegetables, such as spinach, provide much needed fiber.

Increasing fiber consumption is also very important. A high fiber diet not only benefits those with endometriosis by decreasing estrogen levels, but also helps prevent colon cancer and aids digestion and excretion. High fiber foods include:

  • Whole grains (except wheat and rye because of the phytic acid and gluten, which tends to worsen the disease)
  • Legumes
  • Brown rice, quinoa, oatmeal, and spelt
  • Vegetables and fruits (especially green leafy veggies like kale, spinach, mustard greens, cabbage, turnips, and broccoli)

Foods to Avoid

Some foods exacerbate endometriosis, and it is best to avoid them at all costs. Foods to avoid are:

  • Dairy
  • Meats, especially red meats
  • Caffeine
  • Chocolate
  • Alcohol
  • Refined carbohydrates (such as pasta, white bread, cakes, etc.)Butter and margarine
  • Fried foods

Dairy and other animal products, especially meats, are high in saturated fats. All animal products also contain the protein casein. Casein has been proven in several studies to cause cancer, along with many other chronic diseases including diabetes and high blood pressure.

This type of diet is known as the plant-strong diet. It is rich in vitamins and nutrients as well as the all-important antioxidants that prevent cell damage and death. This diet should alleviate the symptoms of endometriosis dramatically, but it may not work for all women. Everyone’s physiology and metabolism are different. Always check with your doctor before making any dietary changes or taking any vitamins or other supplements.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Mel Flagg COA OSC (author) from Rural Central Florida on June 16, 2012:

Thank you Pamela! When I write on medical topics like this, I try to write them as I would explain them to one of my patients, but when you're writing it sometimes comes out differently. So even though I reread it several times, I never really know if I succeeded until a reader tells me. So, Thank you very much!!

Pamela Dapples from Arizona. on June 15, 2012:

This is such a good hub you have written. I like the way you have made this rather complex subject easier to understand. And the dietary information you have provided is very helpful. Voting up, useful and sharing.

Mel Flagg COA OSC (author) from Rural Central Florida on May 14, 2012:

Thank you and indeed, we are what we eat!

Catherine Taylor from Canada on May 14, 2012:

Great info here. diet can have a huge impact on our health.

Mel Flagg COA OSC (author) from Rural Central Florida on May 08, 2012:

@Jeannieinabottle I'm sorry you have to suffer with this disease. Chronic pain can wreck havoc on your quality of life. Please come back and let me know if the diet makes any difference!! I hope it cures it!

Marcy Goodfleisch from Planet Earth on May 08, 2012:

endometriosis is incredibly painful - I hope this hub helps some people deal with it. Some people say having a child helps (if cramping is a symptom). But I'm not sure that's an efficient solution for everyone.

Jeannie Marie from Baltimore, MD on May 08, 2012:

This hub has some great suggestions. I have Endometriosis and I am in a lot of pain. I am going to try this diet and see if it works for me. I've been trying to go hormone-free for the past year since pills were actually making me sicker than before. I've been eating a lot of wheat, but obviously that was a bad idea. I am going to try this since I am willing to try just about anything at this point. I really want to avoid having surgery again if possible. Thank you!!! Voted up and shared!

Amethystraven from California on May 03, 2012:

Finding a place on this planet to live like the Native Indians did is looking oh so good. They grew their own food, caught their own food, and used every part of the plants or animal for clothes, bedding, housing, hair and skin care. Plants were also used for medicine. They didn't have the level of greed we do now. Back then skills and wares were traded to maintain survival. People were a lot healthier then too. While there are some things that are positive about the progress humans have made, the scales are tipped in the negative right now as far as greed. I hope this changes. If not in my future or lifetime, in our children's.

Mel Flagg COA OSC (author) from Rural Central Florida on May 03, 2012:

Either find an eco-friendly farmer or go vegan! lol We chose to go vegan primarily because of the casein, but also because there aren't any friendly farmers around here, let alone eco-friendly. But I wholeheartedly agree with you. The top 1% of people control the country's wealth and for some reason think sharing that money (by paying their fair share of taxes) with the lower class is bad. I really can't believe people are letting this happen. America used to stand for freedom and human rights, now it just stands for greed.

Joanna McKenna from Central Oklahoma on May 03, 2012:

No, Obamacare isn't perfect (YET), but it's "perfect" enough right now that fat cat Rethugs and the 1% - pretty much one and the same - are working overtime to kill it because it'll put a HUGE dent in the obscene profits BigPharma and the health "insurance" industry are currently raking in.

Where I live now, in a cul-de-sac of tiny 1-story duplexes, I've noticed several neighbors have small vegetable gardens. If I stay here, I'll be putting one in next year (it's too late this year). Being inside the city limits, I can't have chickens, but I sure would like to! Guess I need to comb the countryside for an eco-friendly farmer who raises them without drugs, right?

Mel Flagg COA OSC (author) from Rural Central Florida on May 02, 2012:

It's interesting that you mention the pharmaceutical companies possibly owning the meat giants. I have yet to find that link, but I, too, believe it's there. They already own the FDA. Here's another tidbit for you. WHen they test medications for approval, they only have to submit studies that say the drug is better than a placebo. So if they have 2 studies that "prove" the drug is better than a placebo, they can leave out the other zillion studies that say it is not. I think you'll really like FoodMatters as well. Foodmatters delves into how the medical industry and the media keep us from understanding how vitamins can help us. For instance: Doctors proport that Vitamin C in dosages over about 100mg cause kidney stones. That's total crap. Vitamin C in extremely high dosages (amounts near a kilo) has shown to be selectively toxic to cancer cells. It destroys cancer, but leaves our other cells intact. The medical industry has manipulated the system to the extreme. Did you know if you get cancer, and it goes into remission for 5 years you're considered a survivor? Even if you die on your 5 year anniversary of cancer! The Gerson method (which I'm also writing about) cures cancer. It works especially well on melanoma and Non-hodgkins lymphoma.

That's the main reason I write on hubpages, to get that message into the hands of the people so they can choose what's right for them. Not everyone will become a vegan like I did, but they may lower their consumption of animal products drastically and significantly reduce their chances of getting cancer. Read my hub The plant strong diet, there's more info there you might want as well. I could go on and on about this, it drives me absolutely insane that our government treats us the way they do. I know many people don't like Obama, but his Obamacare, while obviously not perfect, is a step in the right direction. I, personally, love him because he fights the system as much as he can get away with. But I'm rambling lol

Amethystraven from California on May 02, 2012:

Thank you. I am very interested in seeing Food. Inc now. It sickens me that millionaires are using the human population without a care in the world as long as they make more $$$$. I grew up with the illusion that people care for one another and are here to help. While I feel 80% are like that, I'm learning there is the small 20% that are greedy and monstrous even to themselves. They remind me of thieves who will steal from everyone including each other for more, more, more no matter what the cost. I'm looking forward to reading your new hub when it comes out. I love learning about what I'm putting in my body and what I'm feeding my family. The more I read and listen the more I want to become self sustainable. In my lifetime I want a farm atmosphere with fresh everything so I know where it comes from. I want to make my own feed for the animals. I'm tired of the illusion the FDA proposes. Since they are the FDA and part of the Federal Government they know what's best for us. Us includes the richest of the rich and the rest of the world are just expendable consumers. Women as well as men are suffering from unnecessary illnesses simply because of what we literally consume. What's made by others is not always made in the best interest of others. You've been every enlightening. This makes me curious as to weather or not any pharmaceutical companies own any of the four meat giants?

Mel Flagg COA OSC (author) from Rural Central Florida on May 02, 2012:

Thanks amethyst! Fluoroquinolone is actually a class of antibiotics that includes Levaquin among others. The antibiotics (or abx) used in chicken feed are actually the Cephalosporin class including tetracycline, penicillin, erythromycin, neomycin sulfate etc because they are the broad spectrum abx. The fluoroquinolones tend to be more bacteria specific. The arsenic compound you referred to is arsanilic acid, 3-nitro-4-hydroxy phenylarsonic acid, and sodium arsanilate. Unfortunately, it doesn't matter what's put in the feed, the close quarters they are kept in is a breeding ground for bacteria. Plus all the abx in the feed leads to super bugs, or bacteria like MRSA (methicillin resistant staphylococcus aureus). That's the whole reason we went vegan! Our government is feeding us the most disgusting and vile foods! Not to mention all the insecticides, herbicides, fungicides etc that are used on vegetables and other produce. Because of that we started our own garden. It's disgusting how the animals are treated, and we're treated no better being forced to eat the crap in grocery stores. Did you know there are only 4 meat companies now that control the meat industry? Tyson, Swift, Cargill and National Beef run all of the 13 slaughter houses in the US. There used to be thousands of slaughter houses. I'm actually in the process of writing a hub on all this, so I've been watching documentaries and reading tons of articles. I recently read a study that broke down all the chemical compounds put in the feed. My hubby laughed at me, he said how can you read that, I can't pronounce any of the words on the page! lmao Why are we eating things we can't pronounce? If you're interested in this sort of thing, the documentary Food. Inc might be right up your alley. I've seen it like 5 times in the past few days, since I'm using it as a reference. Great film though. I sat through it dumbfounded the first time.

Amethystraven from California on May 02, 2012:

Daughter of Maat,pharmaceutical companies supply all of the drugs to the meat industry. I read an article on a Care 2 website I get through my e-mail. The article stated that chickens raised for mass production are fed something called "feather meal". This feather meal includes bones, excrement, blood, and parts from diseased chickens as well as an antibiotic called fluorquinolone, prozac, acetaminophen, roxarsone; a type of arsenic, and benadryl. All of these combined keep the chickens alive enough in their horrible conditions so they can eat. Millions of humans consume this meat and are told it's ok because the FDA approves it. The FDA approves the drug laden chicken feed because of how it's labeled. They say it keeps the chickens healthy because it protects them from disease. This is how it's allowed to be put in their feed. Organic or Free Range animals that are grass fed or fed food without hormones and antibiotics don't cause the human body so much damage. Diet is a huge part of our existence. We literally are what we eat.

Mel Flagg COA OSC (author) from Rural Central Florida on May 02, 2012:

lmao you are so not kidding! The meat packing industry and the pharmaceutical companies run this country I think!

Joanna McKenna from Central Oklahoma on May 02, 2012:

Thanks! I'll check them out! As for why more doctors (and hospitals) don't consider diet in treatment, they probably will when they start receiving kickbacks from grocery store chains and nutrition supplement companies. Presently, though, recommending a change in diet won't make the payments on the new BMW or build that new wing. ;D

Mel Flagg COA OSC (author) from Rural Central Florida on May 02, 2012:

Thanks JamaGenee!! It amazes me that more doctors don't take into consideration diet. Did you know, patients that go into a hospital are more malnourished than when they went in? And most of the time, the problem they have is from malnourishment? There is a great book you should read, if you're interested. Actually, there are 2: Doctor Yourself by Andrew Saul, PhD., and Superfoods by David Wolfe. I've learned so much from those two books. Additionally, the documentary FoodMatters has both Andrew Saul and David Wolfe in it, and they discuss nutrition and vitamins and their effects on health. Forks Over Knives is another great documentary that explains how the animal protein, casein, causes cancer. :D

Joanna McKenna from Central Oklahoma on May 02, 2012:

Well, I'll be! I worked on an OB-GYN unit for 18 months where the standard treatment for severe cases of endometriosis was surgery. Diet as a treatment was never mentioned. I later had a neighbor who suffered from it and would wolf down prescription pain killers several days each month until it stopped. Her doctor never suggested a change in diet, either!

You are so right! We ARE what we eat!

Voted up, useful and awesome! ;D

Mel Flagg COA OSC (author) from Rural Central Florida on May 01, 2012:

@gmwilliams Thank you!! I don't know about infinitely awesome, but I definitely appreciate the compliment!!!!

@Amethystrave I love your name btw, Eating salads, fruits and veggies will definitely help alleviate cramping. Around menarche (the period) prostaglandin levels rise to cause the uterine wall to contract, it's not just limited to endometriosis. So keep eating the good stuff around that "time" and you will definitely alleviate your cramps. Black Cohosh might also help you. Most women think Black Cohosh is just for menopause, but primarily regulates hormones. I take it twice daily. I used to have horrible cramps the first day of my period, and my cycle was about 45-50 days long with a 5 day period. Now, my cycle is 32 days long, I have no cramps and my period is 2.5 days long. :D

Hope that helps you!

Amethystraven from California on May 01, 2012:

Although I don't have Endometriosis, the diet and food information will help me. I have experimented with different foods to see what would happen with my cramps and the other symptoms that come along with my cycle. The foods I crave before I start like fried things, pizza, sweet stuff and salty stuff have never helped when I eat them. Just because I crave them doesn't mean I should eat them. I love salads, fruit juice, and veggies. I found when I eat those foods my cramps and other symptoms aren't as bad. Thank you for this hub.

Grace Marguerite Williams from the Greatest City In The World-New York City, New York on May 01, 2012:

Your knowledge is infinitely awesome. I did not know about this disease- I learned something! Great, informative hub as usual!