{"paper_id":"1baf0e97-6dbb-49fd-bb7b-4f4fe122fa60","body_text":"Diet and Endometriosis: A Comprehensive Review of Current Evidence\nDOI:\nhttps://doi.org/10.12775/QS.2026.54.70453Keywords\nEndometriosis, Diet, Inflammation, Omega-3, Vitamin D, Antioxidants, FODMAP, Gluten-freeAbstract\nEndometriosis is a chronic, estrogen-dependent inflammatory disease affecting 10% of women of reproductive age. Patients often experience symptoms such as pelvic pain, dysmenorrhea, gastrointestinal disturbances, and infertility. Conventional treatment methods, including hormonal therapy and surgery, offer limited relief and high recurrence rates. Dietary interventions have gained interest as potential adjuncts to symptom management.\nThis study reviews current evidence on the impact of diet on the development, symptom severity, and progression of endometriosis, focusing on specific nutrients, dietary patterns, and elimination diets.\nA literature search was conducted using PubMed and Google Scholar for English-language, peer-reviewed studies published up to 2025. Keywords were “Endometriosis”, “Diet”, “Gluten-free”, “Vitamin D”, “Omega-3”, “FODMAP Diet”. Original research articles, randomized controlled trials, and systematic reviews (only if original data were also reported) were analysed.\nAnti-inflammatory, antioxidant-rich diets are associated with symptom reduction. Omega-3 fatty acids show protective effects, while high consumption of red meat and trans fat may increase the risk of endometriosis. Vitamin D shows potential benefits in experimental models, but clinical evidence remains inconclusive. Gluten-free and low-fermentable oligo-, di-, monosaccharide and polyol (FODMAP) diets may relieve gastrointestinal symptoms in selected patients, but should be implemented with caution. Dairy products and dietary fiber may offer protective effects, though data remain inconsistent.\nWhile current evidence suggests that diet may influence endometriosis, most data remain observational. Further randomized controlled trials are needed to confirm causality and develop evidence-based dietary guidelines for endometriosis management.\nReferences\n1. Jurkiewicz-Przondziono J, Lemm M, Kwiatkowska-Pamuła A, Ziółko E, Wójtowicz MK. Influence of diet on the risk of developing endometriosis. Ginekol Pol. 2017;88(2):96-102. doi:10.5603/GP.a2017.0017\n2. Basta A, Brucka A, Górski J, et al. The statement of Polish Society’s Experts Group concerning diagnostics and methods of endometriosis treatment. Ginekol Pol. 2012;83(11):871-876.\n3. Abulughod N, Valakas S, El-Assaad F. Dietary and Nutritional Interventions for the Management of Endometriosis. Nutrients. 2024;16(23):3988. doi:10.3390/nu16233988\n4. Barnard ND, Holtz DN, Schmidt N, et al. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023;10:1089891. doi:10.3389/fnut.2023.1089891\n5. Helbig M, Vesper AS, Beyer I, Fehm T. Does Nutrition Affect Endometriosis? Geburtshilfe Frauenheilkd. 2021;81(02):191-199. doi:10.1055/a-1207-0557\n6. Missmer SA, Chavarro JE, Malspeis S, et al. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod Oxf Engl. 2010;25(6):1528-1535. doi:10.1093/humrep/deq044\n7. Brouns F, Van Haaps A, Keszthelyi D, et al. Diet associations in endometriosis: a critical narrative assessment with special reference to gluten. Front Nutr. 2023;Volume 10-2023. doi:10.3389/fnut.2023.1166929\n8. Tassinari V, Smeriglio A, Stillittano V, et al. Endometriosis Treatment: Role of Natural Polyphenols as Anti-Inflammatory Agents. Nutrients. 2023;15(13):2967. doi:10.3390/nu15132967\n9. Luckow Invitti A, Schor E, Martins Parreira R, et al. Inflammatory cytokine profile of co‑cultivated primary cells from the endometrium of women with and without endometriosis. Mol Med Rep. 2018;18(2):1287-1296. doi:10.3892/mmr.2018.9137\n10. Liu Y, Wang J, Zhang X. An Update on the Multifaceted Role of NF-kappaB in Endometriosis. Int J Biol Sci. 2022;18(11):4400-4413. doi:10.7150/ijbs.72707\n11. Mier-Cabrera J, Aburto-Soto T, Burrola-Méndez S, et al. Women with endometriosis improved their peripheral antioxidant markers after the application of a high antioxidant diet. Reprod Biol Endocrinol RBE. 2009;7:54. doi:10.1186/1477-7827-7-54\n12. Cirillo M, Argento FR, Becatti M, Fiorillo C, Coccia ME, Fatini C. Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis. Int J Mol Sci. 2023;24(19):14601. doi:10.3390/ijms241914601\n13. Gołąbek A, Kowalska K, Olejnik A. Polyphenols as a Diet Therapy Concept for Endometriosis-Current Opinion and Future Perspectives. Nutrients. 2021;13(4):1347. doi:10.3390/nu13041347\n14. Jamali N, Zal F, Mostafavi-Pour Z, Samare-Najaf M, Poordast T, Dehghanian A. Ameliorative Effects of Quercetin and Metformin and Their Combination Against Experimental Endometriosis in Rats. Reprod Sci. 2021;28(3):683-692. doi:10.1007/s43032-020-00377-2\n15. Amini L, Chekini R, Nateghi MR, et al. 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. Gazerani P, ed. Pain Res Manag. 2021;2021:1-6. doi:10.1155/2021/5529741\n16. Haaps AP van, Brouns F, Schreurs AMF, Keszthelyi D, Maas JWM, Mijatovic V. A gluten-free diet for endometriosis patients lacks evidence to recommend it. AJOG Glob Rep. 2024;4(3):100369. doi:https://doi.org/10.1016/j.xagr.2024.100369\n17. Chiaffarino F, Cipriani S, Ricci E, et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021;303(1):17-25. doi:10.1007/s00404-020-05797-8\n18. Schwartz NRM, Afeiche MC, Terry KL, et al. Glycemic Index, Glycemic Load, Fiber, and Gluten Intake and Risk of Laparoscopically Confirmed Endometriosis in Premenopausal Women. J Nutr. 2022;152(9):2088-2096. doi:10.1093/jn/nxac107\n19. Marziali M, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir. 2012;67(6):499-504.\n20. Skodje GI, Sarna VK, Minelle IH, et al. Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity. Gastroenterology. 2018;154(3):529-539.e2. doi:10.1053/j.gastro.2017.10.040\n21. de Graaf MCG, Lawton CL, Croden F, et al. The effect of expectancy versus actual gluten intake on gastrointestinal and extra-intestinal symptoms in non-coeliac gluten sensitivity: a randomised, double-blind, placebo-controlled, international, multicentre study. Lancet Gastroenterol Hepatol. 2024;9(2):110-123. doi:10.1016/S2468-1253(23)00317-5\n22. Ludvigsson JF, Card T, Ciclitira PJ, et al. Support for patients with celiac disease: A literature review. United Eur Gastroenterol J. 2015;3(2):146-159. doi:10.1177/2050640614562599\n23. Varney JE, So D, Gibson PR, et al. Clinical Trial: Effect of a 28‐Day Low FODMAP Diet on Gastrointestinal Symptoms Associated With Endometriosis ( ENDOFOD )—A Randomised, Controlled Crossover Feeding Study. Aliment Pharmacol Ther. 2025;61(12):1889-1903. doi:10.1111/apt.70161\n24. Hill P, Muir JG, Gibson PR. Controversies and Recent Developments of the Low-FODMAP Diet. Gastroenterol Hepatol. 2017;13(1):36-45.\n25. Abramiuk M, Mertowska P, Frankowska K, et al. How Can Selected Dietary Ingredients Influence the Development and Progression of Endometriosis? Nutrients. 2024;16(1):154. doi:10.3390/nu16010154\n26. Abbas MA, Taha MO, Disi AM, Shomaf M. Regression of endometrial implants treated with vitamin D3 in a rat model of endometriosis. Eur J Pharmacol. 2013;715(1-3):72-75. doi:10.1016/j.ejphar.2013.06.016\n27. Miyashita M, Koga K, Izumi G, et al. Effects of 1,25-Dihydroxy Vitamin D3 on Endometriosis. J Clin Endocrinol Metab. 2016;101(6):2371-2379. doi:10.1210/jc.2016-1515\n28. Yarmolinskaya M, Denisova A, Tkachenko N, et al. Vitamin D significance in pathogenesis of endometriosis. Gynecol Endocrinol. 2021;37(sup1):40-43. doi:10.1080/09513590.2021.2006516\n29. Delbandi AA, Torab M, Abdollahi E, et al. Vitamin D deficiency as a risk factor for endometriosis in Iranian women. J Reprod Immunol. 2021;143:103266. doi:10.1016/j.jri.2020.103266\n30. Ciavattini A, Serri M, Delli Carpini G, Morini S, Clemente N. Ovarian endometriosis and vitamin D serum levels. Gynecol Endocrinol. 2017;33(2):164-167. doi:10.1080/09513590.2016.1239254\n31. Almassinokiani F, Khodaverdi S, Solaymani-Dodaran M, Akbari P, Pazouki A. Effects of Vitamin D on Endometriosis-Related Pain: A Double-Blind Clinical Trial. Med Sci Monit Int Med J Exp Clin Res. 2016;22:4960-4966. doi:10.12659/msm.901838\n32. Mehdizadehkashi A, Rokhgireh S, Tahermanesh K, Eslahi N, Minaeian S, Samimi M. The effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis. Gynecol Endocrinol. 2021;37(7):640-645. doi:10.1080/09513590.2021.1878138\n33. Qiu Y, Yuan S, Wang H. Vitamin D status in endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2020;302(1):141-152. doi:10.1007/s00404-020-05576-5\n34. Neri LCL, Quintiero F, Fiorini S, et al. Diet and Endometriosis: An Umbrella Review. Foods Basel Switz. 2025;14(12):2087. doi:10.3390/foods14122087\n35. Piecuch M, Garbicz J, Waliczek M, Malinowska-Borowska J, Rozentryt P. I Am the 1 in 10-What Should I Eat? A Research Review of Nutrition in Endometriosis. Nutrients. 2022;14(24):5283. doi:10.3390/nu14245283\n36. Yamamoto A, Harris HR, Vitonis AF, Chavarro JE, Missmer SA. A prospective cohort study of meat and fish consumption and endometriosis risk. Am J Obstet Gynecol. 2018;219(2):178.e1-178.e10. doi:10.1016/j.ajog.2018.05.034\n37. Trabert B, Peters U, De Roos AJ, Scholes D, Holt VL. Diet and risk of endometriosis in a population-based case-control study. Br J Nutr. 2011;105(3):459-467. doi:10.1017/S0007114510003661\n38. Habib N, Buzzaccarini G, Centini G, et al. Impact of lifestyle and diet on endometriosis: a fresh look to a busy corner. Przeglad Menopauzalny Menopause Rev. 2022;21(2):124-132. doi:10.5114/pm.2022.116437\n39. Parazzini F, Viganò P, Candiani M, Fedele L. Diet and endometriosis risk: a literature review. Reprod Biomed Online. 2013;26(4):323-336. doi:10.1016/j.rbmo.2012.12.011\n40. Arab A, Karimi E, Vingrys K, Kelishadi MR, Mehrabani S, Askari G. Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies. Nutr J. 2022;21(1):58. doi:10.1186/s12937-022-00812-x\n41. Akgun N, Sofiyeva N, Yalcın PB, Laganà AS, Oral E. Role of macronutrients, dairy products, fruits and vegetables in occurrence and progression of endometriosis: A summary of current evidence in a systematic review. Facts Views Vis ObGyn. 2024;16(4):409-428. doi:10.52054/FVVO.16.4.046\n42. Deutch B. Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake. Eur J Clin Nutr. 1995;49(7):508-516.\n43. Savaris AL, do Amaral VF. Nutrient intake, anthropometric data and correlations with the systemic antioxidant capacity of women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):314-318. doi:10.1016/j.ejogrb.2011.05.014\n44. Parazzini F, Chiaffarino F, Surace M, et al. Selected food intake and risk of endometriosis. Hum Reprod Oxf Engl. 2004;19(8):1755-1759. doi:10.1093/humrep/deh395\n45. Harris HR, Eke AC, Chavarro JE, Missmer SA. Fruit and vegetable consumption and risk of endometriosis. Hum Reprod Oxf Engl. 2018;33(4):715-727. doi:10.1093/humrep/dey014\nDownloads\nPublished\nHow to Cite\nIssue\nSection\nLicense\nCopyright (c) 2026 Matylda Kuczma, Marta Kamińska, Adrianna Klimczak, Barbara Pietrzak, Mikołaj Patelski, Maciej Czapla, Mateusz Surma, Jakub Molenda, Wiktoria Mikusek, Wiktoria Kotlarz\nThis work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.\nStats\nNumber of views and downloads: 160\nNumber of citations: 0","source_license":"CC0","license_restricted":false}