MEDICAL NUTRITION THERAPY, TARGETED SUPPLEMENTATION, AND MICROBIOTA MODULATION IN ENDOMETRIOSIS: A NARRATIVE REVIEW

In: International Journal of Innovative Technologies in Social Science · 2026 · vol. 4(3(51)) · doi:10.31435/ijitss.3(51).2026.6204 · W7213621842
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This narrative review evaluates medical nutrition therapy and microbiota modulation in endometriosis, finding that specific diets and supplements alleviate symptoms and inflammation via the gut-uterine axis while emphasizing precision dietary care.

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This narrative review evaluates the role of medical nutrition therapy, targeted supplementation, and microbiota modulation in managing endometriosis, a chronic estrogen-dependent inflammatory disease. The authors synize evidence indicating that the Mediterranean diet reduces oxidative stress while the low-FODMAP diet alleviates gastrointestinal symptoms, whereas routine gluten elimination lacks justification without specific indications. Additionally, supplements like vitamin D and omega-3 fatty acids show immunomodulatory potential, though efficacy varies due to phenotypic heterogeneity, and emerging data highlight the gut-uterine axis as a key etiopathogenetic factor involving dysbiosis and estrobolome modulation. This paper is centrally about endometriosis — specifically exploring non-pharmacological dietary and microbial interventions for symptom management and pathomechanism modification.

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Abstract

Endometriosis is a chronic, estrogen-dependent inflammatory disease for which conventional treatments often prove insufficient. This narrative review comprehensively evaluates the impact of Medical Nutrition Therapy (MNT), targeted supplementation, and the intestinal microbiota on the pathomechanism and clinical course of endometriosis. A structured literature search was conducted across PubMed, Scopus, and Google Scholar databases, analyzing evidence-based studies published primarily between 2016 and 2026. The synthesized findings demonstrate that personalized non-pharmacological interventions exhibit significant therapeutic potential. Specifically, the low-FODMAP diet effectively alleviates overlapping gastrointestinal symptoms, while the Mediterranean diet reduces oxidative stress and modulates estrogen metabolism. Conversely, routine gluten elimination lacks justification without specific medical indications. Targeted supplementation with vitamin D, Omega-3 fatty acids, and antioxidants exhibits immunomodulatory properties, though clinical efficacy often varies due to phenotypic heterogeneity. Furthermore, emerging evidence highlights the gut-uterine axis as a key etiopathogenetic paradigm; dysbiosis and endotoxin translocation actively drive pelvic inflammation, making estrobolome modulation highly promising. Ultimately, nutritional interventions serve as a synergistic complement to conventional medicine, highlighting the urgent need to shift from universal protocols toward multidisciplinary, precision dietary care tailored to the patient’s individual metabolic and microbial phenotype.
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MEDICAL NUTRITION THERAPY, TARGETED SUPPLEMENTATION, AND MICROBIOTA MODULATION IN ENDOMETRIOSIS: A NARRATIVE REVIEW DOI: https://doi.org/10.31435/ijitss.3(51).2026.6204Keywords: Endometriosis, Mediterranean Diet, Low-FODMAP, Supplementation, Microbiota, Oxidative StressAbstract Endometriosis is a chronic, estrogen-dependent inflammatory disease for which conventional treatments often prove insufficient. This narrative review comprehensively evaluates the impact of Medical Nutrition Therapy (MNT), targeted supplementation, and the intestinal microbiota on the pathomechanism and clinical course of endometriosis. A structured literature search was conducted across PubMed, Scopus, and Google Scholar databases, analyzing evidence-based studies published primarily between 2016 and 2026. The synthesized findings demonstrate that personalized non-pharmacological interventions exhibit significant therapeutic potential. Specifically, the low-FODMAP diet effectively alleviates overlapping gastrointestinal symptoms, while the Mediterranean diet reduces oxidative stress and modulates estrogen metabolism. Conversely, routine gluten elimination lacks justification without specific medical indications. Targeted supplementation with vitamin D, Omega-3 fatty acids, and antioxidants exhibits immunomodulatory properties, though clinical efficacy often varies due to phenotypic heterogeneity. Furthermore, emerging evidence highlights the gut-uterine axis as a key etiopathogenetic paradigm; dysbiosis and endotoxin translocation actively drive pelvic inflammation, making estrobolome modulation highly promising. Ultimately, nutritional interventions serve as a synergistic complement to conventional medicine, highlighting the urgent need to shift from universal protocols toward multidisciplinary, precision dietary care tailored to the patient’s individual metabolic and microbial phenotype. References Abokhrais, I. 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Supplementation with vitamin D or ω-3 fatty acids in adolescent girls and young women with endometriosis (DYNAMIC): A double-blind, randomized, placebo-controlled trial. The American Journal of Clinical Nutrition, 112(1), 187–195. https://doi.org/10.1093/ajcn/nqaa096 O'Brien, L., Kasti, A., Halmos, E. P., Tuck, C., & Varney, J. (2024). Evolution, adaptation, and new applications of the FODMAP diet. Journal of Gastroenterology and Hepatology, 39(7), 1332–1341. https://doi.org/10.1002/jgh3.13066 Pellegrini, C., Maggio, R., & Blandini, F. (2020). Resveratrol in endometriosis: A review of the molecular mechanisms. International Journal of Molecular Sciences, 21(21), 8089. https://doi.org/10.3390/ijms21218089 Porpora, M. G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E. K., Lundeberg, T., Nofroni, I., Piccioni, M. G., Pittaluga, E., Ticconi, C., & Parasassi, T. (2013). 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Pharmaceuticals, 16(12), 1696. https://doi.org/10.3390/ph16121696 Downloads Published Issue Section License Copyright (c) 2026 Aneta Sobek, Katarzyna Kraska, Jan Potoniec, Weronika Kępa, Joanna Kadłuczka, Aleksandra Papuga, Magdalena Grzymek, Aleksandra Pawłucka, Katarzyna Pawłucka, Justyna Bury, Martyna Więcławek This work is licensed under a Creative Commons Attribution 4.0 International License. All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles. CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

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