female_health

Endometriosis Pain + Nutrition

Endometriosis affects ~10% of women. Anti-inflammatory diet + pelvic-floor physio + (in many) hormonal suppression reduces pain by 40-70% in RCTs; multimodal care is first-line.

Nutrition

Pattern

Anti-inflammatory Mediterranean + reduced red meat

Foods to emphasise

Fatty fish 2-3×/wk (omega-3 anti-inflammatory)
Leafy greens
Berries
Cruciferous vegetables (oestrogen metabolism)
Turmeric, ginger
Flaxseed (lignans)

Foods to limit

Red + processed meat (associated with risk)
Trans fats
Excess alcohol
Refined sugar

Exercise

Aerobic

Moderate; can flare with high-impact during flares.

Strength

2-3×/wk modulated to symptoms.

Flexibility

Daily yoga; pelvic-floor down-training in conjunction with physio.

Weekly target

150 minutes

Supplements

Omega-3

2-3 g/day

RCT

Anti-inflammatory + pain reduction.

Magnesium glycinate

300-400 mg/day

observational

Cramping.

Vitamin D3

1000-2000 IU/day

observational

Low D associated with severity.

Curcumin

500-1000 mg/day with piperine

observational

NAC

600 mg × 3/day

RCT (small)

May reduce endometrioma size.

Monitor + cadence

What to track

Pain diary + cycle tracking
Functional impact
Symptom escalation triggers
Mental health screening (depression + anxiety common)

Red flags — seek care

Acute severe pelvic pain with fever → rule out PID, torsion, abscess — ER
Bowel obstruction signs (bilious vomiting, no flatus) → ER
Suicidal ideation from chronic pain → urgent psych

Sources

ESHRE Endometriosis Guideline 2022
ACOG Practice Bulletin 114 (2018)
NICE NG73 Endometriosis 2017

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