Researchers reviewed studies about how different diets and supplements might help women with endometriosis—a painful condition affecting about 1 in 10 women. The review found that eating patterns like the Mediterranean diet (lots of vegetables, fish, and olive oil) may reduce pain and improve quality of life. Some newer research suggests ketogenic diets might also help by reducing inflammation in the body. Certain supplements like omega-3 fatty acids and probiotics showed promise in studies too. The review emphasizes that working with a nutritionist to create a personalized eating plan might be an important part of managing endometriosis alongside other medical treatments.

The Quick Take

  • What they studied: Whether different eating patterns and food supplements can help reduce pain and symptoms in women with endometriosis, and what role nutritionists play in treatment
  • Who participated: This was a review of existing research rather than a new study with participants. The researchers looked at many published studies about diet and endometriosis in women of reproductive age
  • Key finding: The Mediterranean diet—which emphasizes vegetables, fruits, fish, whole grains, and olive oil—appears to reduce pain and improve quality of life in women with endometriosis. Some supplements like omega-3 fatty acids and probiotics also showed anti-inflammatory benefits in studies
  • What it means for you: If you have endometriosis, talking with a nutritionist about trying a Mediterranean-style diet or specific supplements might help manage your symptoms. However, this should complement, not replace, medical treatment from your doctor. Results vary by person, so working with a healthcare team to find what works for you is important

The Research Details

This is a review article, meaning researchers looked at and summarized findings from many different studies that were already published. They searched through scientific literature to find studies about how nutrition affects endometriosis and obesity. The researchers focused on three main areas: the Mediterranean diet, ketogenic (very low-carb) diets, and nutritional supplements. They examined what each approach does to reduce inflammation, pain, and other symptoms of endometriosis.

The review also highlighted the importance of nutritionists as part of a medical team. Rather than giving everyone the same diet, the researchers emphasized that nutritionists should create personalized eating plans based on each person’s specific needs and symptoms. This approach is called ‘precision nutrition’ and recognizes that different women with endometriosis may benefit from different dietary strategies.

Review articles are valuable because they gather information from many studies in one place, helping doctors and patients understand what the overall evidence shows. Since endometriosis is a complex condition with many potential causes, looking at multiple studies helps identify patterns and reliable findings. This type of research is especially useful for nutrition because individual studies can sometimes give conflicting results, but reviewing many studies together gives a clearer picture of what actually works

This review was published in a reputable medical journal focused on obesity research. The researchers appear to have systematically looked at current scientific evidence. However, readers should know that review articles summarize other people’s research rather than conducting new experiments. The strength of conclusions depends on the quality of the studies being reviewed. Some areas (like ketogenic diets for endometriosis) had limited clinical evidence, meaning fewer high-quality studies exist. The review is current as of 2025, which is helpful since nutrition science evolves

What the Results Show

The Mediterranean diet emerged as the most well-supported dietary approach for endometriosis management. This diet is rich in anti-inflammatory foods like vegetables, fruits, fish, whole grains, legumes, and olive oil. Studies showed that women following this pattern experienced decreased pain and improved quality of life. The benefits likely come from the diet’s high content of antioxidants (substances that protect cells from damage) and fiber, which help reduce inflammation throughout the body.

Ketogenic diets—which are very low in carbohydrates and high in fats—showed promise in early research. These diets may help by changing how the body processes insulin and reducing inflammatory signals. However, the review noted that clinical evidence (studies in actual patients) for ketogenic diets remains limited compared to Mediterranean diet research. More studies are needed before strong recommendations can be made.

Several supplements demonstrated anti-inflammatory and protective effects: omega-3 fatty acids (found in fish oil), N-acetylcysteine (a compound that supports the body’s natural defenses), resveratrol (found in grapes and berries), vitamins C and E, and probiotics (beneficial bacteria). These supplements appeared to help reduce inflammation and oxidative stress—a type of cellular damage linked to endometriosis pain.

An emerging area of research involves the gut microbiota—the community of bacteria living in the digestive system. These bacteria interact with the immune system and hormone regulation, both of which are disrupted in endometriosis. Probiotics and dietary changes that support healthy gut bacteria may help restore balance and reduce symptoms. The review also noted an interesting relationship between body weight and endometriosis: while being underweight may increase endometriosis risk, having obesity is associated with more severe symptoms and pain. This suggests that achieving a healthy weight through proper nutrition might improve outcomes, though the relationship is complex

This review builds on previous research showing that inflammation plays a central role in endometriosis. Earlier studies established that anti-inflammatory approaches help; this review confirms that dietary patterns and supplements targeting inflammation are effective strategies. The inclusion of ketogenic diets represents newer research directions, as this approach has only recently been studied for endometriosis. The emphasis on personalized nutrition based on individual patient characteristics is also a shift from older approaches that recommended one-size-fits-all diets. The review reflects growing recognition that nutritionists should be core members of the medical team treating endometriosis, not just supplementary providers

This review has several important limitations. First, it summarizes other studies rather than conducting new research, so conclusions depend on the quality of existing studies. Second, many studies on supplements were preclinical (done in laboratories or animals) rather than clinical (in actual patients), so real-world effectiveness may differ. Third, the review notes that ketogenic diet evidence is limited, meaning fewer rigorous studies exist. Fourth, most research on Mediterranean diet benefits comes from observational studies (watching what people eat) rather than randomized controlled trials (the gold standard where people are randomly assigned to diets). Finally, the review doesn’t provide specific information about how long dietary changes take to show benefits or which women are most likely to benefit from each approach

The Bottom Line

Based on current evidence, trying a Mediterranean diet pattern appears to be a reasonable, safe approach for women with endometriosis who want to use nutrition to manage symptoms. This recommendation has moderate confidence because multiple studies support it. Working with a nutritionist to implement this diet increases the likelihood of success. Omega-3 supplements and probiotics may also be worth discussing with your healthcare provider, though evidence is somewhat less robust. Ketogenic diets show promise but need more research before strong recommendations can be made. Any dietary changes should complement, not replace, medical treatment prescribed by your doctor

This research is most relevant for women diagnosed with endometriosis who experience pain or other symptoms. It’s also relevant for women planning pregnancy, since endometriosis can affect fertility. Healthcare providers including gynecologists, nutritionists, and primary care doctors should consider these findings when treating endometriosis. Women with obesity and endometriosis may particularly benefit from working with a nutritionist on weight management. However, this research is less directly applicable to women without endometriosis or those whose symptoms are well-controlled with current medical treatment

Realistic expectations matter: dietary changes typically take 4-8 weeks to show noticeable effects on pain and symptoms, though some people may notice improvements sooner. Supplements may take similar timeframes. Significant improvements in quality of life and pain reduction often take 2-3 months of consistent dietary adherence. Weight loss, if needed, typically requires 3-6 months to show meaningful results. It’s important to track symptoms during this period to determine if changes are helping your specific situation

Want to Apply This Research?

  • Track daily pain levels (using a 1-10 scale), energy levels, and digestive symptoms alongside meals eaten. Note which foods or supplements seem associated with better or worse symptoms. This personalized data helps identify which dietary approaches work best for your body
  • Start by adding more Mediterranean diet foods to meals you already eat: add olive oil to salads, include fish twice weekly, increase vegetable portions, and choose whole grains. Rather than eliminating foods, focus on adding anti-inflammatory options. If considering supplements, add one at a time so you can identify which ones help
  • Use the app to log meals and symptoms daily for at least 8 weeks to establish patterns. Create a simple symptom score combining pain, energy, and quality of life. Review weekly trends rather than daily fluctuations. Share this data with your nutritionist or doctor to adjust your plan based on what’s actually working for you

This review summarizes research on nutrition and endometriosis but is not medical advice. Endometriosis is a serious medical condition requiring professional diagnosis and treatment. Any dietary changes, supplements, or nutrition interventions should be discussed with your healthcare provider or a registered dietitian before starting. This information should complement, not replace, medical treatment prescribed by your gynecologist or doctor. Individual results vary significantly, and what works for one person may not work for another. If you experience severe pain, heavy bleeding, or other concerning symptoms, contact your healthcare provider immediately rather than relying solely on dietary changes.