What does the diet do? In short, it helps in
1) anti-inflammatory (less pain) function,
2) promotes less estrogen (endo grows with estrogen), and
3) builds up the immune system.
However, knowing what not to eat can make a significant difference in the way an endometriosis sufferer feels. In fact, endometriosis diet is about eliminating foods that increase negative prostaglandins, prostaglandin E2 (PGE2) and prostaglandin F2a (PGF2a). Negative prostaglandins stimulate estrogen, which is the main hormone that wreaks havoc in an endometriosis sufferer.
FOOD TO AVOID in Endometriosis Diet
The following are 11 foods to avoid when following an endometriosis diet:
1. Red Meat
Meat promotes negative prostaglandin PGF2a production. Red meat may contain growth hormones that include estrogen. If meat is your main source of protein, you can obtain the protein you need through other protein-rich foods such as chemical-free fish, organic or free-range chicken, beans, walnuts, cashews, chestnuts, sunflower seeds, flaxseed and sesame seeds.
2. Saturated fats and oils
Foods that are high in fatty acids stimulate the production of negative prostaglandin PGE2 and PGF2a. Fatty acids are found in saturated fats, oils (coconut oil, palm oil, etc.), butter, margarine, lard, organ meats, and fried foods.
Fried food, margarine and hydrogenated fats stimulate negative prostaglandins; they should be avoided.
Sugar, in all forms (refined, artificial or natural) produces a more acidic environment within the body that can encourage the inflammatory pain of endometriosis. Therefore, limit the consumption of any food with high content of sugar, such as chocolate, sweeteners, drinks, sweets and honey to the minimum.
Wheat contains phytic acid that can aggravate endometriosis symptoms. Wheat contains gluten and studies have found that many endometriosis sufferers appear to have gluten sensitivity which can cause an increase in painful symptoms. Studies have also shown that 80% of women who took gluten free diet have reduced painful periods. Therefore, products containing wheat and gluten such as breads, cakes, pasta, and so on should be avoided or limited.
5. Soy products and Soy Protein Products
Like wheat, soy contains phytic acid; however the levels of phytic acid in soy are considerably higher than wheat. High levels of phytic acid in soy are known to irritate the digestive system and reduce assimilation of calcium, magnesium, copper, iron and zinc. Soy products also contain high levels of phytoestrogens, toxin which seems to be particularly detrimental for women with endometriosis. Soy phytoestrogens disrupt endocrine function and have the potential to cause infertility and promote breast cancer in adult women. Soy is found in many food products including granola, pasta, imitation meat, soy milk, soy yogurt, soy based cheese, etc.
Exceptions are fermented soy products--tofu, tempeh, and miso. The processing method used by traditional Asian to make this fermented soy products get rid of most of the toxins and make the beneficial phytochemicals more available in the body. Tofu and tempeh are a nearly complete protein and as such are an excellent alternative to meat in a balanced meal. Miso stirred into hot water with a strip of kombu or nori seaweeds is a rich source of minerals.
High consumption of caffeine has been found to increase estrogen levels, which can trigger endometriosis flare ups. Hence, caffeine-rich foods to avoid with endometriosis include coffee, tea and soft drinks. Coffee is a known phytoestrogen. Since it is a phytoestrogen, decaffeinated coffee may still be able to act as an estrogen. Consuming more than two cups of coffee a day may cause estrogen levels to raise.
Optimum liver function is essential for clearing out excess estrogen which in return helps to control endometriosis. Overconsumption of alcohol is best known for causing the liver damage where the liver will swell with acute intoxication, sometimes painfully, and will show fatty infiltration and enlargement. Alcohol ingestion also interferes with vitamin B12 absorption. Eliminating alcohol from the body stresses the liver and this hinders it from expelling other toxic such as excessive estrogen from the body.
8. Dairy products
Dairy products should be avoided as they stimulate the production of negative prostaglandin PGE2 and PGF2a, which can worsen the endometriosis symptoms. The primary dairy foods that you should avoid with endometriosis include milk and cheese. To fulfil calcium requirement for the body, other good sources of calcium are sesame seeds, almonds, salmon, sardines, seaweed, figs, and calcium fortified foods such as orange juice and oat milk.
Note: When substituting dairy products such as pasteurized milk with soy milk, don’t forget that soy can also aggravate the endometriosis symptoms.
9. Refined carbohydrates
Refined carbohydrates also encourage the inflammatory pain of endometriosis. Examples are white bread, cakes, noodles, pasta, flour, pastry, etc. Most of their natural nutrients have been removed. Refined carbohydrates deplete the body’s nutritional stores as they are needed in order for the body to absorb the nutrients in the refined carbohydrates. This can also lead to increased endometriosis symptoms. A better substitute is unrefined carbohydrates such as gluten-free wholegrain breads, pasta, brown rice, potato, kumera (sweet potato) etc.
Note: When substituting refined carbohydrates, remember to look for gluten-free (wheat-free) products, as wheat can aggravate endometriosis symptoms.
10. Additives and preservatives
Processed, frozen and pre-packaged foods should be avoided when following an endometriosis diet as they are full of additives, preservatives chemicals, and many other ingredients that promote ill-health and negative prostaglandin PGE2 and PGF2. These additives and preservatives aggravate inflammation and worsen the menstrual pain.
Some women have reported to achieving great health improvements by following a diet to address Candida yeast infection. I happened to be one of them. Donna Gates, in her book, “The Body Ecology Diet: Recovering Your Health and Rebuilding Your Immunity” has shown strong connection between endometriosis and candida yeast overgrowth. I did the questionnaires in this book, and found out a lot of similarities between my endometriosis symptoms and the symptoms of candida overgrowth in one’s body. A study by the Woman's Hospital of Texas examined 50 women with endometriosis and found that 40 women showed bacterial overgrowth. After eight weeks of candida diet, significant reduction in symptoms was achieved. Yeast foods to be avoided are breads, Chinese Steamed bun (e.g Char Siu Bao), bagels, pretzels, muffins and sugars. I followed the Candida diet, and I have seen tremendous improvements with my Endometriosis symptoms.
Endo Diet is Too Difficult to Follow
After reading the list, do you feel that the Endo Diet is too difficult for you to follow? That’s how I felt in the beginning. However, I didn’t have a choice. I have exhausted my choice in fact. I have decided against surgical operation. Operating theatre in the hospital is the last place I wanted to be. Medication did help to alleviate the pain, but I didn’t want to rely on it forever. I figure I have suffered enough from this disease and I would do almost everything I can to stay symptom free! So, I was determined to try this diet.
IT'S WORTH IT
Well, it wasn’t as hard as I thought, once I fixed up my mind. I follow this Endo diet about 80-90% of the time. Sometimes, it is just too difficult to follow; sometimes it is just not possible, or unprepared on my part like when I am travelling for work. At other times, I like to cheat and take a break from the restricted diet. I think we should give ourselves a break occasionally.
What I am trying to say is, if you can go full force, that is excellent, and you take shorter time to get there! Others may want to do it 75% of the time. That is still excellent, as it is probably a big change in diet for you, and you will be that much healthier; the symptoms will likely to reduce, or it may take longer time for you to achieve the desired results, but you will get there, just later.
I will be honest here, there are days I just say, “forget it just for today” and eat everything wrong. Most of the times, I saved myself from temptation by telling myself that I will only take the “forbidden food” when it is of supreme quality. Since I don’t get to eat top-notch supreme quality food every day, it helps me to control my intake and temptation. When the rare opportunity comes, I do reward myself for my discipline and perseverance. It is a nice short break on occasion, but then I do get right back to eating healthy again as I want to build up my health.
For a start, you do not have to start out full force, and you need time to find out the food that is acceptable by your tongue and stomach. Do a little at a time and work up to it. My advice is, print out this page, and read it again and again, until you can remember the Endo Diet. Then, you will get reminded before taking in any food. You can try eliminating dairy or wheat first and see how you feel. Give it a yourself a few weeks before adding a certain category of food back into your diet to see if it is the food that triggers pain, bloating, bowel, yeast or bladder problems. Keeping a food diary will be helpful for you to look back and find out which foods are the culprits!
People who do respond to the diet often report that it takes a minimum of four weeks before any improvement is noticeable. For me, it took me three months. To deal with endometriosis, diet change is an excellent foundation to assist you in reducing the symptoms, and it definitely helps you to regenerate your health.
Yes it is difficult at first, but it is so worth it to feel GOOD!
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Mom on February 15, 2018:
Well...hate to blow your spot... I have been eating like this for years because I have crones disease and while it has managed to put my crones into remission after years of shots and IV treatments, over the course of the last five years my endometriosis has gotten much worse. I had 3 lapiscopies in three years causing the collapse of my uterus followed by a hysterectomy. Eating healthy is not going to hurt anyone, but telling them it's going to cure their endometriosis is quite the stretch.
Sarah on July 29, 2015:
For soy sauce you can use Tamari sauce it is a gluten free version. I have done a lot of research and agave nectar is ok too. I found unrefined coconut sugar in my grocery and it's wonderful because it seems to be a good sub for white and brown sugar and I am trying to figure out if it is ok but can't find research on it anywhere with endo diet. Can anyone help ? Also, I purchased Carolyn Levett's nutrition book on endo and it's also very informative. Thanks!
Ouch on May 14, 2015:
I'd love to follow this kind of diet, but what I don't understand is how anyone can get enough calories when you cut out carbs, oil, dairy, sugar, and most meat. Fish is caloric but not enough to provide the 2000 calories a day that I need to maintain a healthy weight, and nuts and seeds cause me pain. I have delayed gastric emptying, a condition that causes food to digest too slowly, so I feel full all the time as it is. There's no way I could take in enough fruits and vegetables to equal 2000 calories a day. I don't know how even a "normal" person could do it.
Endolicious on October 21, 2014:
This is spot on. Eating certain foods (caffeine and sugar in particular) causes my cramps to INSTANTLY skyrocket. Thought it was just my imagination but apparently not.
Eating anything during my period causes pain to increase, so I usually eat just enough to take a ton of ibuprofen and Ultram. Fun times.
Tenley Dunlap on September 06, 2014:
This is a very informative hub. It doesn't just say "don't eat that!" but it explains why. Most of the doctors do not mention any dietary restrictions, but are quite happy to hand out pills and surgery. Bravo!
Chuck Bluestein from Morristown, AZ, USA on May 08, 2014:
When you say sugar, you are referring to sugar1a not sugar1b. The latter is not added to foods but is already in them. Fruits and vegetables have a lot of sugar in them. Fruits are mostly sugar while vegetables are more like 50% sugar and 50% starch. The vegetables that are mostly starch, like potatoes are not eaten raw.
jenbeach21 from Orlando, FL on August 30, 2012:
Thank you so much! I also have been diagnosed with endometriosis but I elected to have surgery. After the surgery, I still experience pain once a month around what would be my cycle (I had an ablation done also to help with the pain). I usually don't take any meds and I at one time was following a stricter diet. Your hubs were so great about laying out all the info and I know that I need to get back on the diet.
Ab on July 07, 2012:
I do most of this already but I have just realised that I'm having a lot more "contraction" pains at the moment, weirdly i've just started to eat a lot more steak, bacon i.e. red meat! So I think you def on to something. I agree it's never to hard, if it gets rid of my pain I will try ANYTHING I'm suffering and have already lost two jobs through this damn disease, I am NOT losing another!! Thanks again for giving me hope :) I hope that it carrys on to be good for you too. I am having problems losing weight too, even though my diet is good, and I'm wondering whether this may help with that too, (also have underactive thyroid) so thanks for giving me hope :)
Robbyn Wilkins on June 25, 2012:
I've found that adding chinese bitters (3 weeks on, 1 week off) also helps cleanse the liver which is tremendously helpful for eliminating excess estrogen in the body. Since using it, I have been able to stop taking my pain medication for my endometriosis... It may not be for everyone, but it's something to consider if you're looking to minimize your endo pain and symptoms
creative1975 from Christchurch, NZ on June 17, 2012:
I've had endo for about ten years and I was diagnosed four years ago. During that time I had two ops. I am embarking on the endo diet and today is my first day! I wouldn't consider myself on a terrible diet at the moment, but there is certainly room for improvement and I do eat unhealthy foods. With this diet and leaving out all the foods that I shouldn't eat, which I have been, I'm hoping this will be the turn around that I need, as I have had enough! I have substituted cows milk for rice milk or almond milk and I have my wheat free, gluten free bread! I have ordered the book and the recipe book and can't wait for them to arrive!
I read that 'live' yoghurts were okay? And what about eating chicken?
Cutting out all the 'sugary' foods will be the hardest for me. The cakes, biscuits and chocolate etc. Wish me luck!
Ingenira (author) on April 25, 2012:
Megan, I agreed with dboaz, soy sauce is not good for Endo diet.
dboaz, thank you so much for sharing your success story with us. I really appreciated it. You have encouraged me further as well as other readers with the same issue.
dboaz on April 24, 2012:
My symptoms have significantly decreased in severity since I started this diet. I really appreciate the help.
Megan- Soy sauce is NOT ok in any form for endo. at least not for most. I would suggest taking out everything that this website suggests, and then reintroducing things after 3-4 months to see what the affects are.
Also, It is really overwhelming at first to begin this diet, but there are many alternatives for all kinds of foods (milk, flour, eggs, cheese, etc) I recommend trying to find a WholeFoods store or something of the sort. Don't give up, it is worth the hardship! :)
Megan on March 30, 2012:
Is soy sauce ok since it is fermented? Thanks!
Ingenira (author) on March 21, 2012:
I haven't tried to substitude agave nectar for sugar/honey, so I can't give you a clear yes or no answer. I hope someone else who reads this question can share their experience.
However, as I googled, I found some endo diet recommend using agave nectar as sugar/honey substitude. You can try it out, and if the pain did not reduce, it may be the cause. Do share with us your experience.
"Recipes for the Endo diet" could be a good book for you to learn more, and still enjoy eating your favourite food.
Something Another on March 21, 2012:
Can agave nectar be substituted for sugar and honey, or do you think it will have the same inflammatory affect?
Ingenira (author) on March 06, 2012:
manf, it took me 3 months to have pain-free menstrual period. Some people needs longer time. Keep up the discipline, and afterall this is a very healthy diet, even for people without endometriosis.
manf on March 06, 2012:
Thank you so much. I have not officially been diagnosed with endo, and the doctors I have been to are of VERY little help. My symptoms fit the description of endo to the T, and so I have been doing everything possible to eliminate my symptoms. I have been very discouraged lately about my pain and my new diet. Do you know how long it might take to see results? I have been on the diet for about 3 weeks and saw results in my everyday pain, but the pain during my menstrual period is still overwhelming.
Ingenira (author) on October 03, 2011:
Kwatts, thanks for your comment. Hope all goes well with you.
Kwatts on October 03, 2011:
Thank you so much for all the information, I a have not been diagnosed with endo but have most of the symptoms and have begun my own research until my next dr. Visit. Great help,
Ingenira (author) on January 16, 2011:
Thanks, fadibody. Welcome to my page.
Ingenira (author) on January 08, 2011:
Yes, definitely, yeast free diet will help.
Erik Parsons on October 20, 2010:
By looking at the symptoms, I can say that yeast free diet can also help you alleviate these symptoms. Just make sure to follow this program and you’re assured to see result at the best time possible.