Survey Respondents Report Dietary Modifications Help Relieve Endometriosis-Related Pain

Data published in JAMA Network Open shows that modifications to diet may help individuals manage endometriosis-associated pain. Despite these positive implications, the authors observed that no single medication was uniquely perceived as beneficial, and in some patients, there were not any helpful changes.¹

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Endometriosis is a neuroinflammatory reproductive disorder in which lesions similar to the endometrium form outside of the uterus. A common symptom is chronic pain, but patients can also experience fatigue, infertility, and gastrointestinal symptoms, such as irritable bowel syndrome and abdominal bloating and pain. It is difficult to diagnose and treat, with current therapeutic options being largely limited to hormone-suppressive drugs or surgeries.¹

Because the gut microbiome has been implicated as a regulator of pain related to inflammatory conditions, including endometriosis, the study investigators assessed whether dietary modifications can help provide patients with some symptom relief. The investigators utilized an online survey to gain insights into which dietary modifications and/or supplements were believed to be beneficial for pain management in patients with endometriosis. The survey was conducted between June 10 and September 2, 2022, and consisted of 24 questions written in English on the online platform Qualtrics. Statistical comparisons of distributions were performed using the Mann-Whitney U test, according to the authors.¹

“Women are in need of anything that can help with the pain of endometriosis. This condition is so under-researched, and there is so much to discover, but there is growing evidence that gut bacteria could play a part in symptoms, and that explains why many women have experimented with changing their diets and why we have found that this appears to work for many,” study leader Francesca Hearn-Yeates, PhD researcher, University of Edinburgh, said in a news release.²

Among the 2858 participants who initiated the survey, 2599 had completed over 80% of the questions, and 2388 had a confirmed diagnosis of endometriosis, of which the majority (88.4%; n = 2110) were White. Additionally, most respondents reported frequent pelvic pain (96.9%; n = 2313) and abdominal bloating (91.2%; n = 2177), and about 83.8% (n = 2001) had reported trying 1 or more diets to better manage their symptoms. About 58.8% (n = 1404) of survey responders had also used supplements, with 66.9% (n= 1339) and 43.4% (n = 609) reporting self-help strategies had improved their pain.¹

When respondents’ pain scores (0–10 scale) were represented on a histogram, there was a statistically significant difference between those who reported the modification had improved pain compared with those who did not, according to the investigators. Specifically, the former had lower pain scores than the latter (improvement from dietary modification: median [IQR], 4.0 [3.0-6.0]; vs no improvement: 5.0 [4.0-7.0]; P < .001).¹

“This study provides valuable insights into the lived experiences of individuals with endometriosis who have explored dietary modifications and supplements to manage their pain. While it cannot assess causality, the findings highlight the need for further rigorous research into these potential non-hormonal strategies,” Nilufer Rahmioglu, PhD, MSc, senior research scientist at Nuffield Department of Women’s and Reproductive Health, University of Oxford, explained in the news release.²

Further, pain improvement was reported by 53.2% (n = 666 of 1252) of those who reduced alcohol, 45.4% (n = 523 of 1151) of those who reduced gluten, 45.2% (n = 512 of 1132) of those who reduced dairy, and 43.4% (n = 473 of 1091) of those who reduced caffeine. The low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet was found to be less popular (32.1%; n = 181 of 563). Additionally, among the 812 respondents who used magnesium, approximately 32.3% (n = 262) reported a benefit. Survey respondents also reported that they were likely to attempt different dietary habits because of advice from social media or a health care professional.¹

“It really feels like we are on the cusp of something pretty big with understanding how diet affects endometriosis symptoms. It is so important for women, if they feel they can do something for themselves, to tackle the pain of endometriosis—that is tremendously empowering,” senior study author Philippa Saunders, PhD, FMedSci, professor of reproductive steroids at the University of Edinburgh, said in a news release.²

REFERENCES

1. Hearn-Yeates F, Edgley K, Horne AW, O’Mahony SM, Saunders PTK. Dietary Modification and Supplement Use For Endometriosis Pain. JAMA Netw Open. 2025;8(3):e253152. doi:10.1001/jamanetworkopen.2025.3152

2. The Guardian. Major endometriosis study reveals impact of gluten, coffee, dairy and alcohol. News release. April 5, 2025. Accessed April 24, 2025. https://www.theguardian.com/society/2025/apr/05/major-endometriosis-study-reveals-impact-of-gluten-coffee-dairy-and-alcohol