If you’ve been diagnosed with endometriosis, you’ve likely looked into lifestyle changes that could ease the pain, bloating, and inflammation that often come with it. One question that comes up a lot is: What’s the deal with gluten and endometriosis? Is going gluten-free worth a try?
Let’s explore what the research says about this potential link, how gluten might affect symptoms, and whether eliminating it could be helpful for managing endo.
Table of Contents
What Is Endometriosis?
Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside the uterus—often on the ovaries, fallopian tubes, or other organs in the pelvis. Common symptoms include:
- Painful periods
- Chronic pelvic pain
- Pain during sex
- Bloating and digestive issues
- Fatigue
- Infertility
Since endo is inflammatory and often tied to immune system dysfunction, many people turn to nutrition to reduce symptom flare-ups. It’s interesting to note that endometriosis has a lot of overlap with digestive disorders like Celiac Disease and IBS: not only can symptoms be similar, but people with endometriosis are also more likely to have IBS and Celiac Disease.
So, theoretically, you can understand why people might turn their attention to gluten.
Gluten and Endometriosis: Is It A Concern?
Gluten is a protein found in wheat, barley, and rye. In some people, it may trigger immune responses, gut inflammation, or increased intestinal permeability (“leaky gut”), especially for those with celiac disease or non-celiac gluten sensitivity.
For people with endometriosis, this matters because:
- Endometriosis is an inflammatory condition.
- Gluten may promote inflammation in sensitive individuals.
- Gut issues are common in endo, and gluten can worsen symptoms like bloating, constipation, or diarrhea in some people.
What the Research Says
A 2012 study published in Minerva Chirurgica found that 75% of women with endometriosis experienced a reduction in pain after 12 months on a gluten-free diet. The problem with this study is that 88 people dropped out because the gluten free diet made their symptoms worse, and so the results were only based off those that stayed in the study. This means the data might be skewed, and a gluten-free diet might not be as helpful as we think.
There’s also a growing body of research showing that endometriosis and autoimmune or gut-related conditions often overlap, such as IBS, Celiac Disease, or small intestinal bacterial overgrowth (SIBO). For people with multiple diagnoses, gluten may be at play.
But in IBS, for example, research has found that people are better able to manage their symptoms with a low FODMAP diet, not a gluten-free diet. Similarly, it seems that a low FODMAP diet can be beneficial for people with endometriosis, especially those who may also have IBS.
What To Do If You Think Gluten Is A Problem For You
While the research is still inconclusive on how effective a gluten-free diet is for endometriosis, the truth is, everyone is different, and there’s always a possibility gluten is a trigger for you. If you think it might be, here are some things you can do:
- Rule out Celiac Disease and IBS. As mentioned, people with endo are more likely to have CD or IBS, so it’s worth going to your doctor to find out and be sure.
- Try a gluten-free diet for 2 weeks. Of course, the best way to know if you feel better without something is to, uh, go without it. Try eliminating gluten and notice how you feel. After two weeks, add gluten back in and notice how you feel. A few thoughts before you start: the first, is that there is such a thing as a nocebo effect, meaning you might feel better on a gluten-free diet just because you think you will be. The second, is that gluten-free diets often lack fibre, which (as I’ll explain below) can be really important for endometriosis.
- Try a low-FODMAP diet. Similarly to a gluten-free diet, you can try a low-FODMAP diet and see if that helps with symptom management. I actually recommend doing this with a dietitian or someone trained in low FODMAP, because it’s confusing and should not be done long term. Like the gluten-free diet, this diet is lower in fibre, so while it can help with symptoms short-term, over the long-term it can negatively impact your gut microbiome.
- Use other nutrition strategies (listed below) to see if they help.
Supporting Endo Through Nutrition (Beyond Gluten)
Okay, assuming you’ve gone to see your doctor to rule out IBS and Celiac Disease, here‘s where I think you should start.
1. Reduce Inflammation
Endometriosis is an inflammatory condition, and in fact, the same inflammatory prostaglandins that cause painful period cramps, can increase pain and inflammation in endometriosis. So reducing inflammation can be a really beneficial nutrition strategy.
Here’s how to do that:
- Eat Anti-inflammatory foods: Think leafy greens, berries, fatty fish, ginger and turmeric
- Get more Omega-3 fats: There’s some research to show that omega-3 fats (found in fatty fish like salmon, as well as flax, chia seeds, and walnuts) can help improve endo pain!
- Eat magnesium-rich foods: not only can magnesium reduce pain, it can help reduce prostaglandins by up to 45%! Foods high in magnesium include pumpkin seeds, legumes, and dark chocolate (yes, really). You can also take a supplement at night.
- Limit inflammatory foods. Coffee, alcohol, red meat and trans fats seem to be the big culprits. (I prefer to get clients to focus on how to add anti-inflammatory foods instead of focusing so heavily on what to cut out.)
2. Support Estrogen Detoxification
The second piece of the puzzle is focusing on estrogen levels. Excess estrogen can stimulate those inflammatory prostaglandins and worsen pain and inflammation. And endometriosis is an estrogen-dependent condition. So they goal should be to eliminate excess estrogen.
So here’s where to start with:
- Eat enough fibre. Remember when I said fibre is important for endo? It’s because fibre binds to estrogen to eliminate it from the body. So without enough fibre, excess estrogen can be reabsorbed where it can encourage endometrial cell proliferation. Women should be aiming to consuming at least 25g of fibre every day. (And yeah, fibre-rich foods often contain gluten!)
- Support estrogen metabolism. Cruciferous vegetables (like kale, cabbage, broccoli, cauliflower) contain indole-3-carbinol that help with estrogen metabolism. Other foods that can help include glutathione-rich foods, like asparagus, avocados, cantaloupe, grapefruit and oranges.
- Eliminate plastics and hormone-disruptors. Plastics, and beauty products that contain chemicals like pthalates and parabens, can disrupt the body’s natural hormones and increase estrogen activity. If you’re able to, switch to glass, ceramic and silicone products where you can. When it comes to toiletries and makeup, I recommend just swapping them out as you use them up. (Also, if there are some products you just love, keep it. The goal is to decrease your chemical burden, not to stress you out further!)
Herbs & Supplements For Additional Support
As a final thought, here are some herbs and supplements that can help support you on your endo journey!
- NAC: has been found to decrease endometriotic lesions and decrease inflammation.
- Omega-3s: whether it be through food or supplement form, omega-3s can help decrease prostaglandin activity, which can help with pain and inflammation.
- Ginger: contains anti-inflammatory properties that can help reduce period pain. You can take it either as a tea, a supplement or use it in your daily cooking! Best take a few days before your periods, and throughout.
- Turmeric: another anti-inflammatory herb! Curcumin, the main compound in turmeric, has been shown to suppress endometrial cell proliferation, decrease estrogen levels and lower pain.
- Vitamin D: can help to decrease pelvic pain and reduce inflammation in women with endometriosis.
Other Posts You Might Like
Diet and Endometriosis: Can Nutrition Help With Pain Relief
What Teas Help With Period Cramps?
Final Thoughts: Listen to Your Body
There’s no one-size-fits-all diet for endometriosis.
As always, it’s best to approach dietary changes with curiosity and support, especially from a healthcare provider or nutritionist who understands endo. If you’re looking for additional nutrition support, reach out and let’s work together!
References
- Barnard, N. D., Holtz, D. N., Schmidt, N., Kolipaka, S., Hata, E., Sutton, M., Znayenko-Miller, T., Hazen, N. D., Cobb, C., & Kahleova, H. (2023). Nutrition in the prevention and treatment of endometriosis: A review. Frontiers in Nutrition, 10, 1089891. https://doi.org/10.3389/fnut.2023.1089891
- Brouns, F., Van Haaps, A., Keszthelyi, D., Venema, K., Bongers, M., Maas, J., & Mijatovic, V. (2023). Diet associations in endometriosis: A critical narrative assessment with special reference to gluten. Frontiers in Nutrition, 10, 1166929. https://doi.org/10.3389/fnut.2023.1166929
- Marziali M, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir. 2012 Dec;67(6):499-504. PMID: 23334113.
- Nichols, L., & Hendrickson‑Jack, L. (2024). Real Food for Fertility: Prepare your body for pregnancy with preconception nutrition and fertility awareness (1st ed.). Fertility Food Publishing.
- van Haaps, A. P., Brouns, F., Schreurs, A. M. F., Keszthelyi, D., Maas, J. W. M., & Mijatovic, V. (2024). A gluten-free diet for endometriosis patients lacks evidence to recommend it. AJOG Global Reports, 4(3), 100369. https://doi.org/10.1016/j.xagr.2024.100369
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