It’s difficult for most people to imagine a life filled with chronic pain. But if you’re living with endometriosis, managing various types of often debilitating pain becomes your usual. It can make each day a challenge.

According to the Endometriosis Foundation of America, the average time it takes to receive an endometriosis diagnosis is 7 to 10 years after symptoms begin.

For many people, those years involve going to doctor’s appointments and looking for answers and help. And many of them feel like they’re often dismissed or leave feeling unheard.

Even when a healthcare professional makes a diagnosis, there’s no definitive cure. And treatment options for endometriosis are often invasive and expensive.

As a result, many people living with endometriosis look for other ways to manage their symptoms. Here’s how dietary changes may help.

Pooja Mahtani, PharmD, MS, is a functional medicine clinical nutritionist who says that in her practice, she has absolutely seen people with endometriosis experience benefits from dietary changes.

These benefits have included a significant reduction in:

  • pain
  • bloating
  • weight

“Endometriosis is a complex inflammatory disorder,” she said, explaining that the connection between diet and endometriosis may come down mostly to reducing that inflammation.

The research surrounding diet for endometriosis is limited. So far, scientific understanding of the exact link remains mostly hypothetical. But some studies do back up what Mahtani has witnessed.

For instance, a 2010 report that analyzed 12 years of data collected in a Nurses Health Study found that people who consumed more omega-3 fatty acids appeared to be 22 percent less likely to receive an endometriosis diagnosis. Meanwhile, those with the highest trans fat intake were 44 percent more likely to receive the diagnosis.

It’s important to note that the study did not find a direct correlation (cause and effect) between dietary fats and endometriosis risk. Instead, researchers noted that the consumption of dietary fats seemed to be associated with a higher rate of laparoscopically confirmed endometriosis.

Additional research from 2018 has found potential associations between red meat and endometriosis risk. These findings suggest that replacing red meat with fish may reduce overall risk. However, the researchers noted that more studies are needed to confirm this observation.

“While the science is in its infancy, I believe this field of research will continue to expand,” Mahtani said.

Endometriosis can affect people differently. What works to help manage its symptoms can vary from person to person.

That said, there does seem to be enough evidence to suggest that dietary changes may be worth trying along with monitoring for symptom changes.

Based on the most current information we have, people living with endometriosis may benefit from eliminating gluten and red meat from their diets while increasing their intake of omega-3 fatty acids.

If you’re living with endometriosis, you have probably heard of a few diet plans that have anecdotally helped others manage their symptoms. Here are some of the most popular eating plans claimed to help endometriosis and what you should know about each one.

Anti-inflammatory diet

“The approach I have found to be most effective is an anti-inflammatory diet that’s rich in plant-based antioxidants and omega-3 fats,” Mahtani said.

As the name suggests, an anti-inflammatory diet focuses mainly on foods that help reduce inflammation in the body. For people living with endometriosis, reducing the inflammation associated with the condition may help relieve some symptoms.

“An anti-inflammatory diet typically eliminates inflammatory food triggers such as gluten, caffeine, alcohol, and industrial-based oils such as canola oil,” Mahtani explained. “In addition to eliminating a handful of these inflammatory foods, adding in more plant-based foods that are rich in antioxidants can be powerful.”

If you’re unsure which plant-based foods contain the most antioxidants, Mahtani suggested:

  • dark leafy greens
  • cruciferous vegetables
  • starchy vegetables such as sweet potato

“I usually recommend that 50 percent of your plate should be an assortment of vegetables,” Mahtani said.

She also emphasizes that omega-3 fatty acids can be a powerful tool in reducing inflammation. That includes:

  • cold-water fish like salmon, tuna, or sardines
  • seeds like flaxseed and chia seeds
  • walnuts

Gluten-free diet

A gluten-free diet can be simple to try since there’s only one guideline to follow: Eliminate gluten.

Yet, removing gluten from your diet may be easier said than done. It involves more than cutting out bread, pasta, and baked goods. Products you may not suspect could contain gluten, from sauces and condiments to vitamins and supplements.

If you decide to try a gluten-free diet, you need to be diligent about reading food labels — though it may be worth the effort.

A 2012 study of 207 people with endometriosis found that 156 of them (75 percent) reported a statistically significant reduction in pain symptoms over the course of 1 year when removing gluten from their diets.

Elimination diet

Plenty of people have food intolerances they may not know about. Not to be mistaken with a food allergy, a food intolerance simply means a certain food might not completely agree with your body.

For example, certain foods may increase levels of inflammation in your body without your knowledge. So even if you’re following a specific diet plan, you may not notice results unless you remove other food sources of inflammation from your diet.

That’s where an elimination diet comes in. This type of diet helps you identify personal food intolerances that may be increasing levels of inflammation in your body and triggering your symptoms.

An elimination diet requires removing a large variety of foods from your diet to start. Then you slowly add them back into your diet one at a time to monitor for increases in symptoms.

Because of the intensity and complexity of an elimination diet, it’s best to work with a dietitian or nutritionist. These professionals can help you to ensure you are eliminating and adding back in the right foods at the right time while maintaining overall health.

Dietary changes aren’t a quick fix. It can take some time for your body to adjust to a new way of eating and for you to notice any results.

“Depending on the degree of inflammation and severity of the disease, it may take up to three period cycles, or roughly three months, to notice an improvement in your endometriosis symptoms,” Mahtani said.

In other words: If you’re ready to try a dietary change, be prepared to stay the course long enough to tell whether it’s made a difference.

If you’re not ready to completely overhaul your diet, that’s OK, too. Mahtani emphasized that there are still small changes you can make that may help. By simply incorporating more omega-3 foods and vegetables into your diet, you may begin to notice a difference in your symptoms.

“Start with the small steps,” Mahtani said. “Eventually, these small steps will turn into massive transformation. It’s all about being gentle with yourself on this journey.”

Many people with endometriosis look for steps they can take to better manage their endometriosis. While most of the evidence is anecdotal, making certain types of dietary changes may help relieve your symptoms.

Work with a dietitian, if one is available to you, or a healthcare professional who can help you figure out which changes to focus on.