blue shaded uterus with gold spots outside of it, with an eggshell background blue shaded uterus with gold spots outside of it, with an eggshell background

Endometriosis

What is it?

Endometriosis occurs when tissue similar to the lining of the uterus (endometrium), is found in places outside of the uterus. The tissue can form nodules or plaques which may be visualised at surgery. Endometriosis is commonly found in the pelvic region on the thin pelvic lining called the peritoneum. It may be also be found on the pelvic ligaments, ovaries and bowel. Endometriosis is occasionally found in places outside the pelvis such as in scar tissue, the bellybutton or lungs.
Often if you see your doctor with concern about your periods they will order an ultrasound scan. This can not diagnose most forms of endometriosis, but it can pick up cysts on the ovaries (endometrioma).
Endometriosis is commonly associated with adhesions, which can make surgery more challenging.

Nutrition

Nutrition won't cure endometriosis, but it can make a difference in how your body feels day-to-day. This section keeps things simple and realistic, no strict rules, just gentle guidance to help reduce inflammation, support your hormones, and understand what foods might help or make symptoms flare. The goal is to give you information you can actually use, without it feeling overwhelming.

Irritable Bowel Syndrome (IBS)

Endometriosis and Irritable Bowel Syndrome (IBS) share a lot of overlapping symptoms, which is why many people are first told they have IBS before endometriosis is ever considered. Gut-related symptoms like bloating, diarrhoea during your period, constipation, fluctuations between the two, painful or excessive wind, bowel cramping, nausea, lower back pain, and even rectal pain or bleeding can all appear in both conditions. These symptoms often get worse around menstruation, making the picture even more confusing.
It's also very common to have both endometriosis and IBS at the same time, which can make symptoms feel more intense or unpredictable. Because of this overlap, it's important to rule out other possible causes of gut issues, including Coeliac disease and inflammatory bowel diseases like Crohn's or Ulcerative Colitis, before changing your diet.
Once other conditions are ruled out, some people find that adjusting their food intake helps ease bowel-related symptoms. This can include trying approaches like a low FODMAP food trial, which may provide relief for some.

Feel-Good Foods

Choosing an anti-inflammatory way of eating can be helpful for supporting endometriosis symptoms. A Mediterranean-style approach is a great place to start. This includes plenty of fruits and vegetables, extra virgin olive oil, nuts, seeds, legumes like beans and lentils, and wholegrain carbohydrates. Lean proteins and some dairy products can also fit in well, along with oily fish or seafood, ideally a couple of times a week.
A higher fibre intake from wholegrains, fruits, and vegetables may help lower circulating oestrogen levels and support regular bowel movements. For those who also experience IBS-type symptoms, focusing on soluble fibre is often more comfortable, as it tends to be gentler on the gut and can support both constipation and diarrhoea without causing extra bloating.

Foods To Be Mindful Of

Reducing foods that can promote inflammation may help ease endometriosis-related pain and symptoms. This includes limiting high-fat red meats, processed meats like bacon or salami, and sugary foods or drinks such as fizzy drinks, juices, and sweet tea beverages. Highly processed snacks, including chips, chocolate, snack bars, biscuits, and bakery treats, as well as fast foods and deep-fried options can also contribute to inflammation.
Foods high in saturated fat, like butter, cream, ice cream, meat fat or chicken skin, and coconut-based products, may worsen symptoms for some people. Caffeine can increase gut discomfort, anxiety, or bladder symptoms, and alcohol can raise circulating oestrogen and irritate the gut, potentially making symptoms harder to manage.
You don't need to cut these foods out completely, it's more about being mindful and noticing how your body responds.

Cycle Phases

circular diagram of the menstrual cycle phases

Follicular Phase

What is this phase:
The follicular phase begins on the first day of your period and lasts until ovulation, usually around 13 to 14 days, though it can vary. During this time, your body prepares for ovulation by developing follicles in the ovaries, with one becoming the dominant follicle that will release an egg.


What's happening in your body:
Multiple follicles begin to grow, but one becomes the strongest, about the size of a small button,ready to mature into an egg. Meanwhile, the lining of your uterus starts to rebuild and thicken after your period.


Hormones:
Follicle-stimulating hormone (FSH) from the pituitary gland signals the ovaries to prepare an egg. As the dominant follicle grows, it produces rising levels of oestrogen (and a small boost of testosterone), which peak just before ovulation.

Ovulation

What is this phase:
Ovulation happens around the middle of the menstrual cycle, typically 13 to 15 days before your next period. This is when the dominant follicle releases a mature egg into the fallopian tube.


What's happening in your body:
During ovulation, the dominant follicle opens and releases the egg. After this release, the egg begins travelling through the fallopian tube toward the uterus. This is the window when pregnancy is most likely to occur if sperm is present.


Hormones:
A sudden surge in luteinizing hormone (LH) is what triggers ovulation. Right after the egg is released, oestrogen levels drop. These hormonal changes can influence your energy, mood, and how your body feels.

Luteal Phase

What is this phase:
The luteal phase begins right after ovulation and continues until your next period starts. During this time, the body prepares for a potential pregnancy by thickening the uterine lining.


What's happening in your body:
After ovulation, the body produces more progesterone to prepare the uterus for a possible pregnancy. If pregnancy doesn't occur, progesterone drops, which can trigger PMS symptoms and signals your period to begin.


Hormones:
Oestrogen levels drop and progesterone rises, although many people experience lower-than-ideal progesterone. These shifts can contribute to PMS symptoms such as bloating, breast tenderness, back pain, tiredness, and mood changes.

Myths & Misconceptions

It's normal to have some degree of discomfort during your period, but it should never be distressing enough to prevent you from carrying out day-to-day activities. If you're forced to take time off work or school because of the pain, consult your doctor.

Teens can get endometriosis like anyone else. In fact, the teen years are often when symptoms start. Teenagers, therefore, may experience very severe pain and should always be taken seriously.

Pregnancy is not a cure for endometriosis, this belief is an old myth based on incomplete research. Symptoms may occasionally trail off after having a baby, but it's not a cure.

There are different severities of endometriosis, mild, moderate, and severe. However, this only describes the size and amount of endometriosis lesions present and doesn't necessarily have any bearing on how much pain is felt.

Around 3 or 4 in every 10 people with Endometriosis will have difficulty getting pregnant. This does not mean you're infertile, as many people with endo have no problem conceiving at all.

Symptoms

Common Symptoms

Less Common Symptoms