Endometriosis and Diet: How to Find Balance and Relief at the Same Time

Author of the article: Lucie Plechatá, Femvie ambassador

As someone who has struggled with it for a long time endometriosis and Bechterew's disease, I learned that diet significantly affects the body and can play a key role in managing chronic and inflammatory diseases. However, my journey to better nutrition was quite thorny and not without its missteps. Therefore, in this article, I share my experiences and tips so that you too can avoid similar mistakes.

Start of the food drive

I have always loved food and have never restricted myself in any way. For a long time I thought that diets were only for people who needed to lose weight or had digestive problems. Although I had a positive attitude towards food and thought that we ate healthily at home, my weight was critically low for a long time . Today I know that my diet in childhood and adolescence was not entirely exemplary.

Right after I became independent from my parents, I became interested in healthy eating thanks to my job at a health food store . I couldn't help but be amazed at how many types of food I had never tasted and how much I didn't know about nutrition. It soon became clear to me that my diet lacked protein and quality fats, but was rich in carbohydrates and simple sugars. With my newfound knowledge, I started to create a healthier diet and thanks to that, I finally started to gain weight. I gained a beautiful 12 kilos, which was a really big success for me!

Fighting Bechterew's disease

Unfortunately, by then I was already battling ankylosing spondylitis, an autoimmune disease that primarily attacks the spine and joints . When I was just 21, it started to get worse, resulting in a crazy attack where I stopped walking and was unable to take care of myself. Fortunately, I was put on biologic treatment, which is currently considered the most effective therapy on the market – it does not cure the disease, but it slows its progression, reduces inflammation and alleviates symptoms.

The weeks of treatment passed, but I felt no improvement, at most, by fifty percent. At that time, I began to understand that pharmacological treatment alone would not save me and that I had to start doing something myself to improve .

"And what do you (not) eat?"

I researched and discovered the Autoimmune Protocol (AIP), Whole30, and other types of anti-inflammatory diets. At first glance, they seemed great because of the health benefits they promised. But I jumped on them alone, with little knowledge of the laws of nutrition and how the body works. So if I could recommend anything, it's an experienced nutritional counselor who can help you create a customized diet and guide you through the entire change.

But I'm quite stubborn, and although I felt like I could do it on my own, I sometimes stumbled. You can find a mountain of books on nutrition in my library today, and food is at the top of my list of favorite conversation topics. Despite all this, I can't give a clear answer to the question "What do you (not) eat?" .

Having gone through all this on my own, I think I understand diet… erm, my own body and what my diet does to it very well. My diet today is the result of years of experience learning to respond to what is good for me and what is not. It depends not only on the type of food, but also on the quantity, method of preparation, quality or combination with other foods.

And still no relief...

Changing my diet significantly helped alleviate the symptoms of my ankylosing spondylitis, but unfortunately it wasn't a complete happy ending. Even though I had noticed which foods made my back and joint pain worse, it didn't affect my digestion in any way. I had been struggling with intestinal problems for years, until I was diagnosed with lactose intolerance and irritable bowel syndrome. However, neither the dairy-free diet nor the FODMAP diet brought me complete relief.

A prayed-for diagnosis

At the end of 2023, I went through a phase where I felt like I was sick from everything. I suffered from severe bloating, diarrhea, and stomach cramps. I was afraid to eat anything. On top of that, I had increasing pain during and outside of menstruation, fatigue, menstrual problems, pain during intercourse, and bleeding outside of the cycle – you probably already know what I'm talking about. My appetite was leaving me day after day, it was a very difficult time.

Unfortunately, they never found anything in gastroenterology. The solution came only with the diagnosis of deep infiltrating endometriosis , which also affected the intestine. My years of problems finally got a name and an explanation for why nothing was ever found on a colonoscopy – the endometriosis was on the outside of the intestine , not inside. Changing my diet could never completely relieve me, because the adhesions of endometriosis disrupted the natural peristalsis of the intestine and inflammation was acting on it from the outside. The relief that I was not crazy and was not imagining the problems, but was soon drowned out by the fear of the planned surgery and resection of the affected part of the intestine.

Zero-residue diet

And that brings me to my least favorite, yet essential, diet – the zero-residue diet. It is used, for example, before a planned colonoscopy, when it is necessary to omit difficult-to-digest or indigestible food components such as seeds, nuts, or skins.

I was on it for a planned bowel resection a week before the surgery and four weeks after. The diet is not much, but honestly, the risk of an intestinal fistula scared me so much that I tried to do everything to prepare my intestines as best as possible. In the end, the fistula was not needed, I successfully had a piece of the affected intestine shorter, and a mountain full of hope.

What to eat and not eat with endometriosis?

What now? How should I eat if I want to minimize the risk of endometriosis growth and alleviate its symptoms? Everyone talks about the “endo diet,” but everyone has their own take on it. And actually, I don’t think there’s anything wrong with it at all – except that absolutely everything can be wrong .

But I made the mistake of going on a diet on my own, without professional guidance. The goal is to limit foods that promote inflammation and instead include those that have anti-inflammatory effects. It usually excludes highly processed foods, sugar, red meat, and often dairy products and gluten. Endo diet can be taken in a lighter mode, for example in the style of 80/20 , i.e. eighty percent adhere to the principles of the strict endo diet and twenty percent indulge in foods that are completely "not allowed" in it. The second option is a radical "all or nothing" approach , which, however, can lead to malnutrition, anxiety and an unhealthy relationship with food if the diet is incorrectly composed. And that's exactly what we don't want with any health diet, so never be alone.

I soon realized that the "all or nothing" style was actually doing me harm - and not just in terms of diet. I went back to foods that I knew definitely wouldn't harm me, and I focused mainly on my psyche. That was causing me more problems than the occasional sugary and gluten-filled treat. This doesn't mean I don't take care of my diet, but I'm taking it more seriously and trying to treat myself with love - because care is what a sick body needs most.

Another in the Real Talk series : How I Reset My Nervous System (with Endometriosis in My Back)

It's not just about diet

Finally, I would like to add that diet is a great tool to relieve the unpleasant symptoms of chronic inflammatory diseases, but nothing should be overdone. Alleviating the difficulties of whole-body diseases such as endometriosis requires a comprehensive approach. Even if you don't follow all the dietary changes 100 percent, I believe that you will see improvement - every step forward counts . And most importantly, don't forget that each of us is original : what suits you may not suit another woman and vice versa.

This article is based on the author's personal experience and does not constitute medical advice. If you are dealing with similar problems, please consult a qualified healthcare professional. Every body is different and needs an individual approach.

Looking for a space to talk openly about women's health? Join our new Facebook community - a place to share experiences, understand your own body, and support each other. Whether you're dealing with endometriosis, PCOS, PMS, or going through menopause, you're not alone. ❤️

What else can you read on Femspace?

• Endometriosis: A New Perspective on Pain, Diagnosis, and a Holistic Approach to Care
• Painkillers are not as effective for women. Why?
• Bloating before menstruation: why it occurs and what helps with PMS
• 5-minute massage for menstrual pain relief

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