Diet and supplementation as an element supporting the treatment of endometriosis - literature review

Sabina Kowalczyk-Guzikowska, Dorota Olanin, Zofia Winczewska, Anna Bartnicka, Karolina Karabin, Agnieszka Drosdzol–Cop
Ginekologia polska · 2026 · doi:10.5603/gpl.113814 · PMID:42886549 · W7222663427
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⚙ AI-generated summary by qwen3.7-flash, 2026-10-18 ⓘ

This literature review discusses the pathophysiological basis and evidence for using anti-inflammatory diets and specific supplements as supportive, non-curative interventions to manage chronic inflammation and oxidative stress in endometriosis.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-10-18 · read from full text ⓘ

This literature review examines the pathophysiological basis for using diet and supplementation as adjunctive treatments for endometriosis, focusing on chronic inflammation, oxidative stress, and estrogen metabolism influenced by the intestinal microbiota. The authors discuss an anti-inflammatory nutritional model rich in omega-3 fatty acids, cruciferous vegetables, and fiber, while also evaluating evidence for specific supplements, probiotics, and prebiotics to support microbial balance. They emphasize that these interventions should be individualized based on clinical phenotypes and serve only as supportive measures rather than causal treatments. This paper is centrally about endometriosis — specifically exploring dietary and supplemental strategies to manage its inflammatory and hormonal drivers.

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Abstract

Endometriosis is a chronic estrogen-dependent inflammatory disease affecting about 10% of women of reproductive age. Pharmacotherapy and surgery form the basis of treatment, but emerging evidence points towards the potential role of diet as an adjunct. The paper presents the pathophysiological basis of nutritional intervention in endometriosis, including chronic inflammation, oxidative stress and disturbances in estrogen metabolism related to the functioning of the intestinal microbiota and the estrobolome. The nutritional model based on an anti-inflammatory diet rich in omega-3 fatty acids, cruciferous vegetables and fiber, as opposed to routine elimination of food, as well as the need to individualize the recommendations depending on the patient's clinical phenotype, was discussed. Evidence on supplementation with selected compounds with potential anti-inflammatory and antioxidant effects and the role of probiotics and prebiotics in supporting intestinal and vaginal microbiota were also presented. The paper emphasizes that diet therapy should be treated as a supportive intervention, not as a causal treatment of endometriosis.
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Abstract

Endometriosis is a chronic estrogen-dependent inflammatory disease affecting about 10% of women of reproductive age. Pharmacotherapy and surgery form the basis of treatment, but emerging evidence points towards the potential role of diet as an adjunct. The paper presents the pathophysiological basis of nutritional intervention in endometriosis, including chronic inflammation, oxidative stress and disturbances in estrogen metabolism related to the functioning of the intestinal microbiota and the estrobolome. The nutritional model based on an anti-inflammatory diet rich in omega-3 fatty acids, cruciferous vegetables and fiber, as opposed to routine elimination of food, as well as the need to individualize the recommendations depending on the patient's clinical phenotype, was discussed. Evidence on supplementation with selected compounds with potential anti-inflammatory and antioxidant effects and the role of probiotics and prebiotics in supporting intestinal and vaginal microbiota were also presented. The paper emphasizes that diet therapy should be treated as a supportive intervention, not as a causal treatment of endometriosis.

Keywords

endometriosisanti-inflammatory dietintestinal microbiotaestrobolomesupplementation

References

- Wilk K, Zieba-Domalik M, Wilk K, et al. Prevalence of adenomyosis in adolescents: diagnostic process and symptoms. Systematic review. Ginekol Pol. 2025; 96(9): 776–780. - Becker CM, Bokor A, Heikinheimo O, et al. ESHRE Endometriosis Guideline Group . ESHRE guideline: endometriosis. Hum Reprod Open. 2022; 2022(2): hoac009. - Olcha P, Nowakowski L, Putowski L, et al. A multiple male and female pregnancy in a patient with stage IV endometriosis undergoing single embryo transfer after IVF-ICSI. Ginekol Pol. 2025; 96(8): 700–701. - Nirgianakis K, Egger K, Kalaitzopoulos DR, et al. Effectiveness of Dietary Interventions in the Treatment of Endometriosis: a Systematic Review. Reprod Sci. 2022; 29(1): 26–42. - Neri LCL, Quintiero F, Fiorini S, et al. Diet and Endometriosis: An Umbrella Review. Foods. 2025; 14(12). - Guo C, Zhang C. Role of the gut microbiota in the pathogenesis of endometriosis: a review. Front Microbiol. 2024; 15: 1363455. - Osińska D, Woźniak A, Woźniak S. The Role of Nutrition on the Pathogenesis of Endometriosis. Nutrients. 2026; 18(4). - Huang Li, Shi L, Li M, et al. Oxidative stress in endometriosis: Sources, mechanisms and therapeutic potential of antioxidants (Review). Int J Mol Med. 2025; 55(5). - Saponara S, Scicchitano F, D'Alterio MN, et al. Could the estrobolome have a role in endometriosis pathogenesis and infertility? A systematic review. BMC Womens Health. 2025; 26(1): 43. - Nannini G, Cei F, Amedei A. Unraveling the Contribution of Estrobolome Alterations to Endometriosis Pathogenesis. Curr Issues Mol Biol. 2025; 47(7). - Piecuch M, Garbicz J, Waliczek M, et al. I Am the 1 in 10-What Should I Eat? A Research Review of Nutrition in Endometriosis. Nutrients. 2022; 14(24). - Szczuko M, Ziętek M, Janda-Milczarek K, et al. An Overview of Essential Nutritional Strategies and Products in the Treatment of Endometriosis. Nutrients. 2025; 18(1). - Nabi MY, Nauhria S, Reel M, et al. Endometriosis and irritable bowel syndrome: A systematic review and meta-analyses. Front Med (Lausanne). 2022; 9: 914356. - Watrowski R, Kostov S, Schäfer SD, et al. Low-FODMAP Diet for Gastrointestinal Symptoms in Endometriosis: A Systematic Review. Nutrients. 2026; 18(13). - Wilk-Sikora K, Drosdzol-Cop A. Endometriosis in adolescent: a review of current diagnostic and therapeutic guidelines and expert consensus. Ginekol Pol. 2026; 97(2): 146–153. - Wójtowicz M, Małek P, Olszanecka-Glinianowicz M. The Role of Dietary Supplements in the Treatment of Endometriosis: A Critical Review. Nutrients. 2026; 18(8). - Sienko A, Cichosz A, Urban A, et al. The effect of two anti-inflammatory dietary components, omega-3 and resveratrol, on endometriosis. Ginekol Pol. 2024; 95(7): 573–583. - Colonetti T, Saggioratto MC, Grande AJ, et al. Gut and Vaginal Microbiota in the Endometriosis: Systematic Review and Meta-Analysis. Biomed Res Int. 2023; 2023: 2675966. - Norfuad FA, Mokhtar MH, Nur Azurah AG. Beneficial Effects of Probiotics on Benign Gynaecological Disorders: A Review. Nutrients. 2023; 15(12).

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