Endometriosis is an oestrogen-dependent, chronic inflammatory condition that affects women of reproductive age. It occurs when tissue similar to the lining of the uterus grows outside of the womb, leading to symptoms such as pelvic pain, dysmenorrhoea (painful periods), pain during intercourse, digestive disturbance, and in some cases infertility.
It affects approximately 1 in 10 women in the UK and it is the second most common gynaecological condition. Despite this, diagnosis takes an average of seven years, as symptoms can vary widely and may overlap with other conditions. While the exact cause remains unknown and there is currently no definitive cure, there are many strategies that can help manage symptoms and improve quality of life.
Endometriosis is considered a chronic inflammatory condition. Ongoing research suggests that inflammation and oxidative stress play a significant role in its development and progression. Therefore, lifestyle strategies that reduce inflammation and support hormonal balance may be beneficial.
Nutrition
Although there is no single “endometriosis diet,” dietary approaches that reduce inflammation and support oestrogen regulation may help manage symptoms.
A Mediterranean-style diet is often recommended due to its strong anti-inflammatory properties. This includes:
- Increasing intake of fruits and vegetables (rich in antioxidants)
- Including oily fish (such as salmon and mackerel) for omega-3 fatty acids
- Using olive oil as a primary fat source
- Eating whole grains, legumes, nuts, and seeds
Additional Lifestyle Considerations
- Reduce processed and ultra-processed foods, which may increase inflammatory
- load.
- Limit excessive caffeine intake, particularly during the follicular phase, as caffeine
- may influence inflammatory responses and hormone metabolism.
- Stay well hydrated (aim for at least 2 litres of water daily) to support digestion and
- reduce bloating or constipation.
- Ensure adequate intake of antioxidant vitamins such as Vitamin C and Vitamin E,
- which may help combat oxidative stress and support tissue health.
- Vitamin D has also been proven to be an important supplement, and you can ask
- your GP to review your vitamin D levels.
Exercise & Movement
- Regular physical activity plays an important role in managing endometriosis symptoms.
- Exercise helps to:
- Reduce systemic inflammation
- Support hormonal balance
- Maintain a healthy body weight (which can help regulate oestrogen levels)
- Stimulate the release of endorphins and serotonin, natural chemicals that improve mood and help modulate pain
Low-impact exercise such as walking, swimming, Pilates, yoga, or strength training can be particularly helpful. Movement also supports bowel function and reduces pelvic congestion, mindfulness and diaphragmatic breathing can also play a part in stress reduction and pain processing.
Osteopathy & Manual Therapy
Osteopathy and other forms of manual therapy can be valuable as part of a multidisciplinary approach to endometriosis management. Treatment may include:
- Visceral therapy to improve mobility of pelvic and abdominal organs
- Techniques aimed at reducing scar tissue restriction (particularly post-laparoscopy)
- Addressing tension within the pelvic girdle and lumbopelvic region
- Supporting bowel function and reducing digestive discomfort
While more large-scale research is needed, clinical experience and emerging studies suggest that manual therapy may help reduce pelvic pain, dysmenorrhoea, digestive symptoms, and sexual discomfort. It can also support nervous system regulation, which is often heightened in chronic pain conditions
Because endometriosis is complex and multifactorial, management often works best when approached holistically. This may include:
- Medical management
- Surgical intervention where appropriate
- Nutritional and lifestyle adjustments
- Pain management strategies
- Pelvic health physiotherapy or osteopathy
- Stress management and nervous system support
Although there is no cure at this current time, symptom control and quality of life can be significantly improved with the right support and by modifying lifestyle strategies.