If you have been diagnosed with endometriosis, you have probably heard that it is an "oestrogen-driven" condition. But what does that actually mean, and what can you do about it through food?
What makes endometriosis particularly complex is that the tissue does not just respond to oestrogen from your ovaries. It also produces its own oestrogen locally, through an enzyme called aromatase. This creates a cycle of self-sustaining hormonal inflammation that can be difficult to break.3
Aromatase is an enzyme found throughout the body, which convert androgens into oestrogens.3
In a healthy hormonal system, this conversion is tightly regulated. In endometriosis, aromatase is overexpressed in affected tissue, meaning it produces excess oestrogen right where it is least wanted, directly fuelling lesion growth and pain.1
Certain whole foods contain natural compounds that interact with the aromatase enzyme in a similar, gentler way, either suppressing its activity or supporting the body to process oestrogen into safer, less potent forms. These foods have the potential to turn down the volume on oestrogen signalling in endometriosis, rather than switching it off entirely.
Before diving into specific foods, it helps to understand three key mechanisms through which diet influences oestrogen in endometriosis:
Aromatase inhibition: Some food compounds directly reduce aromatase enzyme activity, slowing the conversion of androgens to oestrogen.33
Oestrogen metabolism support: The liver converts oestrogen into different forms. Some of these forms are more potent and potentially harmful; others are weaker and more easily cleared. Compounds found in cruciferous vegetables, for example, actively shift metabolism toward the safer forms.20
Gut clearance of oestrogen: Dietary fibre binds to used oestrogen in the digestive tract and helps remove it from the body reducing oestrogen concentrations by 10-25%. Without enough fibre, oestrogen can be reabsorbed into circulation.1
White button mushrooms (Agaricus bisporus) are perhaps the most accessible and affordable food-based option on this list. These ordinary supermarket mushrooms contain phenolic compounds and conjugated linoleic acid that have been shown to suppress aromatase enzyme activity and inhibit oestrogen-dependent cell growth.13
Aim for ½–¾ cup (approximately 80–100 g) of cooked white button mushrooms daily.
2. Cruciferous Vegetables: Nature's Oestrogen Detoxifiers
Broccoli, Brussels sprouts, kale, cabbage, cauliflower, and bok choy are rich sources of compounds called glucosinolates, which break down in the body to form indole-3-carbinol (I3C) and diindolylmethane (DIM).20 These compounds actively support the liver's ability to metabolise oestrogen into weaker, less harmful forms, reducing the overall oestrogenic load on the body.
Cruciferous vegetables are high in dietary fibre, which helps bind and eliminate oestrogen through the bowel, reducing its recirculation.1
Aim for at least 1–1½ cups of cruciferous vegetables at two meals per day. Broccoli sprouts offer the most concentrated source and can be added in smaller quantities to salads (2–3 tablespoons).
3. Pomegranate: A Polyphenol Powerhouse for Hormone Balance
Pomegranate is rich in polyphenols, including ellagic acid, punicalagins, and urolithins. A 2024 review found that pomegranate compounds inhibit both aromatase and a second oestrogen-producing enzyme called 17β-hydroxysteroid dehydrogenase.33
Research has also shown pomegranate juice can be effective with regular dietary intake.34
Aim for ¼ cup (approximately 40–50 g) of pomegranate arils daily, or ½ cup (100–120 mL) of unsweetened pomegranate juice.
4. Ground Flaxseed: Fibre and Lignans for Oestrogen Clearance
Flaxseed is the richest dietary source of lignans, plant compounds that gently compete with oestrogen at receptor sites and support the liver's oestrogen detoxification pathways.1 Lignans also increase the production of sex hormone-binding globulin (SHBG), a protein that binds to free oestrogen in the bloodstream, effectively reducing the amount available to stimulate endometrial tissue.3
Combined with its high soluble fibre content, flaxseed supports healthy bowel transit and oestrogen excretion, making it a particularly useful food for women with endometriosis who also experience bloating or constipation.
Aim for 1–2 tablespoons (10–20 g) of freshly ground flaxseed daily. Whole seeds largely pass through undigested; always grind or purchase pre-ground (linseed meal).
5. Resveratrol-Rich Foods: Grapes, Berries, and Dark Chocolate
Resveratrol is a polyphenol found in red grapes, blueberries, mulberries, and dark chocolate.
A 2025 review confirmed resveratrol's anti-inflammatory and anti-oestrogenic mechanisms, including reducing inflammatory signalling pathways that are particularly relevant to endometriosis pain and lesion activity.33
A Mediterranean diet rich in these polyphenol sources has been shown to be beneficial in endometriosis.41
Aim for ½ cup (approximately 75 g) of mixed berries daily or 1 small bunch (approximately 1 cup / 150 g) of red grapes or 1–2 squares (approximately 20–30 g) of dark chocolate (≥70% cocoa) daily.
Hormonal changes through diet tend to be gradual. Most studies observe measurable changes over 8–12 weeks of consistent dietary shifts.
The foods on this list work across three key pathways: suppressing aromatase activity, supporting liver oestrogen metabolism, and improving gut clearance of excess oestrogen. None of them are magic bullets, but together, woven into a consistent, anti-inflammatory dietary pattern, they represent a practical, evidence-informed strategy for women living with endometriosis.
Kate Smyth is a sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary - a holistic healthcare clinic for athletes of all levels and sporting codes.
Kate has a thirst for knowledge, with two bachelor's and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes.
Kate certainly knows what it’s like to face challenges when pursuing a dream.
Kate faced many challenges and obstacles during her eight year journey from fun runner to Commonwealth and Olympic marathoner (2006, Commonwealth Games and 2008 Beijing Olympics). She obtained her personal best time of 2:28 for the marathon in Nagano, Japan at 35 years of age.
Kate believes there isn’t just one way to better health and performance. Her mission is to educate female athletes on how to make the most out of being a female athlete through a holistic and balanced approach.
On the back of her deep desire to help other athletes overcome many of the same health issues she now dedicates her time to improving female athletic performance and health.
Kate has completed three university degrees including a Masters and a Bachelor of Health Science (Naturopathic medicine). She has also undertaken additional training in thyroid health, sports nutrition, digestive health and female athlete hormones…. just in case you are wondering.
She coaches, mentors and facilitates training camps for aspiring runners including some of Australia’s best distance athletes.
Kate is also a celebrant supporting families through holding meaningful ceremonies for loved ones. She has a special interest in baby/ infant naming days and memorial services for infants, babies, stillborn babies and loss through miscarriages.
As an athlete, coach and business owner she understands what it can be like to juggle many priorities. She is described by her patients as compassionate, warm, grounded, realistic, practical, and knowledgeable.
