endometriosis Archives - Athletes Sanctuary

5 Essential Foods for Women with Endometriosis

athletesanctuary — Fri, 22 May 2026 05:12:02 +0000

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 and its impact on endometriosis

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.

How Does Diet Support Oestrogen Balance?

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

5 Evidence-Based Foods That May Help Manage Oestrogen in Endometriosis

1. White Button Mushrooms: The Everyday Aromatase Inhibitor

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).²⁰These 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.¹Lignans 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.

Consistent intake matters

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.

10 symptoms of endometriosis

athletesanctuary — Fri, 24 Jun 2022 14:00:00 +0000

Endometriosis is a painful condition impacting over 830,000 Australian women and girls and over 176 million women worldwide. With endometriosis, inflammation and estrogen dominance impacts tissue similar to the uterine lining and encourage growth in other areas of the body outside the womb such as in the pelvic cavity, the ovaries, fallopian tubes, intestines, or bowel.

Treatment commonly consists of medical and surgical therapies to remove the endometrial-like tissue. Painkillers and hormonal treatments are frequently offered to sufferers, but unfortunately, up to 50% of women will experience a recurrence of symptoms within 5 years ⁽²⁾. Many find the years before diagnosis extremely frustrating as they seek validation for their symptoms.

The exact causes of endometriosis remain unknown, however, family history, retrograde menstruation, metaplasia (conversion of normal pelvic tissue into endometriosis), alcohol intake, and early onset of periods (prior to 11 years of age) may play a role.

A third of women will be diagnosed after being unable to fall pregnant or inadvertently during an operation.

10 symptoms of endometriosis:

Abdominal, lower back, or pelvic pain during periods
Pain during or after sex
Pain on going to the toilet
Ovulation pain, including pain in the thigh or leg
Heavy bleeding or bleeding longer than usual
Bleeding from the bladder or bowel
Increased abdominal bloating, constipation, and other digestion issues such as small intestine bacteria overgrowth
Tiredness or lack of energy
Anxiety
Depression

Athletes and endometriosis

Endometriosis impacts athletes at all levels. Olympian Elinor Baker along with many women in sport are working to improve the awareness of endometriosis in sports. If you suffer from this condition it's likely you may be able to relate to Elinor's painful symptoms “as though someone was ringing out my organs as if they were a tea towel”. The fatigue, pain and heavy bleeding can severely impact athletes and their ability to compete and train. It is not uncommon for athletes to miss competitions due to surgeries, muscle cramps, and debilitating pain.

Natural treatment options

Our understanding of endometriosis is deepening, and holistic treatment approaches are showing promising results. Symptom reduction and improvements in quality of life have been demonstrated through food first and a targeted treatment approach including herbal and nutritional medicines.

By reducing underlying inflammation, improving the immune response, and clearing excess estrogen, women can reduce the severity of symptoms, scarring, and formation of endometrium growths.

Dietary interventions alone have reported reductions in painful symptoms and bowel complaints in up to 75% of women. Increased consumption of essential fatty acids, antioxidants, and a combination of vitamins and minerals have also been shown to have positive effects on endometriosis-associated symptoms. Other nutraceuticals such as resveratrol may improve endothelial wound healing while phytochemicals such as Diindolylmethane (DIM) or calcium-D-glucarate may help support clearance of excess estrogen and relieve pain associated with periods in sufferers of endometriosis.

Our seed cycling blog describes the benefits of using seeds to maintain healthy hormones. purchase your seeds for your cycle here

It can be reassuring to know that with the right self-care and a holistic approach to health, you can continue to achieve life goals and sporting success. An early diagnosis and understanding of your condition may result in better management of your symptoms.

About the Author: 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. For more information visit https://athletesanctuary.com.au/kate-smyth

References

Endometriosis in Australia: prevalence and hospitalizations. VIEW

Hickey M, Ballard K, Farquhar C. Endometriosis BMJ 2014; 348:g1752 doi:10.1136/BMJ.g1752

Hui, E., & Nap, A. (2020). The effects of nutrients on symptoms in women with endometriosis: a systematic review. Reproductive BioMedicine Online, 41(2), 317-328. https://www.sciencedirect.com/science/article/abs/pii/S147264832030225X

Marziali M, Venza M, Lazzaro S, et al. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chirurgica. 2012 Dec;67(6):499-504. http://europepmc.org/article/med/23334113

Moore, J. S., Gibson, P. R., Perry, R. E., & Burgell, R. E. (2017). Endometriosis in patients with irritable bowel syndrome: the specific symptomatic and demographic profile, and response to the low FODMAP diet. Australian and New Zealand Journal of Obstetrics and Gynaecology, 57(2), 201-205. https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/ajo.12594

Jean Hailes www.jeanhailes.org.au

Oregon State University (2022).Resveratrol www.https://lpi.oregonstate.edu

Endometriosis Australia www.endometriosisaustralia.org

BBC Sport www.bbc.com/sport/56276626

Contraception options- friend or foe?

athletesanctuary — Mon, 02 Dec 2019 14:00:00 +0000

We aim to equip women with a balanced perspective so they can make an informed choice about contraception options and what they put into their bodies. We in no way suggest women should come off their medications without due consideration. We also don't shy away from the fact that there is a dark side to artificial hormones. It is important to consider all the pros and cons of any medication.

The most widely used contraceptive medications include the combined oral contraceptive pill (OCP) (containing synthetic estrogens and progesterone) such as Yasmin or Estelle, or injections, patch and vaginal ring. Progestin-only contraception includes the mini-pill (e.g. Noriday 28), implanon (progestogen) and hormonal IUDs (Mirena). Intrauterine devices such as the copper IUD are also a preferred option for some women.

Although contraceptive medications have similar names and molecular structures to female hormones, they have very different functions in the body. Artificial hormones mimic our natural hormone responses by “approximately” fitting into our hormone receptors but provide a different response. For example, progestin used in medications prevents pregnancy by inhibiting ovulation, changing cervical mucus making it unfriendly to sperm and by reducing the proliferation of uterine lining to inhibit implantation. Natural progesterone, on the other hand, thickens the uterus lining and helps with the implantation of an embryo. Contraceptives are metabolised differently between individuals due to the type, concentration, duration and timing of medication used. Although generally relied upon as contraceptives, they may also be used to manage issues such as acne, period pain, endometriosis and heavy bleeding.

Albeit highly effective as contraceptives, there is a dark side to long-term use of these pharmaceuticals such as toxicity and nutrient depletion through their impact on gut and vaginal microbiomes, liver function, oxidative stress and chemical accumulation.

Let’s now consider the drawbacks and benefits of contraceptive medication.

Pros

Up to 99.5% effective as a contraceptive (depending on type)
Easy to use (in pill form)
May manage symptoms such as period pain, acne, irregular or heavy bleeding
Improves predictability and regularity of bleeding
May reduce the risk of iron-deficiency anaemia if caused by heavy bleeding, some cancers (colorectal and ovarian) and ectopic pregnancy
Prevent bleeding or symptoms on race day or hard training days (if PMS is an issue)
Lighten bleeding

Cons

They don’t prevent sexually transmitted diseases like other barrier forms of contraception.
Not all women will experience side effects, but some may have weight gain, depression, acne, hair growth, irregular bleeding, nausea, mood swings and headaches. Studies show that women on higher doses of OCP had 50% greater incidence of bloating, breast tenderness and nausea than those on low dose options.
May impact on the immune system and alter immune response, triggering autoimmune disorders. Studies show an increased risk of developing Lupus in women who take OCPs.
OCP use is linked to increased risk of cardiovascular issues, high blood pressure, blood clots, and thromboembolism. OCPs may be potentially contributing to an increased risk of cancer and liver tumours, and reproductive issues including premature menopause and reduced fertility.
May alter the intestinal microbiota and vaginal microbiome composition after just 6 months of use. Both IUDs and OCPs may increase the risk of bacterial vaginosis, trichomonas vaginalis and candida albicans infection in sexually active women. Studies suggest OCPs may also contribute to leaky gut through changing tight junction expression in the gut which can contribute to food intolerances and other immune reactions.
May indirectly contribute to body toxicity by adversely affecting the capacity of the gut to metabolise and excrete other xenobiotics (e.g. polycyclic aromatic hydrocarbons, pesticides, polychlorobiphenyls, heavy metals, benzene derivatives, dyes, artificial sweeteners) and metabolic by-products.
May reduce vital nutrients and contribute to excess accumulation of others. Studies show the OCP reduces zinc, selenium, vitamin E, Co-enzyme Q10 (a cofactor in energy production), B12, phosphorus and magnesium levels but contributes to higher copper and cadmium levels. OCP use may also increase ferritin levels, resulting in enhanced iron absorption, but potentially contributing to iron overload and oxidative damage. The toxic effects of potentially high copper and cadmium in the body deplete antioxidant (glutathione) levels, inhibit antioxidant enzyme activity, and increase the synthesis of harmful free radicals and may damage liver cells.
OCP use is also associated with environmental chemical accumulation in the body. An analysis from the Norwegian study of 1090 women over a 5-year period, found higher levels of the harmful chemical PFAF (Perfluorooctanesulfonate) in women who used the OCP for more than 12 months. Elevated PFAF levels have been associated with infertility, preclampsia, cancer and adverse effects on the liver, thyroid organs and endocrine system.
High environmental impact from oestrogen contraceptives. Over 700kg/year of synthetic oestrogens derived from contraceptives (OCPs, patches and vaginal rings) are released into the environment and contribute to 16% of the oestrogenic load present in waterways worldwide. Oestrogens and progestin are detrimentally impacting the physiology of fish and other aquatic animals. The impact extends to our water and soils.
Although the OCP is widely prescribed to prevent further bone fractures or as a protective measure, however the long-term effect of oral contraceptive use on risk of fracture remains unclear. A 2014 study from the University of Wisconsin School of Medicine and Public Health, involving high school athletes concluded there was no difference in the frequency of musculoskeletal injury between athletes who used the OCP users and non-users. Another 2015 study reported there was no difference in fracture risk for women aged 38-49 years of age between OCP users and non-users. A 2015 study published in the Journal of Women’s Health suggested contraception injections such as DMPA have been shown to be associated with low bone mass and osteoporosis in women.

Minimise the downside to contraception

If you choose to take the OCP or other contraceptive, read up on possible side effects and talk to your prescribing G.P about other options if you experience side effects.
Ensure your diet is high in nutrients that help with drug and hormone metabolism and detoxification such as the cruciferous family of vegetables ( broccoli, cauliflower, kale, cabbage, Brussels sprouts, arugula, daikon, bok choy, horseradish, Chinese cabbage, Romanesco broccoli, kohlrabi, radish, turnip, wasabi, turnips and watercress). These vegetables are rich in indole-3-carbinol and glucaric acid which assists with oestrogen detoxification and healthy hormone metabolism. Glucaric acid is also found in many fruits and vegetables with the highest concentrations also in oranges, apples and grapefruit.
Speak to your naturopath about your current mineral status. Minerals tests can detect issues in nutrients such as copper, zinc, selenium and other nutrients affected by OCP use.
Improve your antioxidant status to counteract any side effects of OCP use by including brightly coloured fruits and vegetables in your diet daily.
Speak to a natural awareness fertility (FABM) educator who can explain other contraception options and methods of predicting or calculating the fertile phase of a woman’s cycle. Natural family planning is estimated to be around 85% effective when performed correctly.
Speak to your partner about other methods of contraception.
Reduce your overall toxin and chemical load by using organic skin and personal hair products and opting for non-toxic household chemicals.
Consider natural options (such as herbal medicines, nutritional medications and dietary intervention) for hormone balancing if you are using the OCP for symptom management. Consider natural options to manage PMS.

For further information on the suitability of these options for your particular situation, contact us for an individual assessment.