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This post was half inspired by another instagram question, and half by my own life experience. The other day, another lovely girl inquired about low carb diets and endometriosis, and if I have any experience with this. Fun story – I do. The TL;DR is that a low carb diet is the way to go here. But, I’ll explain below with the actual details…
Most of the articles I’ve found online about endometriosis and diet link the type of diet that is correlated with the existence of endometriosis. Well, that doesn’t help us at all. If you’ve already got endometriosis, you don’t need to know what kind of diet or lifestyle is related to maybe not getting the condition. Even then, if you want to follow that advice to see if a statistically and theoretically preventative diet will help you manage symptoms, the articles tend to focus on things NOT to eat – don’t consume meat, or dairy, or alcohol. Okay, cool.
So, we’re left with a dearth of articles actually focusing on what to eat if you have endometriosis. So, let’s get into it. Spoiler – low carb diets and endometriosis were meant to be.
What is endometriosis?
Just in case you aren’t wholly familiar with this situation, let’s take a look: endometriosis is a condition where the tissue that lines your uterus (the endometrium), grows outside of your uterus. It’s commonly considered to be an auto-immune condition. It’s also important to note that this is the tissue that grows that nice little blood cushion, egg bed every month. So, that same little cushiony egg bed that was totally fine inside of your uterus, now grows outside of it, too.
This contributes to symptoms like lower back pain, severe cramping, heavy periods, fertility issues, often painful bowel movements or IBS, and period pain that is so bad you can become nauseous and dizzy.
Tell me about low carb diets and endometriosis!
So, this article is heavily based on n=1 experimentation. What does that mean? The test pool is one person, and that person is me. I’ll pull in lots of science and some studies, though. Fear not.
I’ve had endometriosis pretty much as long as I can remember. I was put on birth control pills at 16 to deal with such an irregular cycle. They helped to normalize the amount of days, but that’s about it.
I honestly didn’t feel any relief with my period until I started eating low carb, about ten years later. Seriously, ten years later. From my own experience, it was a revelatory change. I felt normal. My symptoms stopped taking over my life. The change has been so drastic that even if there were no other benefits, I would still maintain this lifestyle. It’s that worth it to me.
Why didn’t I title this article “keto and endometriosis?” I thought about it – but, since I’ve experienced the same results on a ketogenic diet, as I have on a low carb (<75g net carbs daily) diet, I thought I’d leave things more open.
Why would a low carb diet help endometriosis?
So, endometriosis is a double whammy of hormone disregulation in the form of excess estrogen and autoimmune issues. We’ve discussed before how low carb diets are actually really beneficial for regulating hormonal issues, and that autoimmune condition symptoms are improved by a low carb diet, but let’s go over the basics one more time:
- grains, gluten, legumes and sugar are all highly inflammatory
- inflammation causes gut permeability issues, and leads to autoimmune disorders
- eliminating these inflammatory compounds can help to seal up your gut, and allow your body to do what it’s supposed to do – heal yourself
- inflammation = swelling and pain, so there’s another argument for eliminating it right there 😉
- sugar consumption leads to excess estrogen via insulin production, in a crazy mechanism explained in this article
“When insulin spikes, typically after a meal high in sugar, this can lead to lower levels of an important protein known as sex hormone binding globulin (SHBG). SHBG binds excess estrogen and testosterone in the blood, but when it’s low, these hormone levels increase. Insulin also increases the production of testosterone, which is then converted into even more estrogen by fat tissue in the belly.” – Dr. Sarika Arora, MD, for Women’s Health Network
Thus, we can see how a low carb diet would help out here. Reducing sugar, grain, gluten and legume intake decreases inflammation and helps with healing our guts. The move away from sugar not only decreases inflammation, but also helps to steady hormone levels, particularly estrogen.
Dietary support for endometriosis
- Liver support – one of the liver’s many functions is to clear excess estrogen from our systems, so eating cruciferous vegetables (kale, cauliflower, broccoli…), taking milk thistle and dandelion, and avoiding alcohol can all help to support liver function
- increase your omega-3 fatty acid consumption to decrease inflammation and balance hormones!
- Make sure you’re getting enough fiber – excess estrogen can exacerbate your symptoms and eating fiber actually helps to clear out excess estrogen from your system – aim for 25g per day
- reduce exposure to BPA and other endocrine disruptors by switching to natural cleaning products, makeup and body care
- choose high-quality, pasture-raised antibiotic and hormone-free meats
- dairy may be too inflammatory for you – try removing it and seeing the impact on symptoms (or, you may be fine – I do well with moderate amounts of fermented dairy)
- soy is pretty contorversial in the field of hormone disorders – I tend to avoid it, but if you have to eat soy – choose organic 🙂
- nuts & seeds (pumpkin seeds are especially high in zinc)
- wild-caught, cold water fish (like salmon, which are high in omega-3 fatty acids!)
- coconut (butter/manna, oil & whole fruit!)
- pastured meats
- eggs from cage-free, pastured hens
- nuts & seeds also have some protein (remember those pumpkin seeds!)
- In absolute moderation (a few times a week)
- choose berries (which are lower in sugar) over other fruits
- the more fiber and less sugar, the better!
- go wild with leafy and crunchy veggies
- minimize or eliminate starchy veggies (like potatoes & sweet potatoes)
- dark, leafy greens have the most nutritional bang with minimal carbs
- broccoli, cauliflower, kale and other cruciferous vegetables are supportive of liver function, and the liver helps to clear out excess estrogen!
- list of keto-friendly veggies
29 thoughts on “Low Carb Diets and Endometriosis”
Awesome post! My epilepsy is connected to my hormones and my endometriosis is the root of all, well do I want to say evil?, my hormone trouble we’ll say. So finding a way to even out my hormones without adding more medication to my daily routine would be awesome. I already only use vegan toiletries and cosmetics. Thanks for sharing the brains healthygamergirl!
Misslojo – Thanks so much for this comment! I’m so glad you’re figuring out ways to feel better without extra medication!
It’s also awesome to see someone else prioritizing vegan products that don’t utilize animal testing.
I hope this information is helpful on your health journey! Best of luck. 😀
I’m feeling incredible a week into my new eating plan and hoping to hit nutrional ketosis. I’ve also hit my first cycle, which has been slightly less crampy, significantly less PMS, but no less heavy and my backs been just as sore…. I wouldn’t expect much of a change just yet, but I would love to know how quickly you saw a reduction in endo symptoms?
I really get the ‘this is enough’ feeling – I can’t believe the increase in my mental acuity… Liz, I thought I was heading for dementia/Alzheimer’s at 40! I couldn’t concentrate, my memory has been awful, I felt as though I’d dropped 40 IQ points and I found I couldn’t ‘find’ the words I was looking for mid conversation. Worse, I’ve struggled to follow a book for six or seven years – for a normally avid reader, this has been devastating!
I’ve got a good 40kg or so to lose (88lbs) – but if I lost not a gram more, but could remain feeling sharp and clear headed, I’d still stick with it. Interestingly, that very feeling has helped take the focus off weight for me. I feel so good and have so much more energy and focus that it just doesn’t seem important, it’ll just be a nice bonus 🙂
Hi Cath! Thank you so much for sharing this! You’re dealing with a scary set of symptoms, and it’s good to know that a low carb diet is helping. I can totally understand the cloudy headed feeling – I was having similar issues with finishing books, and I also used to be so gung-ho about reading!
For the endometriosis symptoms…it did actually take a few months before I noticed a lighter blood flow and reduction of symptoms. The good news is, that it just keeps improving. Granted, there are still some months where things don’t feel that great, but cramping and soreness has definitely gone down overall.
Please feel free to keep me updated with your progress – I’d love to hear!
I have had Endo for nearly 30 years and have been through the full range of medical treatments. I also have IBS which may or may not be related. I am very lucky that I had three children naturally conceived too. But my last lot of progesterone treatment left me feel awful and made me gain lots of weight. When looking into weight loss I stumbled upon low carb as being better than low calorie and began last week, I am really hoping that there is a very positive change in my Endo too. I am vegetarian so it’s more of a menu planning challenge than maybe other people have but I am sure I will manage!
I love your article! My husband kids and I are about to start on the keto diet and are really hopeful and excited about it. Him with his bi-polar and me with my Endometriosis and pelvic adhesive disease which I have found no relief from to this date. Also my son with his A.D.D. and hoping to do everything possible for my daughter not to ever have endo to begin with. It would kill me if she ever had to go through this. What are your thoughts on drinking kefir (homemade) on the keto diet? Also do you have any baking recipes that are keto friendly? I love to cook and bake and feel that will be the only thing I’ll miss out on switching over to keto.
Hi Faith! I don’t blame you for wanting to shield your daughter from endometriosis – it’s just so exhausting and painful. I really hope the keto diet helps out your family with everything. It’s definitely not a miracle, but has demonstrated so many positive effects in a variety of cases!
I think fermented beverages (like kefir and kombucha) are great on a ketogenic diet, so long as there isn’t a ton of added sugar. A lot of the sugar present in fermented foods is actually consumed by the bacteria during the fermentation process, so unless it’s really heavily flavored, it should be more than okay!
I do have baking recipes that are keto friendly over at http://meatfreeketo.com. There are quite a few sugar-free baked good recipes and allergen-free baked good recipes as well!
Best of luck to you and your family! Please feel free to reach out with any questions you might have. 🙂
hi, there are so many keto bread ideas on line, we love keto bread in a cup from almond flour and peanut butter bread. They are great alternative. All my fav ideas (and my husband’s) originally from this web site – https://headbangerskitchen.com/ this guy also have lots of videos on keto cooking.
peanut bread – https://www.youtube.com/watch?v=uYw7_1lxk8Y
almond flour bread – https://www.youtube.com/watch?v=uE98gHygT4Y
Really recommend to watch his other videos, he has great ideas!
Thanks for sharing these links, Leah!
Thank you for sharing your ideas and suggestions. They have given me some encouragement.
I was a vegetarian until just a few weeks ago, when I very randomly met someone who suggested I try fat fasting and staying in ketosis in order to reduce the symptoms of my endometriosis (and fibroids). He suggested a diet that is inclusive of meat and I have been trying it— out of desperation.
In my research, I have come across mixed reports online about the effects of ketosis on women’s bodies, in particular. But, again, out of desperation for some relief, I have greatly reduced my carb intake and upped my fats and proteins, eliminated coffee and reduced my sugar (sweet food) intake.
Luckily, I absolutely feel better and haven’t experienced any negative issues with my sleep or cycle, which seem to be the most common complaints. My pain isn’t completely gone but it’s nowhere near what it was only a few weeks ago.
I miss sugar so much. She was my best friend for 36 years… But, I am feeling well for the first time in a long time.
I look forward to trying some of your vegan/vegetarian recipes maybe I don’t need the meat!
Thanks so much.
Hi Tamara, I am so happy to hear that your symptoms are improving! We are all so different, that it is impossible to pinpoint a diet that will help everyone with endometriosis. However, the fact that you are experiencing an improvement with this way of eating is so encouraging!
I 100% understand the frustration of feeling zero relief whatsoever after trying something new (everyone told me going gluten free would be the silver bullet), and can tell you from experience that it’s so worth giving up sugar in order to feel better.
I also spent the better part of my life as a total sugar addict without realizing it, and while I truly missed sweets and cakes so much at the start, I don’t even think much about them at all at this point. Berries and a little stevia do the trick now. I bet you’ll get to this point as well!
Thank you so much for commenting and sharing your experience. I hope you continue to improve!
I just started 2 weeks ago the lchf… quite strictly. Till now not really feeling the good effects, had a lot of weakness, fatigue, tinnitus, felt dizzy, … so not great yet. Still I’m very much motivated because of feeling sick since years, lost my memories , I’m 40, concentrationdifficulties, easily upset, depressed, … and always pains in my body: legs, butts, belly after every meal, feeling without force, like 80 years old body….
Now on top of all that I do have also endo. Never had pain though related to the symptoms like back pain. I already got 2 surgeries, out of wich 1 ovary has disappeared (another long story… Both surgeons say it’s the other…, so somehow it simply disappeared ), and am confirmed menopause since 2012.
However, I’ve had 2 cycles per year, I was very glad, thinking that maybe the menopause was gonna reverse and of course in my big luck, I got endo back!!! (Analysed with blood, echo, irm…)
So I’m hoping that with the lchf, it will disappear. .. maybe not. The doctor said I should go for a surgery, and maybe I’ll do it. Not yet convinced.
My question (yes, finally): I fear very much the glucose they will feed me with by iv, after/during the surgery, and to have like a bomb in my vains after a strict keto.
Any feedback on that? I would really appreciate info on that.
P’s excuse my English but I’m native french
Hello, and thank you so much for sharing your experience.
Firstly, I am so sorry that you are having such a difficult time with endometriosis, and all of those symptoms on top of it! This must be so frustrating for you, and I hope that your symptoms do start to improve.
As for teh tinnitis, dizziness and fatigue…those can often come with low carb eating when people aren’t consuming enough electrolytes. Usually, adding more pink salt (or any salt with high mineral count) to your foods, trying to drink mineral water and even drinking vegetable broth can provide enough minerals to eliminate these symptoms. If they don’t go away soon, though, I would definitely talk to your doctor!
As for the IV, I’m sorry, but I really don’t feel qualified to answer that! There are definitely instances (type 1 diabetics, for example), where post-surgery complications can arise because of high blood sugar levels from IVs, but this is an entirely different case. I would definitely talk to the doctor and mention any blood sugar regulation concerns you are having!
Also, your English is great. 🙂
Bonne chance au médecin!
Hi. I recently started the LCHF diet 2 months in, I am suddenly reminded of how awfull endo can be, with pain needing strong painkillers for whole four days and nights during my period. And now I have midcycle pain again too. Now I do believe LCHF to be good for me in every other way. But after reading your blog I remember that some 15 years ago I figured out that dairy was the big cause of my Endopain, and the reason I dont drink milk or eat yoghurt or any dairy on a daily basis. Thank you so much ?❤️ I was thinking I would need to stop this way of eating ?
Hi Inga! Firstly, I’m sorry you have to deal with endo – it really is just awful pain, and can be such a challenge. I’m so glad that you realized it was dairy, though! It’s so strange how different things can trigger endo pain in different people. I really hope everything settles down, and you can continue with this way of eating, (relatively) pain-free! ?❤️
So glad to have found this post, I thought I was just crazy! I started Keto 2 mos ago, and have slowly weaned my way to just low carb (less than 75g a day) and my endometriosis pain is almost nonexistent. I’ve done gluten free to no avail, and my last option was going to be a medically induced menopause. Never did I think Keto could change my life so much. Hope you’re still going strong and relatively symptom free!!
Hi Kate! Thank you so much for sharing your story. Isn’t it crazy how such a simple dietary change can make such a dramatic difference? I am still going strong, and while every month isn’t perfect, I’m still so much better off than before I started eating keto/low carb. I truly can’t even believe the difference to this day. I’m so happy that you’ve seen such an incredible change and no longer have to look at medical intervention to try and feel normal.
Hello! I am wondering, I was diagnosed with Stage 4 Endo 7 years at the age of 40, I was also diagnosed with PCOS at the age of 22. Double whammy YAY. I am infertile as a result, have made my peace with that finally. BUT I have been on Deporolvera injections every 3 months since my diagnosis of Endo and it has been AMAZING for me. No periods, no pain, no symptons of endo. I started Keto on January 1st this year and over the last couple of weeks I have been experiencing some spotting, just minimal, but I’ve not had an issue with spotting since my first cycle of Depo 7 years ago. I’m off to the Dr on Tuesday to discuss with her, but I’m wondering if the keto could be the cause of hormonal changes that could be causing the spotting? I am terrified of going off the depo injections, literally terrified. So I’m hoping the spotting is just a result of my hormones returning to a more normal level?
I’m experiencing the same thing w severe cramping and hip pains. I started Keto March 4th. I have annual follow ups w my Dr but tnisnt until June. Happy to see I’m not the only one experiencing similar issues. Would you be comfortable sharing what your dr thinks in regards to hormones levels from change of diet?
Thank you for this article. I have had endometriosis and Fibriods for over twenty years. I was mis diagnosed and haven’t learnt of the endometrisos Till this past month. Since then I have noticed that a low carb diet is def the way to go. I had an awful reaction to squash… Which made me rethink carbs… I have had a very healthy diet, didn’t eat bread, processed food was gluten free vegan. No sugar, no caffeine, no coffee. I was still getting horrible pain after eating rice and beans. Recently I have taken out the vegan aspect and have added just fish. I eat a lot of mushrooms … I graze on healthy homade granola during the day. Very small amount.
Eat salads. I have a small blueberry strawberry and half a banana breakfast smoothie. I have also started taking a apple cider vinegar drink (no stevia) just water and ACV. I sip this all day, with meals which has helped emmensly with digestion.
I take magnesium, vitamin c 3000-5000, VIT e, a & evening primrose.
I rub castor oil on my stomach nightly.
This combination takes a lot of effort but it has helped me emmensly.
I haven’t tried grass fed meat. I will add it slowly and see if there is a reaction.
Eggs/dairy – even grass fed organic are not great for me.
I hope this helps someone else.
Hello, all this is pretty new to me (keto, vegan etc – endometriosis is not new to me) and I am a bit confused. I read some keto diet plans and they do include a lot of meat and diary products. But other diets suggest that diary and meat are bad for endometriosis. So does keto means just low crab or it does mean to include a lot of meat and diary? I am so lost and still trying to figure our how to help myself. Thank you
Hi Piya, this is a great question! You are totally correct that dairy and meat have been shown in studies to be problematic for endometriosis. I’m actually vegan and on a low carb/keto diet, so I don’t actually include either of those things in my meals. 🙂
I have a bunch of low carb recipes that are vegan at MeatFreeKeto.com, so you can get the idea of what to eat. There are also “what I eat in a day” posts and meal plans. 🙂
I hope you find the site helpful – you definitely don’t have to do a low carb diet with meat or dairy!
Thank you for your answer 🙂 I do love cheese and all other sort for food but I prefer to stay away if that will make my life better 🙂 Before I found your blog I was reading about keto and mostly people suggest tons of meat and dairy to get protein, high fat and low carbs, so it was confusing for me: does keto mean low carbs or it means low carbs with plenty of meat 🙂 Thank you very much:)) as I said I am pretty lost lately because for the last 2 months I cut milk, cheese, meat (not that I was a big meat fan before that) gluten and so on to 90% and I know it is not 100% but my high hopes were not rewarded and I was a bit devastated. lets just hope that 2 months is short period and in long run there will be improvement. Thank you 🙂
I have been dealing with Endo for over 10 years. I have been eating Paleo for over 2 years now with no relief. I have in the past eaten keto. All the research I have done says to stay away from any and all kinds of dairy? Is this something you practice?
Hi Julia, I’m sorry that paleo hasn’t helped your symptoms. I actually do vegan keto – so, not meat, eggs or dairy. You are correct in that there is a ton of research out there that indicates dairy is really pro-inflammatory, especially for those with endometriosis. Similarly, research indicates that red meat consumption can also exacerbate endometriosis symptoms.
I’ve been on the keto diet for 2 months. All of my endo symptoms that were rising up again years after my first few treatments and surgeries have all gone away. I read books that told me to avoid animal fats, etc. to help endo so I had no idea when I started this way of eating (since it’s so different than the things I read) for weight loss that it would actually help my endo. I feel so great for the first time in years! I’m pain free and I’m losing weight. Best decision I’ve ever made!
Hi Miranda! Thank you so much for sharing your story. I’m so happy you’ve found something that has worked for you, and that you feel so much better!
Hi Liz, first sorry for my English, im French leaving in Toulouse in the south of France. I know you posted this article a long time ago but I was so surprised by reading your article. Im suffering a lot during my periods (I’m making the test for endometriosis in few days..don’t know yet) and I started the keto style some weeks ago and now the pain disparead it’s just incredible …!
I would like to thank you for all the explanations because nothing exist in French and I’m so surprised about that. I’m making now some research on this topic and would have maybe some questions for you if you are opened to share your experience.we can contact each other on the social networks (deborah kge) or by email.
Thank you and take care