Lifestyle also influences the severity of endometriosis symptoms

According to a recent review by researchers at Semmelweis University, published in the journal Nutrients, lifestyle and dietary changes may help people living with endometriosis. The study analyzed more than 100 international papers and found that factors such as a healthy diet, regular physical activity, stress management, good sleep and adequate micronutrient intake can help reduce pain and improve quality of life.

The Semmelweis University research team reviewed international studies to better understand the role of lifestyle factors in managing endometriosis.

Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting around 10% of women of reproductive age. It is characterized by tissue similar to the uterine lining growing outside the uterus. These lesions respond to the menstrual cycle and can cause pain, inflammation and bleeding, often leading to severe menstrual pain, chronic pelvic symptoms, fatigue and infertility. Diagnosis is often delayed, and symptoms can significantly affect quality of life over time.

One of the key findings is that regular physical activity – at least 150 minutes per week, according to general recommendations, three times a week – can have several benefits. Exercise can influence hormone balance and the way the body processes pain.

Clinical studies show that activities such as yoga, stretching and strengthening exercises, cardio workouts and resistance training, as well as relaxation techniques like progressive muscle relaxation, can help reduce endometriosis-related pain and improve quality of life.

“Physical activity and other lifestyle factors do not replace medical treatment, but they can support it,” said Dóra Boroncsok, PhD candidate at Semmelweis University and first author of the study.

The researchers also highlight the benefits of a Mediterranean-style diet, which is high in vegetables, fruits, whole grains, fish and olive oil, while limiting red and processed meat. This type of diet has been linked to reduced pain and improvements in some digestive symptoms. By contrast, pro-inflammatory diets, particularly those high in red meat, may increase the risk of the disease.

The review also looks at the possible role of several micronutrients and dietary supplements – including vitamins C, D and E, omega-3 fatty acids, magnesium, zinc and certain antioxidant compounds – while noting that further clinical research is needed to confirm their benefits.
Lifestyle factors also include good sleep, effective stress management, limiting alcohol consumption and reducing exposure to chemicals such as BPA, DEHP and DES, which can act as endocrine disruptors and interfere with hormonal function.

“A key message is that patients can actively contribute to improving their condition. Everyday choices – from physical activity to diet and stress management – can reduce symptoms. Lifestyle change is not a cure, but it offers a real opportunity for women to take an active role in their own health,” added Dr Gábor Sobel, associate professor at the Department of Obstetrics and Gynecology at Semmelweis University and senior author of the study.

The publication also introduces a new dietary approach currently under investigation, known as the fasting-mimicking diet (FMD). This is a short, typically five-day, plant-based, low-calorie program designed to trigger effects similar to fasting without requiring complete food restriction.

In clinical studies of other chronic inflammatory and metabolic conditions – such as type 2 diabetes and cardiovascular risk – FMD has been shown to reduce inflammation, support hormonal and metabolic balance, and activate cellular repair processes.

Based on its biological effects, FMD appears promising, but it has not yet been studied in gynecological diseases. The Semmelweis University research team has therefore developed a clinical trial protocol, which will be the first study worldwide to investigate FMD in gynecological conditions, including endometriosis.