Endometriosis and nutrition: why the gut plays an important role

Pain in the abdomen, cramps, digestive issues – “It’s normal.” But it may not be. Endometriosis is still a taboo topic in Switzerland. So it isn’t surprising that one in every two sufferers is initially diagnosed with irritable bowel syndrome. Ellen Weber, a nutritionist at santé24, has advice on how a gut-friendly and balanced diet can help those who are affected.

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AuthorOlivia Fey
4 minutes reading time30. September 2026

About one in ten women in Switzerland suffers from endometriosis. It’s a challenging disease that is often protracted and painful for those affected. The condition occurs when tissue similar to the uterine lining grows outside the uterus, sometimes in the lower abdomen, intestines, nerves or diaphragm.

Typical symptoms of endometriosis are fatigue or digestive problems such as flatulence or diarrhoea, and also often include severe abdominal pain, irregular and heavy menstrual periods or intermittent bleeding. To relieve the pain, medication is often prescribed to suppress the menstrual cycle. An anti-inflammatory diet can help relieve symptoms in the long term. 

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«A targeted diet cannot cure endometriosis, but it is an important component of pain and symptom management.»

Ellen Weber

Ernährungsberaterin BSc BFH, Onlinepraxis santé24

Why the gut plays an important role

The symptoms of endometriosis vary greatly from individual to individual. “No two people are affected the same,” emphasises Weber. The gut plays an important role in this respect – often even before a diagnosis is made. “Individuals report non-specific symptoms such as flatulence, diarrhoea, constipation, nausea or abdominal pain.” Irritable bowel syndrome is often suspected initially. “Almost one in two people affected by endometriosis gets this diagnosis first,” explains the nutritionist.

This is not a coincidence: People with endometriosis have altered intestinal flora, which in turn affects the symptoms of endometriosis. A healthy gut is essential for the absorption of important nutrients. “These nutrients help regulate the menstrual cycle, maintain bones, strengthen muscles and influence mood,” explains Weber. If important bacteria are missing, this can affect the regulation of hormones. 
 

«Taking care of intestinal flora is very important – especially for women suffering from endometriosis.»

Ellen Weber

Ernährungsberaterin BSc BFH, Onlinepraxis santé24

Do not ignore symptoms

One common accompanying symptom of endometriosis is known as “endo belly” – a severely bloated, painful abdomen. This should not be ignored. “Endo belly is often the reason why people with endometriosis seek nutritional advice,” says Weber. 

Because symptoms and their triggers can vary greatly from person to person, a nutrition or symptom journal can help to better reveal the links between symptoms, eating habits and symptom relief.

 

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Nutritional basis: balanced instead of perfect

Both online and offline, there are many sources of advice and special endometriosis diets. “However, there is no universal rule for people affected by endometriosis on how to eat properly. Nutrition is as individual as the disease itself,” says the nutritionist. 

A balanced, varied diet that includes regular meals, sufficient fluids and a wide range of foods is a good way to go. In many cases, having to follow strict rules often leads to unnecessary extra stress in everyday life and can also result in malnutrition. 

Help from Mediterranean cuisine

One simple, sensible and of course tasty option is a Mediterranean diet. “It focuses on fruits, lots of vegetables, whole grains, high-quality vegetable oils, pulses and nuts,” Weber advises. Fish also regularly appears on the menu, as well as moderate amounts of dairy products. Vegetable protein sources should be used in accordance with an individual’s tolerance. Red meat and sweets are consumed as little as possible in this diet. 

Mediterranean cuisine provides many different minerals, vitamins and secondary plant compounds. It is considered to be an anti-inflammatory diet, which is why those who suffer from endometriosis should absolutely give it a try. 

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Nutrient check: which ones are particularly important?

Getting plenty of minerals and vitamins is particularly important when you have endometriosis. The list includes iron, magnesium, zinc, selenium, the various B vitamins and antioxidant phytochemicals. Flavonoids from berries and apples also support gut health, and vitamins A, D, and E are integral to this diet. These nutrients can be obtained in the long term primarily through a balanced and varied Mediterranean diet. 


 

The magic of omega-3 fatty acids 

Fats play an important role in anti-inflammatory diets. Since this form of nutrition is also indicated for endometriosis, it is worth taking a look at omega-3 fatty acids. These are found in fatty fish, flax seeds, chia seeds, linseed oil, rapeseed oil and walnuts. In contrast, highly processed foods should be consumed as little as possible. These predominantly contain inflammatory fatty acids.

Even small changes can help with endometriosis symptoms. A higher intake of dietary fibre from vegetables and conscientiously including healthy omega-3 fatty acids in your diet can have a positive effect on relieving symptoms. 

A diet for endometriosis: at a glance

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    Eat two servings of fruit and three servings of vegetables every day.

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    Opt for whole grain products whenever possible.

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    Use high-quality vegetable oils such as rapeseed or linseed oil.

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    Regularly include foods rich in omega-3, such as fish, flaxseed or walnuts, in your diet.

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    Reduce sugar and highly processed foods.

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    Drink enough, choosing sugar-free beverages – this applies to everyone, not just those affected by endometriosis.

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    Record any issues in a nutrition and symptom journal.

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    Don’t impose harsh restrictions on yourself. Instead, choose a diet that you can maintain over the long term.

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Focus on women’s health

From September to October, the Swica newsroom will be addressing the focus topic of “women’s health”. The two female-specific issues of endometriosis and menopause are examined from a political, psychological and health perspective. 

The articles can be found in SWICA's world of health.
 

Topics in this story:
Nutrition while ill
Women's health
Nutritional science

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