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Nutrients
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Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis
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Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: 5 September 2026 | Viewed by 11691

Special Issue Editor

Dr. Marika Cordaro

E-Mail Website
Guest Editor
Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: oxidative stress; nutrition; cell physiology; animal model; inflammation; molecular pathways
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Endometriosis is a chronic, estrogen-dependent inflammatory disease with complex pathophysiology involving hormonal, immunological, and metabolic pathways. While current treatments focus primarily on hormonal regulation and surgical intervention, increasing attention is being directed toward the role of nutrition in modulating disease risk, progression, and symptomatology.

This Special Issue aims to explore the biochemical and physiological interactions between diet and endometriosis. Contributions may address the influence of specific macro- and micronutrients, dietary patterns (e.g., anti-inflammatory, Mediterranean, low-FODMAP), nutraceuticals, and the gut–immune–endocrine axis. Of particular interest are studies elucidating the molecular and metabolic mechanisms by which dietary components affect oxidative stress, prostaglandin synthesis, estrogen metabolism, immune modulation, and chronic inflammation in endometriosis.

For this Special Issue, we welcome original research, systematic reviews, and mechanistic studies in both clinical and preclinical models, with the aim of advancing a nutritionally integrated perspective on endometriosis.

Dr. Marika Cordaro
Guest Editor

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Keywords

  • endometriosis
  • nutrition
  • dietary patterns
  • micronutrients
  • nutritional supplement
  • gut–immune–endocrine axis
  • oxidative stress
  • endocrine system
  • inflammation

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Published Papers (4 papers)

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Review

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19 pages, 1768 KB  
Review
Non-Mineral Antioxidant Supplementation in Endometriosis: Biological Rationale, Clinical Evidence, and Therapeutic Implications—A Narrative Review
by Kamila Pokorska-Niewiada, Katarzyna Janda-Milczarek, Khasan Kayumov, Maciej Ziętek and Małgorzata Szczuko
Nutrients 2026, 18(8), 1182; https://doi.org/10.3390/nu18081182 - 9 Apr 2026
Cited by 1 | Viewed by 847
Abstract
Background/Objectives: Oxidative stress plays an important role in the pathophysiology of endometriosis, contributing to inflammation, immune dysregulation, and lesion progression. This has led to growing interest in antioxidant-based strategies as potential supportive interventions. Methods: A literature search was conducted using PubMed, [...] Read more.
Background/Objectives: Oxidative stress plays an important role in the pathophysiology of endometriosis, contributing to inflammation, immune dysregulation, and lesion progression. This has led to growing interest in antioxidant-based strategies as potential supportive interventions. Methods: A literature search was conducted using PubMed, Scopus, and Web of Science databases, covering studies published from database inception until the end of January 2026. The review focused on clinically relevant endpoints, including pain intensity, markers of inflammation and oxidative stress, reproductive parameters, and quality of life. Results: Among the analyzed interventions, the most consistent clinical effects were observed with melatonin, with randomized controlled trials indicating a moderate reduction in pain. N-acetylcysteine shows potentially beneficial effects; however, the available clinical data remain limited and heterogeneous. For other supplements, the evidence is inconsistent or insufficient to support clear clinical conclusions, and in many cases relies on indirect or mechanistic findings rather than well-established clinical outcomes. Conclusions: Current evidence does not support the use of non-mineral antioxidant supplements as standalone therapy for endometriosis. They may be considered as adjunctive strategies, although their clinical effectiveness remains uncertain and requires confirmation in well-designed randomized clinical trials. Full article
(This article belongs to the Special Issue Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis)
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19 pages, 777 KB  
Review
Dietary Fiber in Endometriosis: Mechanisms, Evidence, and Potential Clinical Benefits—Up-to-Date Review
by Justyna Czerniak, Michał Ciebiera, Natalia Zeber-Lubecka and Piotr Olcha
Nutrients 2026, 18(4), 690; https://doi.org/10.3390/nu18040690 - 21 Feb 2026
Viewed by 2390
Abstract
Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder. It is associated with hormonal dysregulation, pelvic pain, and a reduced quality of life. Dietary factors may influence disease development and symptom severity. Objective: This article aims to summarize current evidence on the role of [...] Read more.
Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder. It is associated with hormonal dysregulation, pelvic pain, and a reduced quality of life. Dietary factors may influence disease development and symptom severity. Objective: This article aims to summarize current evidence on the role of dietary fiber in endometriosis and to discuss the underlying biological mechanisms and clinical implications. Methods: A narrative review of the literature was conducted using peer-reviewed original research articles and review papers published in English. Studies examining dietary fiber intake, fiber-rich dietary patterns, and their associations with endometriosis risk, symptoms, estrogen metabolism, gut microbiota, and inflammation. Results: Observational studies suggest that higher dietary fiber intake, particularly from fruits, vegetables, and whole grains, may be associated with a reduced risk of endometriosis. Interventional evidence remains limited. However, available studies indicate that fiber-rich dietary patterns may contribute to pain reduction and improvements in quality of life. Conclusions: Current evidence suggests that dietary fiber may play a supportive role in the prevention and management of endometriosis through multiple interconnected biological pathways. Nevertheless, the limited number of high-quality interventional studies highlights the need for further well-designed clinical trials to clarify the therapeutic potential of fiber-rich diets as an adjunct to standard endometriosis care. Full article
(This article belongs to the Special Issue Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis)
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19 pages, 328 KB  
Review
The Role of Lifestyle and Diet in the Treatment of Endometriosis: A Review
by Dóra Boroncsok, Anna Filó, Marianna Török, Hajnalka Vágó, Nándor Ács and Gábor Sobel
Nutrients 2026, 18(1), 142; https://doi.org/10.3390/nu18010142 - 1 Jan 2026
Cited by 2 | Viewed by 5707
Abstract
Endometriosis is a chronic, oestrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age, frequently associated with chronic pelvic pain, dysmenorrhoea and infertility, substantially impairing quality of life. While pharmacological and surgical therapies represent the standard of care, growing evidence indicates that [...] Read more.
Endometriosis is a chronic, oestrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age, frequently associated with chronic pelvic pain, dysmenorrhoea and infertility, substantially impairing quality of life. While pharmacological and surgical therapies represent the standard of care, growing evidence indicates that lifestyle and dietary factors play an important complementary role in symptom management and may influence disease progression. Regular physical activity appears to attenuate systemic inflammation, improve hormonal regulation and support psychological well-being. Dietary patterns rich in anti-inflammatory components, particularly Mediterranean-diets and low-inflammatory diets, have been associated with reduced pain and improved gastrointestinal symptoms, whereas high consumption of red and processed meats may increase disease risk. Micronutrients and selected supplements, including vitamins C, E and D, magnesium, zinc, folate, omega-3 fatty acids, N-acetylcysteine, curcumin, probiotics and green tea polyphenols, show promising but variable evidence for symptom relief. Additional lifestyle factors, such as avoiding endocrine-disrupting chemicals, moderating alcohol intake, ensuring adequate sleep and managing psychological stress, may further modulate inflammatory and hormonal pathways relevant to the disorder. Overall, current evidence indicates that integrating lifestyle interventions alongside conventional treatments offers clinically relevant benefits, although larger, well-designed clinical studies are needed to clarify the magnitude of these effects and to explore further promising lifestyle-based therapeutic approaches. Full article
(This article belongs to the Special Issue Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis)

Other

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16 pages, 844 KB  
Systematic Review
An Overview of Essential Nutritional Strategies and Products in the Treatment of Endometriosis
by Małgorzata Szczuko, Maciej Ziętek, Katarzyna Janda-Milczarek, Ewa Rębacz-Maron, Jolanta Nawrocka-Rutkowska and Kamila Pokorska-Niewiada
Nutrients 2026, 18(1), 77; https://doi.org/10.3390/nu18010077 - 26 Dec 2025
Viewed by 1959
Abstract
Background/Objectives: Recent reports on the co-occurrence of allergies and endometriosis have provided grounds for expanding research in this area, suggesting that diagnostics should be extended to women with endometriosis. However, numerous studies on nutrients and antioxidants do not specify the type of diet [...] Read more.
Background/Objectives: Recent reports on the co-occurrence of allergies and endometriosis have provided grounds for expanding research in this area, suggesting that diagnostics should be extended to women with endometriosis. However, numerous studies on nutrients and antioxidants do not specify the type of diet that supports the treatment process. In our review, we focus on the types of food elimination and dietary approaches that have been used. Methods: This systematic review was conducted according to the PRISMA guidelines. We searched the EMBASE, PUBMED and SCOPUS databases, as well as the bibliographies of research papers and reviews, including the latest reports from June 2025. The search keywords were “endometriosis” and “type of diet”, “nutrition”, “food products”, “nutrients”, “elimination diet”, and “allergies”. Results: Excluding coexisting allergies and introducing an anti-inflammatory diet low in animal products, limiting butter and margarine, and eliminating fried foods and refined simple sugars may be the best solution to help treat endometriosis. Conclusions: Personalised nutritional counselling for patients with endometriosis is particularly helpful and necessary, as there is no single elimination diet that can be recommended for all patients with endometriosis. The first step should be an anti-inflammatory diet, such as the Mediterranean diet or the MIND diet (Mediterranean-DASH diet intervention for neurological delay), followed by more in-depth allergy screening. The phenotypic diversity of this group of patients may require the use of a low-FODMAP (fermentable oligo-, di-, monosaccharides and polyols), low-nickel, gluten-free or other elimination diet. Full article
(This article belongs to the Special Issue Nutrition, Dietary Patterns, and Biochemical Mechanisms in Endometriosis)
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