Diet quality and perceived effects of dietary changes in Dutch endometriosis patients: an observational study

Reprod Biomed Online. 2021 Nov;43(5):952-961. doi: 10.1016/j.rbmo.2021.07.011. Epub 2021 Jul 24.


Research question: What is the current diet of women with endometriosis, in terms of adherence to dietary guidelines and use of diets, and what are the perceived effects of dietary modifications?

Design: In this online explorative observational study, the Dutch Healthy Diet 2015 index (DHD-15) and quality of life (QoL) with the Endometriosis Health Profile-30 questionnaire (EHP-30) were used to assess diet quality.

Results: The questionnaires were completed by 157 participants. Many participants made one or more dietary adaptations for their endometriosis, in the form of a specific diet (46.5%), with the use of dietary supplements (56.1%), with other dietary adjustments (64.3%), or all. Endometriosis patients had a significantly lower DHD-15 score, indicating a lower diet quality than a healthy reference group (P = 0.004). In the endometriosis group, diet users had a significantly higher total DHD-15 score than non-diet users (P < 0.0001). Diet quality was not correlated with QoL (Pearson's r = -0.010, P = 0.904). Many specific dietary adjustments (71.3%), however, were reported to reduce endometriosis pain-related symptoms. The removal of gluten, dairy or soy, as well as the addition of vegetables, showed the greatest perceived reductions of symptoms in participants.

Conclusions: Although no specific dietary adjustment was found to increase QoL, endometriosis patients do feel that dietary adjustments have a beneficial effect on their symptoms. Therefore, more research is needed to gain evidence about the specific effects of nutrients on endometriosis symptoms.

Keywords: Dietary behaviour, endometriosis; Nutrition; Pain, quality of life, self-management.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Diet, Healthy* / psychology
  • Endometriosis / diet therapy
  • Endometriosis / physiopathology*
  • Female
  • Gastrointestinal Diseases
  • Health Behavior
  • Health Status
  • Humans
  • Netherlands
  • Pain
  • Quality of Life
  • Self-Management
  • Surveys and Questionnaires