If you have endometriosis, you probably know the pain stretches well beyond your period.
Many women deal with a second battle in the gut, from bloating and cramps to trips to the bathroom.
The usual medical advice says little about that side of the condition.
Now a systematic review in Nutrients, published in July 2026, suggests that a short diet change may calm those gut symptoms for most women who try it.
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The review pulled together five clinical studies on the low-FODMAP diet in endometriosis.
The strongest piece of evidence is a feeding trial run by Monash University. On that diet, 60 percent of women reported clinically meaningful relief. On a standard control diet, only 26 percent did.
Low-FODMAP diet
FODMAP stands for fermentable carbohydrates, short-chain sugars that the small intestine does not absorb well.
They travel into the colon, where gut bacteria ferment them and make gas. In sensitive people, that process triggers bloating, pain and loose stools.
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A low-FODMAP diet temporarily limits foods richest in these carbohydrates. The main groups are wheat and other grains, onions and garlic, dairy, apples and pears, chickpeas and lentils, and stone fruits.
It is designed as a short-term tool, not a lifelong way of eating.
The Monash trial
The feeding trial, called EndoFOD, was published in May 2025 in Alimentary Pharmacology and Therapeutics.
The researchers gave 35 women with endometriosis and troublesome gut symptoms either a low-FODMAP diet or a nutritionally matched control diet based on dietary guidelines.
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Each woman tried both diets for 28 days, with a washout period in between.
On the low-FODMAP diet, 21 of the 35 women reported clinically meaningful relief. Abdominal pain eased, bloating went down, and stool form improved to normal in most of them.
Scores on quality-of-life questionnaires rose, both on general gut measures and on an endometriosis-specific scale.
The trial also tracked mood. Among women who started with raised depression scores, those scores fell on the low-FODMAP diet. Stress scores dropped as well. Anxiety did not shift.
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Why gut symptoms get overlooked
Endometriosis affects roughly 1 in 10 women of reproductive age. More than 75 percent of them deal with gut symptoms on top of pelvic pain. Despite that, the gut side is often invisible in clinical practice.
"Gastrointestinal symptoms associated with endometriosis are largely ignored in clinical guidelines," Associate Professor Rebecca Burgell told News-Medical. She heads the Functional Gut Service at Alfred Health in Melbourne.
According to Burgell, most endometriosis guidelines do not mention gut symptoms, and standard irritable bowel syndrome guidelines never screen for endometriosis.
The EndoFOD trial, led by senior research dietitian Jane Varney at Monash University, is the first rigorous feeding trial of the low-FODMAP diet in women with endometriosis.
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What to know before you try it
The low-FODMAP diet is restrictive, and the authors of the Nutrients review are careful about how to use it.
They describe it as a temporary symptom tool, not an endometriosis treatment, and recommend that it is followed with the help of a dietitian.
The idea is a short restriction phase of a few weeks, followed by a careful reintroduction of foods.
The goal is a long-term pattern that keeps symptoms down without needlessly cutting whole food groups.
If you have endometriosis and gut symptoms that get in the way of daily life, speak to your doctor or a dietitian before changing your diet.
The findings are early and built on small trials, and the diet needs to be run properly to be safe and useful.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.