FFHA Newsletter – Quarter 1, 2026
How Diet May Ease Pain and Boost Energy in Women with Endometriosis
This small study from Spain explored how diet relates to pain and daily life in women with endometriosis (a condition where tissue like the lining of the uterus grows outside the uterus), comparing those with ovarian endometrioma (ovarian cysts caused by endometriosis) and deep endometriosis (growths that invade deeper organs) to women without the disease. Women with endometrioma ate more total fat and monounsaturated fats (healthier fats found in olive oil and nuts) and cholesterol, plus more meat and snacks, and they scored lower on the Mediterranean diet and the Healthy Eating Index. Both endometriosis groups used less dairy than women without endometriosis, and women with deep endometriosis were more likely to take dietary supplements. Higher fat intake was linked to worse body pain control, lower vitality, and poorer sexual and reproductive health, while better scores on healthy eating patterns were linked to better menstrual symptoms and higher vitality. In deep endometriosis, eating more fat and meat related to lower energy, but following a healthier overall diet related to feeling more energetic; the authors suggest that targeted changes, especially focusing on healthier fats, may help.
Women with endometriosis—especially those with ovarian endometrioma—who eat more fat, meat, and processed snacks tend to have more pain and less energy, while those who follow a healthier, Mediterranean-style diet feel better.
Spagnolo E, Díaz Fuentes B, López A, Alonso de Celada R, Buño A, Ramiro-Cortijo D, Hernández A. Impact of dietary patterns on pain and quality of life in ovarian and deep endometriosis: observational study for nutritional interventions. BMC Women’s Health. 2025;25:613. https://doi.org/10.1186/
Lifestyle Changes That May Help Pelvic Pain in Endometriosis and Adenomyosis
This article reviews what we know about lifestyle steps that might ease pelvic pain in women with endometriosis and adenomyosis (when the uterus lining grows into the muscle of the uterus). The authors looked at 21 studies and found promise for a Mediterranean diet, a low FODMAP diet (limits certain carbs that can cause gas and bloating), and a gluten‑free diet, plus regular exercise, yoga, mindfulness, and transcutaneous electrical nerve stimulation (TENS: a small device that sends gentle electrical pulses through the skin to help with pain). New digital tools, like phone apps and virtual reality sessions, also gave short‑term relief for some women and can be used at home. Still, most studies were small, used different methods, and very few included women with adenomyosis, so the evidence isn’t strong enough to make firm rules. Even so, because these options are generally low risk and self‑directed, many women may want to try them with their clinician’s guidance and track what helps their pain, energy, sex comfort, and daily life.
Several lifestyle changes—diet, movement, mind‑body practices, simple devices, and helpful apps—may ease pelvic pain for some women with endometriosis or adenomyosis, but better research is needed.
Hough B, Drever N, Manger S. What is the Evidence on Lifestyle Interventions for the Symptom Management of Pelvic Pain in Women With Endometriosis or Adenomyosis? A Scoping Review. American Journal of Lifestyle Medicine. 2026. doi:10.1177/15598276261419770
Online CBT Eases Endometriosis Pain and Boosts Daily Life
Endometriosis often hurts daily life, so researchers tested two online options to help. In this randomized controlled trial (a study where people are randomly put into groups to test treatments) with 334 adults, participants did either cognitive behavioral therapy, or CBT (a type of talk therapy that teaches new ways to think and act to manage pain), yoga classes, or got emailed education for 8 weeks, all by telehealth. People who took CBT reported better health-related quality of life and less pelvic pain, including period, bowel, bladder, and sexual pain, than those who only got education. Yoga did not change overall quality of life but did help menstrual symptoms and pain during sex, suggesting it can be a helpful add-on. Most side effects were mild, and many participants liked the programs, which may be especially useful for women in rural areas or those who can’t travel. Because the programs were online during COVID times, the authors note we still need to see how well they work face-to-face, but they recommend adding endometriosis‑tailored CBT to care plans to improve pain and daily functioning.
An 8-week online CBT program tailored to endometriosis improved daily life and pain more than education alone, and yoga helped some symptoms like period issues and pain with sex.
Evans S, Skvarc D, Esterman A, Mackay MI, O’Shea M, Van Niekerk L, et al. Telehealth cognitive behavioural therapy improves health-related quality of life and pain in endometriosis: the Healing Pelvic Pain Intervention (HaPPI)—a randomized controlled trial. Human Reproduction Open. 2026;2026(1):hoag006. doi:10.1093/hropen/hoag006.
Cutting Out vs. Burning Endometriosis Spots: What This Study Found
This study followed 67 women with peritoneal (the thin lining inside the belly) endometriosis to see how they did after laparoscopic (keyhole surgery through small cuts using a camera) surgery. It compared excision (cutting the spots out) and ablation (burning or destroying the spots) and looked at pain, need for another surgery, and chances of getting pregnant over a median of about 3.5 years. Both surgeries led to lasting drops in painful periods, pain with sex, and ongoing pelvic pain, with no clear winner between them. Women who took hormone therapy after surgery had extra relief from painful periods. About 18% needed another surgery later, and among those trying to conceive, about 63% became pregnant, no matter which surgery they had. These results suggest the best choice is the one that fits each woman’s needs, symptoms, and goals, along with good after-care.
Both cutting out and burning endometriosis spots work similarly for pain relief and pregnancy, and adding hormones after surgery may boost period-pain control.
Kolben T, Schröder L, Kaiser‑Rix C, Mahner S, Beyer S, Ehmann L, Czogalla B, Seifert C, Ganster F, Kost B, Burges A, Trillsch F, Keckstein S. Ablation compared with excision in the surgical management of peritoneal endometriosis: a retrospective study of pain, re-operation, and pregnancy outcomes. Archives of Gynecology and Obstetrics. 2026;313:73. doi:10.1007/s00404-026-08331-
Endometriosis and Mental Health: What Women Should Know
This study looks at endometriosis and how it affects women’s mental health. It is a systematic review (a careful summary of all good studies on a topic) and meta-analysis (a study that combines numbers from many studies to get a clearer answer) of nine studies. Women with endometriosis were about three times more likely to have anxiety and depression than women without it. Ongoing pelvic pain, delays in getting a diagnosis, and low social support were key reasons for worse mood and stress. Some studies also found higher risks of self-harm and death, showing why mental health screening is important. The authors suggest “whole-person” care that includes pain treatment, mental health checks, and support like counseling, mindfulness, or support groups.
Endometriosis can strongly affect mood and mind as well as the body, so getting both pain and mental health care matters.
Li W, Feng H, Ye Q. Relationship between endometriosis and mental health: a systematic review and meta-analysis. Archives of Medical Science. 2025;21(5):1985–1996. doi:10.5114/aoms/208502
