Terapia nutricional em pacientes com endometriose: estratégias alimentares na redução da inflamação e na regulação hormonal.

Abstract

Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the presence of endometrial tissue outside the uterine cavity. It mainly affects women of reproductive age and is associated with clinical manifestations such as chronic pelvic pain, dysmenorrhea, and dyspareunia, significantly compromising the quality of life and fertility of affected women. Considering that its pathophysiology involves persistent inflammation, oxidative stress, and hormonal alterations, nutritional therapy has been investigated as a complementary strategy in the management of the disease. In this context, the present study aimed to analyze the influence of nutritional therapy in the management of endometriosis, evaluating the effects of dietary interventions on inflammatory modulation, hormonal balance, and symptom reduction. This is an integrative literature review conducted in the PubMed, SciELO, and Google Scholar databases, including publications between 2019 and 2025. The search terms endometrium, inflammation, nutrition, and dietary intervention, as well as their English translations, were used, combined using the Boolean operators "AND" and "OR" to refine the results. At the end of the selection process, 38 articles were used to compose this review. In general, the results indicated that certain dietary patterns can influence the inflammatory and hormonal mechanisms involved in endometriosis. Among the dietary factors associated with beneficial effects, omega-3 fatty acids stand out, related to the reduction of pelvic pain and pro-inflammatory mediators; vitamins C, D, and E, due to their antioxidant and modulating potential; adequate fiber intake, associated with reduced estrogen bioavailability; and the minerals selenium and magnesium, linked to inflammatory modulation. Furthermore, bioactive compounds such as curcumin and resveratrol have shown potential to contribute to limiting disease progression due to their anti-inflammatory and anti-angiogenic properties. On the other hand, high consumption of red meat, saturated fats, trans fats, and ultra-processed foods has been associated with increased inflammation and worsening of symptoms. It has also been observed that, in some women, foods rich in FODMAPs and gluten may be related to the worsening of gastrointestinal manifestations frequently associated with endometriosis. In addition, soy has also been discussed as a possible factor of interest in this context, due to the presence of phytoestrogens, which have a structure similar to endogenous estrogen and may influence inflammatory and hormonal responses. Thus, nutritional therapy is a relevant complementary strategy in the management of endometriosis, acting on the modulation of inflammation, oxidative stress, and hormonal balance, with potential positive repercussions on symptoms and quality of life.