What lifestyle modifications should a 37-year-old woman with endometriosis adopt to improve her reproductive health?

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Last updated: February 20, 2026 • View editorial policy

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Lifestyle Modifications for Reproductive Health in Endometriosis

Direct Evidence-Based Recommendation

Current major guidelines from the World Endometriosis Society and the American College of Obstetricians and Gynecologists do not include specific recommendations on nutrition or lifestyle modifications as part of the treatment for infertility associated with endometriosis. 1

Understanding the Evidence Gap

The absence of guideline-endorsed lifestyle interventions reflects the current state of evidence:

  • No proven medical therapy eradicates endometriosis lesions completely, and lifestyle modifications have not been demonstrated to improve fertility outcomes in controlled trials 2
  • Medical treatment of endometriosis does not benefit fertility and should not be used with this exclusive indication, according to the American College of Obstetricians and Gynecologists 1
  • Treatment of pain and fertility are separate therapeutic objectives requiring different strategies 1

Emerging Dietary Considerations (Not Guideline-Endorsed)

While not formally recommended for fertility improvement, recent research suggests potential symptom management benefits from dietary patterns:

Anti-inflammatory Dietary Patterns

  • Mediterranean and anti-inflammatory diets rich in dietary fiber, omega-3 fatty acids, plant-based protein, vitamins and minerals show promise for symptom improvement (not fertility enhancement) 3
  • Diets rich in antioxidants, polyunsaturated fatty acids, and vitamins D, C, and E—alongside avoidance of processed foods, red meat, and animal fats—may modulate the inflammatory environment 4

Important Caveat

  • These dietary interventions may alleviate pain and potentially reduce lesion growth, but their impact on fertility outcomes remains unproven 4

Critical Fertility-Focused Actions

Immediate Priorities for a 37-Year-Old

  • Do not delay fertility treatment while pursuing lifestyle modifications or hormonal suppressive therapy, especially given age-related decline in ovarian reserve 2
  • Approximately 50% of women with endometriosis experience infertility, and women with endometriosis face higher risk of premature ovarian failure 1
  • Fertility preservation should be discussed immediately with women of reproductive age at risk of compromised fertility due to disease progression or surgical treatment 2

Evidence-Based Fertility Interventions

  • Surgery is probably effective for all stages of endometriosis in the context of infertility, according to the American College of Obstetricians and Gynecologists 1
  • Laparoscopic surgical treatment of minimal and mild endometriosis has been demonstrated to increase fecundity 5
  • Assisted reproduction treatments such as in vitro fertilization may be more appropriate than medical therapy when infertility is the primary concern 5

Cardiovascular Risk Management

Screening and Prevention

  • Women with endometriosis have 16-34% higher risk of stroke (HR 1.34,95% CI 1.10-1.62) 1
  • Endometriosis is associated with hypercholesterolemia, hypertension, and increased cardiovascular risk, requiring evaluation and modification of vascular risk factors 1

Screen for and aggressively manage traditional cardiovascular risk factors including blood pressure, lipid profile, and glucose metabolism 1

Multidisciplinary Support Approach

While not directly improving fertility, comprehensive management includes:

  • Psychological support and pain management strategies to improve quality of life 6
  • Exercise and NSAIDs for symptom management (not fertility enhancement) 7
  • Management of gastrointestinal symptoms that frequently accompany endometriosis 4

Bottom Line for Clinical Practice

For a 37-year-old woman prioritizing reproductive health, the focus should be on timely fertility evaluation and treatment (surgery or assisted reproduction) rather than lifestyle modifications alone. 1, 2 Lifestyle changes may support overall health and symptom management but lack evidence for improving fertility outcomes in endometriosis. 1

References

1
Guideline

Endometriosis and Fertility: Current Scientific Evidence

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

2
Guideline

Fertility Considerations in Endometriosis and Adenomyosis Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

4
Research

Endometriosis and Nutrition: Therapeutic Perspectives.

Journal of clinical medicine, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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