FODMAP diet for fertility and endometriosis

If you don’t have endometriosis, IBS (irritable bowel disease) or unexplained gastrointestinal problems, there is no known benefit of FODMAPs for fertility.

Irritable bowel syndrome (IBS) and endometriosis share many common features like low-grade inflammation, hypersensitive abdomen, gut pain, bloating, distension, and altered bowel habits. When a woman comes to the specialist with chronic abdominal and/or pelvic symptoms, it can be challenging to decide if she has endometriosis, IBS or both.

For women with endometriosis, diet is especially effective to relieve gastrointestinal symptoms and reducing inflammation.

What is a FODMAP diet?

FODMAP is the acronym for fermentable oligosaccharides disaccharides, monosaccharides and polyols.

The name is quite a mouth full, but actually, it is a group of simple carbohydrates found in a variety of fruits, vegetables and grains.

FODMAPs are small molecules that don’t absorb easily and stay in your gut fermenting. They tend to pull in water to the gut, causing gas, abdominal distension, pain and bloating.

This diet excludes foods that exaggerate the symptoms. Let’s have a look at what you should exclude.

  • Oligosaccharides are in wheat, rye, legumes, nuts artichokes, onion and garlic.
  • Disaccharide, primarily lactose, is in dairy products.
  • A monosaccharide is fructose. It is found in high amounts in processed foods containing corn syrup. It is also abundant in honey, sugar snap peas and fruits such as apples, pears, watermelon and mangos.
  • Polyols- (mannitol, sorbitol, xylitol, isomalt) are in sugar-free foods like chewing gum and mints. Polyols are also in apples, pears, stone fruits, snow peas, mushrooms and cauliflower.

The new eating plan is introduced in stages:

  • restriction,
  • reintroduction,
  • personalisation.

Once you conclude these steps, you will have a personalised FODMAP menu.

There will be FODMAP components that you may react to, while others will not be important. In most cases, you will not be avoiding all FODMAPS. The individual eating plan will increase food variety and flexibility.

To start with, the FODMAP diet could be quite difficult to grasp. However, it’s worth giving it a go for everyone who is trying to conceive and have uncomfortable abdominal symptoms and/or have endometriosis. FODMAP diet offers gastrointestinal relief to up to 80% of IBS sufferers and up to 72% of women with endometriosis.

Diet resources: A good place to start is the Monash University website. They are creators of the FODMAP diet.


Intermittent fasting for your fertility

Intermittent fasting is an eating pattern that interchanges between periods of fasting and eating. It is not focused on specific foods, the emphasis is when you eat.

Our bodies have the ability to go without food for long periods of time. We developed this feature perhaps because our ancestors did not always have an abundance of food.

How does intermittent fasting help with fertility?

Intermittent fasting may improve your sensitivity to insulin, therefore, supporting healthy blood sugar levels, restoring ovulation and improving your chances to conceive.

Unfortunately, most of the intermittent fasting studies were done on men or mice. Consequently, science has limited proof of how it affects women’s bodies and their fertility.

However, we believe, intermittent fasting may play an important role in these situations::

  • high levels of insulin (prediabetes),
  • need to lose weight fast
  • your periods stopped because of the excess weight
  • you are diagnosed with PCO with metabolic syndrome.

Popular intermittent fasting regimes:

  1. Fast for 16 or 14 hours each day, and then eat within an eight or 10-hour window.
  2. Alternate-day fasting: alternate days of regular eating with days of fasting.
  3. 5:2 fasting: fast for two days a week, and eat normal meals the other five days.
  4. One meal a day, no snacking in between.

A word of caution

Intermittent fasting may also disrupt your menstrual cycle, especially if you are underweight or a healthy weight.

The female reproductive system is sensitive to calorie restriction. When you fast for long periods of time, your brain may decide that because no food is coming you must be in danger. Consequently, it starts conserving energy. The reproductive hormone axis goes into a pause mode, reducing estrogen production. Insufficient estrogen leads to suppressed ovulation, and your periods may become irregular or disappear completely. Even if it is scary, it’s not an irreversible condition. In most cases, periods resume when you start eating regularly again.

One of the best guides to intermittent fasting is the book by Jason Fung ‘The Obesity code’.

Why Low Carb Diet is good for fertility

Firstly, a low carbohydrate diet does not equal a keto. Following a low carb eating plan, you aim to get about 20% of your nutrition from carbs, while Keto is extreme and limits you to only 5% energy from carbs.

In some low carb studies, participants had as much as 40% energy from carbs.

How does a low carb diet help your fertility?

Reduces chronic inflammation

A low carbohydrate diet may reduce chronic inflammation.

When you eat high amounts of refined starches and sugars you may start producing unhealthy amounts of inflammatory cytokines. This response may activate your immune system and switch on chronic inflammation.

Ongoing inflammation can arrest ovulation and reduce reproductive hormone levels. Chronic inflammation is no friend when trying to conceive. It alters endometrial receptivity and it has been associated with endometriosis.

Furthermore, when you reduce your carbohydrate intake you naturally increase fats and proteins in your menu. Healthy amounts of foods high in Omega 3 fatty acids (salmon, oysters, walnuts, linseeds) have been linked with higher progesterone levels, lower inflammation markers and a reduced risk of anovulation.

Restores ovulation, optimises reproductive hormones

A low carb diet improves fertility by increasing insulin sensitivity.

Furthermore, for PCOS patients this type of eating restores the balance of inositol, thereby improving insulin resistance, decreasing the level of androgen, and improving the quality of oocytes.

Additionally, the reduced amount of carbs may help to prevent anovulatory infertility in otherwise healthy women.


If you are diagnosed with PCOS, or you are trying to conceive and it takes longer, low carb eating plans are worth a shot because they may enhance your ovulation.

Low carb diet resources: